| Summary: | Background
Monitoring
prevalence of smoking is essential for evaluating the impact of national
tobacco control policies. This study
aims to estimate national pooled smoking prevalence trends over a 16 year
period for adult South Africans.
Methods
Smoking
prevalence by age, sex and race from 14 South African population and national
household surveys conducted between 1998 - 2014 were used to generate trends
over time by 1) performing a series of transformations of the aggregated
prevalence data, 2) investigating interactions with race/time, and 3) using a
posthumous regression. Bias within surveys were adjusted for by using a
risk-of-bias weight.
Results
The
overall observed smoking prevalence decreased from 23.7 (22.4; 24.9) in 1998
to 20.3 (19.3; 21.4) in 2014. Downward trends were observed in both males
and females, although it was steeper in males. There were significant
differences between race groups, as well as within race groups across age, most
notably Asian males, which also seemed to drive the steep decline among males. Whilst the downward trend was
evident in older ages (25 + years), the youngest group (15 - 24 years) had a
non-linear trend differing from the linear trend in the older group.
Conclusions
Pooling
estimates from different national surveys over time, gave an effective picture
of trends in smoking in South Africa. Although not directly observable, the
trends reported indicate that the South African Tobacco Control Act of 1993 had
influenced and maintained decreasing smoking trends in the last couple of
decades, albeit to a lesser extent among females.
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