Tobacco use is a significant cause of preventable non- communicable diseases and avoidable deaths globally.1 Tobacco and its smoke contain numerous cytotoxic and carcinogenic substances that are harmful to the oral and general health of users and those exposed to its smoke.2 Some deleterious effects include cancers (oral, lung), cardiovascular, respiratory, and gum diseases.2–5 The World Health Organization (WHO) puts the current global tobacco-related mortality at eight million,6 with 80% of the current smokers coming from Low and Middle-Income Countries (LMICs).6
Tobacco use has attained the level of an epidemic in many LMICs, including Africa.7,8 The epidemic is sustained by the addition of adolescents to the current pool of tobacco users,9 with thousands of adolescents initiated daily.10 Adolescents are particularly vulnerable to proximal and environmental influences to use tobacco, and four out of every five adult smokers usually start smoking during adolescence.2,9
Although the current prevalence of tobacco use among adults indicates that smoking prevalence is lower in the African region compared to other regions, the situation is changing. The current trend shows that the prevalence of tobacco smoking is reducing among adults in all the world regions (Americas, European, South-East Asia, Western Pacific) except for Africa and the East Mediterranean regions.11 Consequently, Africa has been described as the future epicentre of the tobacco epidemic, representing “the greatest threat in terms of future growth in smoking.”12 Modeling based on available data has predicted that while tobacco use in the African region is relatively low, compared to the other regions,12,13 some African countries will experience up to nearly 40% increase by 2030.8,14 There are early signs that the predicted change has commenced because while the prevalence of adult (male) tobacco smoking is a lot lower in Africa compared to other regions, this is not the case among the youth and adolescents.12