Non-cigarette tobacco use and stroke among West Africans: evidence from the SIREN study

Authors

Adekunle Gregory Fakunle, University of Ibadan, Nigeria
Akinkunmi Paul Okekunle, University of Ibadan, Nigeria
Osahon Jeffery Asowata,, University of Ibadan, Nigeria.
Onoja Akpa, University of Ibadan, Nigeria.
Fred S. Sarfo, Kwame Nkrumah University of Science and Technology, Ghana.
Albert Akpalu, University of Ghana Medical School, Ghana.
Kolawole Wahab, University of Ilorin Teaching Hospital, Nigeria.
Reginald Obiako, Ahmadu Bello University, Nigeria.
Morenikeji Komolafe, Obafemi Awolowo University Teaching Hospital, Nigeria
Philip Adebayo, Aga Khan UniversityFollow

Document Type

Article

Department

Internal Medicine (East Africa)

Abstract

Abstract Introduction:

Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans.

Methods: A total of 7,617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigation Research and Educational Network study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial CT/MRI. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship between NCT and stroke at p<0.05.

Results: Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-smokers (62.8±15.7 vs 57.7±14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95%CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95%CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95%CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates. Conclusions: NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Nicotine & Tobacco Research

DOI

https://doi.org/10.1093/ntr/ntad239

Recommended Citation

Fakunle, A. G., Okekunle, A. P., Asowata,, O. J., Akpa, O., Sarfo, F. S., Akpalu, A., Wahab, K., Obiako, R., Komolafe, M., Adebayo, P. (2023). Non-cigarette tobacco use and stroke among West Africans: evidence from the SIREN study. Nicotine & Tobacco Research, 1-27.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/368