Determinants of cigarette smoking and smoking intensity among adult males in Ghana

Background: In spite of the adverse health and financial implications of smoking, it still remains one of the leading causes of preventable diseases and deaths in the world. Key to discouraging the habit of smoking is knowledge of the drivers of smoking. In Ghana, though smoking behaviours are relatively more associated with adult males than youth and adolescents, studies on smoking behaviours of adult males are scant. This study, therefore, investigates the determinants of cigarette smoking and smoking intensity among adult males in Ghana. Methods: Data were obtained from the most recent Ghana Demographic and Health Survey (DHS) conducted in 2014. Based on the 2014 GDHS, a negative binomial-logit hurdle model was estimated to explore the socioeconomic and demographic characteristics associated with cigarette consumption and smoking intensity among adult males in Ghana. To ensure robustness, separate estimations were performed for the respective logit and negative binomial models used in the two-part model. Results: We find that men in lower socioeconomic category (poor and low education) have a higher likelihood to smoke. Also, age proved significant in explaining smoking behaviors in Ghana. Moreover, religion and region of residence are reported to affect cigarette consumption decision. Furthermore, we find that among the men who smoke, those between the ages of 44 and 60 years and have attained approximately primary education have a higher likelihood to smoke greater quantities of cigarette daily. Also, the smokers who reside in the Upper East and Upper West regions are reported to smoke more intensely than their counterparts in the Greater Accra region. Conclusion: Since smoking remains one of the major causes of diseases and deaths the world over, the current study provides recent empirical evidence based on a nationally representative sample for public health policies geared towards smoking reduction and ultimately cessation. This study suggests that public policies that promote higher educational attainment and improved incomes (wealth) are crucial in smoking reduction and cessation in Ghana.