Characterisation of Tobacco Use and its Associated Factors Among Older Youths in an Urban Setting: The Case of Wakiso, Uganda.

Introduction: Tobacco smoking increases the risk of death from many diseases, including ischemic heart disease, cancer, stroke, chronic obstructive pulmonary disease, diabetes, and other fatal and non-fatal diseases. Efforts have been invested towards cessation of tobacco smoking among youths aged 18-35 years. However, population-based data is limited on tobacco smoking in Wakiso district among youths. Therefore, this study aimed to determine the prevalence and factors associated with tobacco smoking among youths aged 18-35 years in Wakiso district Uganda. Methods: Data from a Population-based survey in Wakiso district collected between October 2019 and September 2020 were used to determine the prevalence of tobacco smoking and associated factors. A cross-sectional design was employed. This study used multivariable logistic regression to estimate odds ratios and 95% confidence intervals (CI) for the association between tobacco smoking and various factors among youths aged (18-35) years in Wakiso district Uganda. Results: A total of 1,092 participants were enrolled of whom 631(57.8%) were females. The mean age was 25.8 (SD=4.8) years. A total of 35 (3.2 %) reported current tobacco smoking while 64(5.9%) ever used tobacco. The mean age at smoking initiation was 20.6 (SD= 5.3) years. In the multivariable analysis, age groups 25-29 years (aOR= 3.66, [95% CI: 1.15, 11.65]) and 30-35 years (aOR= 4.26, [95% CI; 1.32, 13.72]) were more likely to smoke compared to those under 25 years). Other positively associated factors included alcohol users (aOR= 4.86, [95% CI: 2.01, 11.74]), HIV positive status (aOR= 5.43, [95% CI: 1.86, 15.86]), living with friends or relatives who smoke (aOR=9.93, [95% CI: 1.86, 15.86]), and being male (aOR=4.50 [95% CI; 1.82, 11.13]). Conclusion: Overall tobacco smoking among youths aged 18-35 years is low compared to national prevalence of 9%. However, the focus should be on males, older youths, alcohol users, and HIV-positive youths including those living with friends or relatives who smoke.

Challenges in managing HIV and non-communicable diseases and health workers' perception regarding integrated management of non-communicable diseases during routine HIV care in South Central Uganda: A qualitative study.

BACKGROUND: Non-communicable diseases are highly prevalent among adults living with HIV, emphasizing the need for comprehensive healthcare strategies. However, a dearth of knowledge exists regarding the health systems challenges in managing HIV and non-communicable diseases and the perception of health workers regarding the integrated management of non-communicable diseases during routine HIV care in rural Ugandan settings. This study aims to bridge this knowledge gap by exploring the health system challenges in managing HIV and non-communicable diseases and health workers' perception regarding the integration of non-communicable diseases in routine HIV care in South Central Uganda. METHODS: In this qualitative study, we collected data from 20 purposively selected key informants from Kalisizo Hospital and Rakai Hospital in South Central Uganda. Data were collected from 15th December 2020 and 14th January 2021. Data were analyzed using a thematic content approach with the help of NVivo 11. RESULTS: Of the 20 health workers, 13 were females. In terms of work duration, 9 had worked with people living with HIV for 11-15 years and 9 were nurses. The challenges in managing HIV and non-communicable diseases included difficulty managing adverse events, heavy workload, inadequate communication from specialists to lower cadre health workers, limited financial and human resources, unsupportive clinical guidelines that do not incorporate non-communicable disease management in HIV care and treatment, and inadequate knowledge and skills required to manage non-communicable diseases appropriately. Health workers suggested integrating non-communicable disease management into routine HIV care and suggested the need for training before this integration. CONCLUSION: The integration of non-communicable disease management into routine HIV care presents a promising avenue for easing the burden on health workers handling these conditions. However, achieving successful integration requires not only the training of health workers but also ensuring the availability of sufficient human and financial resources.

Motivations for continued tobacco smoking and reasons for quitting among youths in Wakiso district, Uganda: a qualitative study.

BACKGROUND: Efforts have been invested towards cessation of tobacco use among youths aged 18-35 years, however, motivators for continued tobacco smoking and reasons for quitting are limited in Ugandan settings. Therefore, this study aimed to explore motivations for continued tobacco smoking and reasons for quitting in Wakiso district Uganda. METHODS: This study used explanatory sequential method. Data from a Population-based survey collected from October 2019 to September 2020 was used to select participants for this qualitative study. Twenty-three in-depths interviews were conducted from July to October 2021 among youths (18-35years old) who reported continued tobacco use and those who quit. Data were analyzed using a team-based thematic content approach with the help of NVivo. RESULTS: Data was collected from a total of twenty three participants, fourteen were tobacco quitters and nine were current tobacco smokers. Recurrent habit, desire to complement the use of other drugs, peer pressure, using smoking as a replacement for alcohol consumption, low tobacco prices, smoking as a tradition were reported as motivators for continued tobacco smoking. However, reported reasons for quitting smoking by youths included; packaging health warnings, school based prevention programs, fear of associated health risks due to tobacco use, embarrassment from family members. CONCLUSION: Targeted, and tailored tobacco prevention counselling through family support programs, intensified health education on the risks of smoking, and implementing stronger health warnings on tobacco packaging can be employed to reduce or stop tobacco use among urban youth.