Abstract
Objective: To examine the relationship between smoking habits and indicators of socioeconomic status, the urban/rural dimension and gender among secondary school students from selected districts in Zimbabwe. Design: A two-stage stratified random sample of students was drawn. Schools were stratified by school type and students were stratified by gender and grade. Setting: The data collections took place in schools by trained personnel from Department of Psychiatry, University of Zimbabwe. Subjects: A total of 3500 students were sampled. Questionnaires were completed by 3308 students. After exclusion of incomplete and inconsistent questionnaires, the material consisted of questionnaires from 3061 students (87.5%). Results: Only 0.9% reported to be daily smokers, 2.1% smoked weekly (but not daily), and 19.8% smoked more seldom. The increase in the prevalence of smokers across age groups proved to be small. Smoking (daily, weekly and more seldom combined) is more common among male students (27.6%) than among female students (17.5%). The risk of being a smoker increases with increasing socioeconomic status. According to the students' proxy reports, more fathers (25.5%) than mothers (8.7%) were smokers. Among mothers, being a smoker (as reported by their offspring) increases with higher education, occupational status and with having their son or daughter in a private school. Among fathers there is no association between indicators of socioeconomic status and smoking. This indicates that the population being surveyed has reached a stage in the diffusion of smoking process, where smoking is becoming less fashionable among high status segments of the adult male population. Conclusion: A rather modest income in large groups may explain the low prevalence of daily and weekly smoking among secondary school students in the districts covered by the present survey. The proportion of experimental smokers is, however, high. A future increase in the income level may therefore lead to a marked increase in tobacco consumption. In order to prevent this, there is an urgent need for developing intervention strategies which are relevant to the Zimbabwean culture and societal context. Smoking among young women deserves special attention.