Prevalence of Tobacco Use in Zambia

Overall tobacco smoking prevalence is estimated at 9.9% with 11.0% and 8.2% for rural and urban areas respectively. Approximately 1 in every 10 (11.6%) people aged between 25 and 39 years in Zambia smoke cigarettes.

Cigarette smoking is most prevalent in the Eastern (13.07%) and Luapula (12.47%) provinces, and lowest in Western (9.38%) and Muchinga (9.58%) provinces.

Tobacco control data in Zambia is scarce and incomprehensive with minimal disaggregation, similar to other African countries.

This page provides insights into the prevalence of tobacco use by different sub-groups in the country. The main data source is the Zambia Demographic and Health Survey (DHS) 2018

and the Zambia Global Youth Tobacco Smoking Survey 2011. Other data sources include International Tobacco Control Policy Evaluation Project (ITC) Wave 1 (2012) and Wave 2 (2015) studies.

Tobacco smoking prevalence is higher among males at 18.5% compared to females at 0.9%. The prevalence of tobacco use among men declined from 26.4% in 2001 to 18.5% in 2018. On the contrary, tobacco use among women increased from 0.5% in 2001 to 0.9% in 2018.  Tobacco smoking prevalence among men has been declining from 26.4% in 2001,

23.8% in 2007, and 18.5% in 2018.

The graph shows tobacco prevalence by gender between 2001 and 2018.

Tobacco use prevalence by gender 2001-2018

DHS 2001DHS 2007DHS 20180%5%10%15%20%25%30%Prevalence rate0.5%0.7%0.9%26.4%23.8%18.5%

Source: Zambia DHS 2001, 2007 and 2018

Forms of tobacco consumed by gender

Among all current tobacco users, cigarettes are the most prevalent form of tobacco use at 96% and 20% of male and female tobacco consumers respectively. Smokeless tobacco use is most common among females at 79% compared to 4% among males.

The chart shows the forms of tobacco consumed among males and females in Zambia.

Forms of tobacco consumed by gender

TotalMaleFemale0%10%20%30%40%50%60%70%80%90%100%Prevalence rate1.0%18.4%4.0%79.0%81.4%96.0%20.0%

Source: MOH, 2018

The Zambia DHS 2018 estimates on the prevalence of tobacco use among adults was lowest among persons aged between 20 and 24 years at 6.9%. The prevalence was higher among persons aged between 25 years and 39 years at 11.6%.  Tobacco smoking was most common among older persons with a 17.4% prevalence among those aged 45-49 years.

The graph shows tobacco prevalence by age.

Tobacco use prevalence by age group in 2018

20-2425-2930-3435-3940-4445-49Age Group0%2%4%6%8%10%12%14%16%18%Prevalence rate6.9%11.6%11.2%11.6%14.2%17.4%

Source: MOH, 2018

Tobacco use among youth

The Zambia Global Youth Tobacco Survey 2011 estimates tobacco use prevalence among youths (13 to 15 years) at 6.2%;  5.7% for girls, and 6.2% for boys. Further, the Zambia Demographic Health Survey 2018, estimated tobacco use among teenagers (15-19 years) at 3.0% among boys and negligible among girls. This is lower than the estimates observed in the GYTS 2011 and has been attributed to the different methodologies and scope between the two studies.

Although the prevalence of tobacco smoking is lower among teenagers, there is a higher prevalence of the use of alternative tobacco products. These alternative products include Insunko and Shisha.

Insunko is a herb belonging to a group we call Smokeless Tobacco Products. In Zambia it’s made from smashed or powdered tobacco mixed with ash and Soda. It’s sniffed, chewed or inserted into the private parts of women. The belief is that Insuko will lead to tightness and create warmth in the female private part. All aimed at satisfying the male partner sexually. But this is a traditional myth that cannot stand scrutiny. It’s also claimed by the users that this Insuko treats Hypertension and lowers blood Sugar. Again none of this has been proven by Science.

Shisha is a form of pipe smoking where fruit flavored tobacco is heated using charcoal, wood or coal and then the smoke is passed through a container with water. Smoke bubbles out from the water into a pipe through which it is inhaled. Shisha use is not yet widely spread in Zambia and statistics are still low, but indications are that it is spreading fast among the youth.

The graph shows tobacco prevalence levels among the youth.

Tobacco consumption among boys and girls (13-15 years) in 2011

Current tobacco smokersAny tobacco productEver smoked cigarette0%2%4%6%8%10%12%14%16%18%20%22%24%26%Left Legends6%26%19%6%25%20%6%26%18%

Source: Zambia Global Youth Tobacco Survey, 2011

Tobacco consumption of factory-manufactured vs hand-rolled cigarettes

The consumption of factory-manufactured cigarettes increased from 49% for Wave 1 (2012) to 59% for Wave 2 among current smokers. The use of hand-rolled cigarettes was reduced by 10% during the same period. Further, the prevalence of use for both hand-rolled and factory-manufactured cigarettes reduced from 3% in Wave I (2012) to 1% in Wave 2 (2014).

The chart below shows the prevalence of consumption of factory-manufactured vs. hand-rolled cigarettes.

Factory vs hand-rolled cigarettes

Wave 1Wave 20%5%10%15%20%25%30%35%40%45%50%55%60%Consumption rate49.0%59.0%48.0%39.0%3.0%1.0%

Source: ITC Wave I and Wave II surveys

Prevalence of consumption of other tobacco products among current smokers

Among current tobacco users, Shisha and menthol were the most commonly consumed alternative tobacco products at 68.3% and 48.0% respectively. The overall prevalence rate for smokeless tobacco consumption is 0.6% with 0.3% and 0.6% for males and females respectively.

The graph below shows the prevalence of other tobacco products among existing tobacco users.

Prevalence of other tobacco products among existing tobacco users

0%10%20%30%40%50%60%70%Prevalence rateWaterpipe (Shisha)Menthol tobaccoBidis (cigarette wrapped in leaves)E-cigaretteDry stuff (Nsunko)Chewing tobaccoVaporizersCigarsOral productsHeated tobacco productsMoist snuffKreteks (clove cigarettes)RYO (Balani)SnusOther68.3%48.0%22.9%19.1%15.7%9.7%8.2%7.8%6.3%6.0%3.1%2.8%2.2%1.9%1.6%

Source: DHS, 2018

Cigarette smoking by education

Smoking prevalence reduces as the level of education increases. People with no education are 4 times more likely to smoke tobacco than those with higher education. Among women, the prevalence of smoking was 1.2% for women with higher education compared to 2.5% for women with no education. Among men, people with no education were three times more likely to consume tobacco products compared to those with higher education at 8.3% and 25.7% respectively.

The chart below shows cigarette smoking by the level of education and gender.

Prevalence of cigarette smoking by level of education and gender

0%2%4%6%8%10%12%14%16%18%20%22%24%26%Prevalence rateHigherSecondaryPrimaryNo educationEducation level8.3%16.2%22.9%25.7%1.2%0.7%0.7%2.5%

Source: MOH, 2018

Cigarette smoking by wealth

Smoking prevalence is highest among persons within the lowest wealth quintile at 28.2% for men and 1.3% for women. Among women, the highest prevalence was estimated for women within the lowest and the highest quintiles at 1.3% and 1.0% respectively. Women within the 2nd quintile had the lowest tobacco use prevalence at 0.6%. A male in the lowest quintile is more than twice more likely to use tobacco than a male in the highest quintile.

The charts below show tobacco smoking prevalence by wealth quintiles and gender.

Prevalence of cigarette smoking by wealth quintiles and gender

LowestSecondMiddleFourthHighest0%5%10%15%20%25%30%Prevalence rate1.3%0.6%0.7%0.9%1.0%28.2%21.2%17.9%16.5%12.1%

Source: DHS, 2018

Prevalence of menthol tobacco use by level of education

The prevalence of consumption of menthol tobacco was higher among the moderately educated and the highly educated at 47.5% and 43.6% respectively. People with higher education have more disposable incomes to spend on menthol tobacco products.

The charts below show menthol cigarette smoking by the level of education.

Prevalence of menthol cigarette smoking by level of education

0%5%10%15%20%25%30%35%40%45%50%High (secondary school or higher)Moderate (completed primary school)Low (illiterate/not completed primary school)Education level43.6%47.5%8.9%

Source: DHS, 2018

Cigarette smoking prevalence was highest in Eastern (13.07%) and Luapula (12.47%) provinces and lowest in Western (9.38%) and Muchinga (9.58%) provinces.

Prevalence of Tobacco Use by Province with Eastern and Luapula Provinces indicating the highest prevalence levels.

Prevalence of tobacco use by province

  • Prevalence rate|
  • 0% - 3.99%
  • 4% - 7.99%
  • 8% - 11.99%
  • 12% - 15.99%