Tobacco use patterns and associated factors among youth in Kampala’s informal settlements: a cross-sectional study in Bwaise

Tobacco use remains a major global public health challenge, in Uganda it is notably higher among the youth, especially those in informal settlements. Despite periodic national surveys, recent data on this high-risk group is scarce. In this study, we aimed to assess tobacco use patterns and associated factors among the youth in informal settlements, focusing on daily tobacco smoking and smokeless tobacco use. We conducted a cross-sectional study using secondary data from the ‘Motivators of persistent tobacco use and cessation barriers: A mixed methods study among the youth in Bwaise slum, Kampala, Uganda’. The data was collected from March to April 2021. The dataset included responses from 422 youth aged 18–30 years living in Bwaise, an informal settlement in Uganda. Modified Poisson regression models with robust standard errors were applied to identify factors associated with daily tobacco smoking and the use of smokeless tobacco. Of the 422 respondents, 160 (37.9%) reported daily tobacco smoking, while 69 (16.4%) used smokeless tobacco. The majority were male (58.8%). The most smoked product was ‘Kibanga,’ with 71.3% daily smokers reporting its use. Factors significantly associated with daily tobacco smoking included being male (adj. PR = 1.68; 95% CI: 1.27–2.23), being aged 21–30 years (adj. PR = 1.72; 95% CI: 1.28–2.33), having education below secondary level (adj. PR = 0.69; 95% CI: 0.56–0.87), being from central Uganda (adj. PR = 0.64; 95% CI: 0.46–0.89), and lacking awareness that smoking causes serious illness (adj. PR = 1.50; 95% CI: 1.11–2.03), heart attacks (adj. PR = 1.49; 95% CI: 1.11–4.83), and lung cancer (adj. PR = 1.71; 95% CI: 1.25–2.35). Smokeless tobacco use was significantly associated with being aged 21–30 years (adj. PR = 1.75; 95% CI: 1.04–2.96) and not believing that smokeless tobacco causes heart attacks or serious illness (adj. PR = 3.02; 95% CI: 1.87–4.87). This study provided data on patterns of tobacco use, mainly daily tobacco smoking and smokeless tobacco use among youths in informal settlements. Our findings highlight the need for targeted interventions directed at males aged 21–30 years, individuals with lower levels of education, and youth residing in central Uganda. Additionally, public health strategies should prioritize addressing misinformation and increasing awareness about the health risks associated with tobacco use.