BACKGROUND: Although less common compared to tobacco smoking (TS) in men, TS in women has increased over the past decades. Epidemiological studies have confirmed the higher vulnerability of smoking women to earlier death and risk of stroke. We aimed to estimate the prevalence of TS in tunisian adult women and investigate its association with socio-demographic and socio-economic characteristics.
METHODS: A cross-sectional descriptive multicenter study was conducted in December 2023. Based on two-stage stratification sampling method, the study targeted
women aged 25-65 years, living in the Grand Tunis region. Socio-demographic characteristics and lifestyle habits were face to face collected by trained investigators. A binary logistic regression model was used to identify factors associated with TS, and Adjusted Odds Ratio (AOR) were presented with 95% Confidence Interval (95% CI).
RESULTS: A total of 2324 women were enrolled with a mean age of 44.0 years±0.2. Almost quarter of participants [26.4%; 95% CI (24.5-28.6)] had university education, [77.7%; 95% CI (75.8-79.5)] had an average socio-economic level, and [37.7%; 95% CI (35.4-40.1)] had a stable professional status. The prevalence of TS was 7.8% (95% CI, 6.6%-9.1%) significantly higher in single / divorced women compared to married women (18.9% vs 7.3%, p value=0.002) and significantly higher in women with elevated socio-economic level (11.6% vs 7.3%, p value=0.05). In multivariable analysis, there was no significant association between TS and age, educational level, professional status and socio-economic level. Marital status was, however, significantly associated with TS, with AOR equal to 2.7; 95% CI (1.3 to 5.7) for single/divorced women.
CONCLUSIONS: Our study showed a relatively high prevalence of TS in tunisian adult women compared to previous published data. Taking into consideration the potential impact of new tobacco products and the tobacco industry's efforts targeting this vulnerable population, awareness-raising efforts and law enforcement should be strengthened.