A systematic review of tobacco use among sub‐Saharan African youth

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Abstract
Aims (1) To provide a synthesis of prevalence data among young people in sub‐Saharan Africa (SSA); (2) to examine whether factors such as gender, age, socio‐economic status (SES), ethnicity, and urban versus rural location increase the risk for, or protect against tobacco use among SSA youth; and (3) to identify gaps in existing research, and offer suggestions for future research and prevention/intervention program development. Methods Using relevant databases, we identified articles reporting prevalence rates of current tobacco use among youth in SSA that were published in peer‐reviewed journals between 1990 and mid‐2004. Articles were included if they reported current tobacco use among SSA school‐aged populations. Articles pertaining to tobacco‐related medical conditions were excluded. Results Forty‐five articles (52 studies) from 15 of the 48 countries that comprise SSA were included. South Africa has the highest prevalence of current tobacco use of all the SSA countries. Across most countries, current tobacco use was higher among males than females. Higher SES appears to place youth at additional risk for tobacco use in specific country contexts. Rates of tobacco use among urban versus rural populations is country‐specific. The lower limit for tobacco use initiation in most countries is 12–14 years old. Conclusions Studies within countries should address the possible heterogeneity between regions, cities, or states, and prevention/interventions should be context‐specific within and between countries.