RESEARCH PAPER
Tobacco smoking patterns in Samoa in 2010: Implications for interventions
 
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1
International Health Institute, School of Public Health, Brown University, Providence, United States
2
Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, United States
3
Samoa Ministry of Health, Apia, Samoa
4
Lutia i Puava ae Mapu i Fagalele, Apia, Samoa
5
Department of Epidemiology, School of Public Health, Brown University, Providence, United States
6
Department of Anthropology, Brown University, Providence, United States
CORRESPONDING AUTHOR
Stephen T. McGarvey   

International Health Institute, School of Public Health, Brown University, Providence, Rhode Island 02912, United States
Publication date: 2019-12-17
Submission date: 2019-08-20
Final revision date: 2019-10-22
Acceptance date: 2019-11-17
 
Tob. Prev. Cessation 2019;5(December):50
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Tobacco use in Samoa has been described over time by age, sex and education, but little work exists on other sociodemographic factors associated with tobacco use. We describe current smoking and daily tobacco use in adults from Samoa, with a focus on sex and age stratified analyses of the influence of occupation, education, census region, household asset ownership and alcohol use in order to help develop potential targeted interventions.

Methods:
In 2010, a nationwide survey of 3745 adults aged 25–65 years from 33 villages was completed in Samoa. Current smoking status, daily tobacco use, as well as current alcohol use, and a variety of sociodemographic factors were assessed by interview. Bivariate and multivariable models, and sex and age group stratified analyses, were performed to determine different patterns of correlates.

Results:
More than half of all men (51.3%) and 21.8% of women were current tobacco smokers. Men and women smoked on average 10.9 and 8.7 cigarettes/ day, respectively. Twenty per cent of men consumed ≥20 cigarettes/day. In men, being married, a subsistence-farmer/laborer, an alcohol user, and having low household assets, were independently associated with being a tobacco smoker (all p<0.01). Among women, not completing secondary education, being 25–34 years, residing in urban Apia, and being an alcohol user, were independently associated with being a tobacco smoker (all p<0.01).

Conclusions:
Tobacco use in Samoa remains high and correlates of smoking suggest that interventions for cessation need to be developed within the contexts of sex, age, education, and household socioeconomic status.

ACKNOWLEDGEMENTS
The authors thank the Samoan participants of the study, local village authorities and the many members of our field team over the years, especially research associates Melania Selu and Vaimoana Lupematisila. We acknowledge the Samoa Ministry of Health, Bureau of Statistics, and the Ministry of Women, Community, and Social Development for their partnership in this research.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
This work was supported by the United State National Institute of Health, National Heart, Lung and Blood Institute (Grant No. R01-HL093093). The funders reviewed the research application for the present study but had no direct role in the design of this study of tobacco use, nor the collection, analysis, interpretation of data and writing of the manuscript.
AUTHORS' CONTRIBUTIONS
STM conceived and led the study. ACA performed the majority of the statistical analysis and with STM wrote the initial draft of the manuscript. With guidance from STM, NLH led the fieldwork data collection in 2010 and contributed to writing the manuscript. MSR facilitated the 2010 fieldwork in Samoa, and with TN, contributed to the discussion of the interpretation and public health implications of the findings. All authors read and approved the final manuscript.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
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