Abstract:
Tobacco use is a risk factor for many chronic health conditions. Quantifying burden of tobacco
use among people with tobacco-related illnesses (TRI) can strengthen cessation programs. This
study estimated prevalence, patterns and correlates of tobacco use among patients with TRI at
four national referral hospitals in Kenya. We conducted a cross-sectional study among patients
with five TRI (cancer, cardiovascular diseases, cerebrovascular disease, chronic obstructive pul-
monary disease, and pulmonary tuberculosis) during January–July 2022. Cases identified from
medical records were interviewed on socio-demographic, tobacco use and cessation informa-
tion. Descriptive statistics were used to characterize patterns of tobacco use. Multiple logistic
regression models were used to identify associations with tobacco use. We identified 2,032 indi-
viduals with TRI; 46% (939/2,032) had age �60 years, and 61% (1,241/2,032) were male.
About 45% (923/2,032) were ever tobacco users (6% percent current and 39% former tobacco
users). Approximately half of smokers and 58% of smokeless tobacco users had attempted quit-
ting in the last month; 42% through cessation counselling. Comorbidities were present in 28% of
the participants. Most (92%) of the patients had been diagnosed with TRI within the previous five
years. The most frequent TRI were oral pharyngeal cancer (36% [725/2,032]), nasopharyngeal
cancer (12% [246/2.032]) and lung cancer (10% [202/2,032]). Patients >60 years (aOR 2.24,
95% CI: 1.84, 2.73) and unmarried (aOR 1.21, 95% CI: 1.03, 1.42) had higher odds of tobacco
use. Female patients (aOR 0.35, 95% CI: 0.30, 0.41) and those with no history of alcohol use
(aOR 0.27, 95% CI: 0.23, 0.31), had less odds of tobacco use. Our study shows high prevalence
of tobacco use among patients with TRI in Kenya, especially among older, male, less educated,
unmarried, and alcohol users. We recommend tobacco use screening and cessation programs
among patients with TRI as part of clinical care.