The prevalence of tobacco consumption was 9.3 per cent among young men in SSA. This finding is consistent with the findings of Sreeramareddy, Pradhan, and Sin [6] in their study that looked at the prevalence, distribution and social determinants of tobacco use in 30 sub–Saharan African countries. Our study also found out that age, level of education, wealth status, type of occupation, marital status, religion and place of residence had a statistically significant association with tobacco consumption among young men in SSA. Furthermore, our study found out that the odds of tobacco use was higher for the older group compared to the younger age group. This is consistent with previous studies [6,12,14, 21]. The possible explanation is that older men have a higher level of exposure to tobacco compared to younger men and this may influence the lifestyle and health choice.
Our study also found out that the likelihood of consuming tobacco reduces as the level of education increases. Young men with a primary, secondary and higher level of education had lesser odds of consuming tobacco as compared with those with no education. This finding is in line with earlier studies [6,10,14, 22]. The possible explanation would be the educated young men may be exposed to information about the dangerous health risks associated with the consumption of tobacco and are more likely to stay away from consuming tobacco in any form. Education prepares individuals with requisite knowledge and skills so that they can make an informed choice that will positively impact on their health.
Also, we observed that the likelihood of consuming tobacco declines as wealth status increased. For instance, young men with poorer, middle, richer and richest wealth status had a lesser likelihood of using tobacco compared to those from the poorest wealth status. This finding is consistent with the studies of Shrestha et al. [6], Nketiah –Ampoosah, Afful – Mensah and Ampaw [10] and Abdulrahim and Jawad [23]. Our study found a significant association between the type of occupation and tobacco use. Young men who were working had a higher likelihood of using tobacco compared to those who were not working. For instance, those who worked in sales, agriculture, skilled and unskilled labour had higher odds than those who were not working. This finding is consistent with the findings of Fernando et al. [24], Wang et al. [22], Dickson and Ahinkorah [14] and Doku, Darteh & Kumi-Kyereme, [12]. This may be attributed to the fact that those who are working would have the financial power to afford and purchase of tobacco in all its forms. Work status comes with its social networking and work-related stress and traumas and this can have an influence in health choice and the consumption of tobacco. People may use tobacco to be accepted in a certain social space, whiles others may consume tobacco to destress from work-related traumas and stress.
Our study also found out that young men who were widowed/divorced/separated had a higher odd of using tobacco compare to those who were never married. This finding is consistent with the findings of Ramsey et. al. [25], Dickson and Ahinkorah [12] when they found out that formerly married men had a higher likelihood of using tobacco compare to those who were currently not married. This could be ascribed to the stress and psychological trauma that comes with divorce, separation and the loss of loved ones. Young men may turn to the usage of tobacco as a form of coping strategy in those hard times.
It was seen from our study that young men who are associated with the traditional religion and those with no religion had higher odds of using tobacco compared to Christian young men which confirm previous studies [12, 14, 22, 26]. Behaviour boundaries and restrictions vary between regions. Religious affiliations are social networks that influence the individual. Theses influences are affected by the religiosity of the individual [27]. Once religious affiliation may promote or restrict their lifestyle and this may affect their health.
With the place of residence, our study found out that young men from the rural areas had a lesser odd of using tobacco compared to those from the urban centre. This is in line with previous studies [14,28,29]. The possible explanation may be that urban centres may have higher exposure and accessibility to tobacco in all its forms compared to rural areas.
Strength and Limitations
There are some limitations to our research worth noting. The sample used was not uniform for all countries. The cross-sectional nature of the DHS data was from the current versions of DHS is SSA countries and this ranged from 2010 to 2018 but social behaviour pattern changes with time. It is also impossible to ascertain temporality of sequence thus, only associations could be assessed but not causality. Nevertheless, the strengths of our findings are entrenched in the standardized study design, thoroughly data collected using standardized methodologies, yielding comparable samples across 21 SSA countries, reflecting a large sample size of 48,885 young men. This is also an erratic look at the young people’s usage of tobacco, which is essentially important to understand the consumption of tobacco in SSA.