Predictors of tobacco use among the youth in an urban slum in Kampala, Uganda: A cross-sectional study

Abstract Background and justification Tobacco use remains a significant public health concern worldwide and is the leading risk factor for developing non-communicable diseases. In Uganda, the youth use tobacco at three times the rate of adults, with those residing in slum areas exhibiting even higher prevalence levels. Since 2015, strict laws regulating public tobacco use have been implemented in Uganda, however, these measures have not led to a significant decline in tobacco consumption among the youth in slums. Objective To assess the predictors of persistent tobacco use and associated factors among youth living in the slum areas of Kampala, Uganda. Methods This cross-sectional study utilized mixed methods of data collection. Conducted in Bwaise slum of Kampala, the study recruited 422 youths aged 18-30 years. Households were sampled systematically, and quantitative data were analyzed using STATA version 14. Logistic regression was used, Odds ratios were used to measure the associations. Factors were considered significant at p<0.05 Results The prevalence of current tobacco use was 52.6% while the prevalence of ever use was 71.6%. The majority (87.4 %) of the participants knew the health effects of tobacco use. Males were more than twice as likely to smoke compared to females (aOR: 2.72, 95% CI: 1.66-4.44). Participants aged 21 years and above were over twice as likely to smoke compared to those 20 years and below (aOR: 2.54, 95% CI: 1.45-4.45). Additionally, participants who were unaware that smoking causes serious illness were four times more likely to smoke compared to those who were knowlegeable (aOR: 4.49, 95% CI: 1.15-17.56). Conclusion More than half of the youth use tobacco despite awareness of its health effects. Male gender aged 21-30 years and lack of knowledge regarding the serious illness caused by smoking were strongly associated with tobacco use. This calls for development and implementation of targeted educational initiatives that address the unique needs and behaviors of males aged 21 to 30 years.