Tobacco control programmes in multi-ethnic societies must take into account ethnic differences in the determinants of smoking. The I-Change Model, an extension of the Theory of Planned Behaviour, was used to investigate the factors related to smoking among a sample of 3378 Black African, Coloured and White, monthly and non-monthly smokers in the Southern Cape-Karoo Region, South Africa. Across the ethnic groups, non-monthly smokers reported a more positive attitude towards non-smoking, social influences that were more supportive of non-smoking, higher self-efficacy in stressful, routine and social situations, greater intention not to smoke in the next year and lower levels of depressive mood and risk behaviour. Regression analyses suggested that the weight of these determinants may differ in predicting monthly smoking among the ethnic groups. Black African students may benefit from the development of attitudinal cognitions and coping skills to counter peer influence. Coloured students also require skills to resist peer influence. White students require coping skills in stressful and social situations. Although there are more common than unique determinants of smoking among South African adolescents, further research is needed to understand the influence of differing social, economic and cultural contexts on smoking onset.
"Many studies have shown that not only do South African adolescents use substances such as alcohol, tobacco and other drugs, but they also engage in high levels of sexual activity and unprotected sex (see e.g. Flisher, Reddy, Muller and Lombard 2003; Kaaya et al. 2002; Panday, Reddy and Bergstrom 2007). In their study, Shisana and Simbayi (2003) identified a similar trend towards earlier sexual debut amongst younger respondents, where the median age at first sex for respondents aged 15-24 year was found to be 16 years. "
"Still, the generally low, but increasing rates of tobacco use in SSA countries [3,10], along with demographic and socioeconomic changes such as increasing incomes and urbanization , and relatively weak tobacco control policies and programs  provide a potential market for the tobacco industry to exploit. Although research to provide insight into adult and youth tobacco use in SSA [11-16] has slowly been growing over the past decade, there is an inadequate analysis across countries and limited information on many countries, including Madagascar . Therefore, this study investigates adult tobacco use in SSA with a greater emphasis on Madagascar because of high rates of prevalence of tobacco use compared with SSA countries. "
[Show abstract][Hide abstract] ABSTRACT: The tobacco industry has globalized and tobacco use continues to increase in low- and middle-income countries. Yet, the data and research to inform policy initiatives for addressing this phenomenon is sparse. This study aims to estimate the prevalence of adult tobacco use in 17 Sub-Saharan Africa (SSA) countries, and to identify key factors associated with adult tobacco consumption choices (smoked, smokeless tobacco and dual use) in Madagascar.
We used Demographic Health Survey for estimating tobacco use prevalence among adults in SSA. A multinomial logistic regression model was used to identify key determinants of adult tobacco consumption choices in Madagascar.
While differences in tobacco use exist in SSA, Madagascar has exceptionally higher prevalence rates (48. 9% of males; 10.3% of females). The regression analyses showed complexity of tobacco use in Madagascar and identified age, education, wealth, employment, marriage, religion and place of residence as factors significantly associated with the choice of tobacco use among males, while age, wealth, and employment were significantly associated with that of females. The effects, however, differ across the three choices of tobacco use compared to non-use.
Tobacco use in Madagascar was higher than the other 16 SSA countries. Although the government continues to enact policies to address the problem, there is a need for effective implementation and enforcement. There is also the need for health education to modify social norms and denormalize tobacco use.
BMC Public Health 09/2013; 13(1):856. DOI:10.1186/1471-2458-13-856 · 2.26 Impact Factor
"shown to be appropriate to predict a number of health behaviours including , condom use, substance use, and physical activity (Ajzen, 1991). Furthermore, the TPB has been shown to be applicable in African populations (Aaro et al., 2006; Panday, Reddy, & Ruiter, 2007). As part of a study examining predictors of traditional healer referral, the aim of this exploratory qualitative study was to gain an understanding of how traditional healers reach a decision to refer adolescent and adult patients suffering from a mental illness to Western health professionals. "
[Show abstract][Hide abstract] ABSTRACT: Drawing on data collected from 3 focus groups with 24 traditional healers, the aim of this qualitative study was to use the constructs of the Theory of Planned Behaviour (TPB) to gain an understanding of traditional healer referral practices of their patients with a mental illness. Results indicated that traditional healers possess a concept of mental illness, mainly referring to a patient behaving abnormally. They often report regularly treating patients with these behaviours. Traditional healer referral to Western care is considered a temporary measure or a last resort. A majority of healers feel that allopathic physicians do not treat them with the respect that they feel their contribution to the health of the community warrants. Recommendations include the need for traditional healers to be trained to identify potential cases of mental illness in their communities and for dialogue between traditional and allopathic physicians in regard to mental health care.
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