Exploring the association of alcohol consumption, tobacco use, and multimorbidity in a nationally representative sample of South African adults
Abstract
Background: Non-communicable diseases are the leading cause of deaths across the globe and low-to-middle income countries (LMICs) are disproportionally affected. Consequently, people living with multimorbidity or multiple chronic conditions and the potentiating risk factors such as alcohol consumption and tobacco use is increasing in LMICs.
Methods: This study made use of nationally representative data collected from 3 459 South African adults (aged > 18 years) and assessed alcohol consumption, tobacco use, and multimorbidity and explored socioeconomic and demographic associations thereof.
Results: 20.0% of respondents reported having smoked at some point, with the majority of those indicating that they currently smoke (96.1%). Among current smokers, most were classified as light smokers, consuming fewer than 10 cigarettes per day (73.1%). Among alcohol consumers (34.2%), 6.7% of the respondents showed moderate–severe alcohol consumption. When stratified by sex, more men consumed alcohol (by > 16%) than women. Nearly 13% of the total sample reported having multimorbidity, with a larger proportion being women (by 4%) when compared with men. When stratified by urbanicity, nearly 40% of respondents in the urban group reported consuming alcohol compared with the rural group at 28.0%. In multivariable adjusted binary logistic regressions, tobacco use and alcohol consumption increased the likelihood of reporting multimorbidity (p < 0.001) when compared with their counterparts. Consuming a moderate–severe level of alcohol increased the likelihood of multimorbidity twofold (p < 0.001) in those who reside in urban areas and more than threefold (p < 0.001) in those who reside in rural areas when compared with those who do not consume alcohol. All associations are independent of other sociodemographic determinants.
Conclusion: This study highlights the complex relationship between lifestyle factors and multimorbidity and the potential effect of urbanicity and sociodemographic characteristics on these relationships. Public health interventions targeted at the consumption of alcohol therefore need to be upscaled in these settings.
Keywords: alcohol, tobacco, multimorbidity, national survey, South Africa
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