背景:截至2018年的趋势数据表明,南非(SA)的吸烟人数正在增加,但关于COVID-19大流行对当前烟草和尼古丁产品(TNP)使用模式的影响的信息有限。
目的:评估使用TNP的社会人口统计学模式的趋势,以及社会人口统计学因素和非香烟烟草使用可能解释2017/18至2021年间TNP使用率可能变化的程度。
方法:分析了南非社会态度调查(总N=8140)的三波数据(2017年,2018年和2021年)。当前每日和非每日使用工厂制造的香烟(FMC)的社会人口统计学相关性,卷起你自己的(RYO)香烟,水管/喧闹,电子烟(ECigs),鼻烟(一种无烟烟草)和FMC的任何组合,将2017/18年(大流行前)的RYO香烟和水烟/暴躁(“当前吸烟”)与2021年(大流行期间)的香烟和水烟进行了比较。卡方分析和广义线性模型用于比较两个时期之间TNP使用的患病率。Blinda-Oaxaca分解分析还用于探索各种社会人口统计学因素的作用,包括使用TNP的任何差异,这可能解释了2017/18年至2021年吸烟率的任何差异。
结果:目前的吸烟率从2017/18年的22.4%(95%置信区间(CI)20.4-24.5)显著上升至2021年的27.6%(95%CI24.3-31.1)(p=0.009)。在这两个时期之间,FMC的吸烟总体上没有显着变化(20.1%对22.1%;p=0.240),除了那些自我认定为非洲黑人的人中的显着增加,而那些自我认定为有色人种的人和目前受雇的人中的减少。然而,使用水管/赫布,ECGs,RYO香烟和鼻烟明显增加。女人,年龄<35岁的个体和非洲黑人的水烟斗/暴躁和ECig使用量增加最大。分解分析表明,增加水管/Hubbly和RYO的使用解释了52%和15%,分别,吸烟率的增加,而2021年与2017/18年相比就业率较低,解释了2021年吸烟率增长的15%。
结论:所有TNP在SA中的使用持续增加,尤其是妇女和失业者。这些发现对解决烟草相关疾病的社会经济差异具有政策和实践意义。
BACKGROUND: Trends data up to 2018 suggest that tobacco smoking was increasing in South Africa (SA), but only limited information is available on the impact of the COVID-19 pandemic on the current pattern of use of tobacco and nicotine products (TNPs).
OBJECTIVE: To assess trends in sociodemographic patterns in the use of TNPs and the extent to which sociodemographic factors and non-cigarette tobacco use may explain possible changes in rates of TNP use between 2017/18 and 2021.
METHODS: Data from three waves (2017, 2018 and 2021) of the South African Social Attitudes Survey (total N=8 140) were analysed. The sociodemographic correlates of current daily and non-daily use of factory-manufactured cigarettes (FMCs), roll-your-own (RYO) cigarettes, waterpipe/hubbly, electronic cigarettes (ECigs), snuff (a smokeless tobacco) and any combination of FMCs, RYO cigarettes and waterpipe/hubbly (\'current smoking\') in 2017/18 (pre-pandemic) were compared with those for 2021 (during the pandemic). Chi-square analyses and generalised linear models were used to compare the prevalence of TNP use between the two periods. A Blinda-Oaxaca decomposition analysis was also used to explore the roles of various sociodemographic factors, including any differences in the use of TNPs, that may explain any observed differences in smoking rates between 2017/18 and 2021.
RESULTS: Current smoking increased significantly from 22.4% (95% confidence interval (CI) 20.4 - 24.5) in 2017/18 to 27.6% (95% CI 24.3 - 31.1) in 2021 (p=0.009). Smoking of FMCs did not change significantly overall between these two periods (20.1% v. 22.1%; p=0.240), except for a significant increase among those who self-identified as black African and a decrease among those who self-identified as coloured and those currently employed. However, the use of waterpipe/hubbly, ECigs, RYO cigarettes and snuff increased significantly. Women, individuals aged <35 years and black Africans had the largest increase in waterpipe/hubbly and ECig use. A decomposition analysis showed that increased waterpipe/hubbly and RYO use explained 52% and 15%, respectively, of the increase in smoking rates, while lower employment during 2021 compared with 2017/18 explained 15% of the increase in smoking rates during 2021.
CONCLUSIONS: The use of all TNPs continued to increase in SA, particularly among women and unemployed people. These findings have policy and practice implications for addressing socioeconomic disparities in tobacco-related diseases.