Tobacco consumption and non-communicable diseases in Ghana; Identifying accentuating factors and further evidence from 2014 Ghana demographic and health survey

Background: Non-communicable diseases such as hypertension, diabetes, strokes, cancers and chronic kidney conditions have caused disabilities and negatively impacted on eco-nomic development. While greater effort s of controlling these non-communicable diseases are clinically motivated, the non-clinical factors such as behavioural lifestyle and the as-sociated accentuating factors have not been given due attention. It has been established elsewhere that, tobacco use which is a risk factor for non-communicable diseases occur-rence is influenced by individual's residential status, educational status, occupational sta-tus, income level and access to media projections. This study therefore sought to identify associations between accentuating factors and tobacco use and its implications for the oc-currence of non-communicable diseases prevalent in Ghana.Methods: This was a mixed method study involving in part, use of secondary data from the Ghana Demographic and Health Survey 2014 with a sample of 4,122 respondents and primary qualitative interviews of 32 respondents respectively, from 4 Regions of Ghana. Descriptive statistics, probit regression and content thematic analysis were used for data analysis for both the quantitative and qualitative arms respectively.Results: The study found that, there was statistically significant association between ed-ucational status and tobacco use [X 2 (5, 4,123) = 164.5619; p = 0.0 0 0 ], income levels and tobacco use [X 2 (7, 4,123) = 68.5615; p = 0.001), occupational status and tobacco use [X 2 (8, 4,123) = 195.6919; p = 0.0 0 0], residential status and tobacco [X 2 (3, 4,134) = 82.7824; p = 0.0 0 0)] and finally, access to mass media and tobacco use [ X 2 (2, 4,134) = 1.2352, p = 0.009]. Again, the regression result shows that, the accentuating factors determine about 51% (50.579) of the tobacco use by individuals in the relation [R 2 = 0.305, F(17, 4,077) = 50.579, p = 0.0 0 0]. Moreover, 62.4 percent of females were less likely to smoke than males. Within the educational levels, secondary school completion category influence smoking by 82.8 percent. Also, assessing the relations between wealth quintiles and smok-ing, the study found that, the middle class income earners category influence smoking by 53.4 percent. Lastly, in the residential status, living in rural area contributed 41 percent to tobacco use. The implication is that, urban dwellers are more likely to use tobacco than rural dwellers.Conclusion: The study concludes that, educational status, residential status, occupational status, wealth quintiles and access to media accentuates tobacco use within a population with implications for the occurrence and control of non-communicable diseases. The study calls for a strengthening of the WHO Framework Convention on Tobacco Control in Ghana.(c) 2023 The Authors. Published by Elsevier B.V. on behalf of African Institute of Mathematical Sciences / Next Einstein Initiative. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )