A new study has found that alcohol use and tobacco smoking among Ugandan adults are closely connected behaviours shaped by similar social and demographic factors.
The research, published in PLOS One, suggests that public health programs should address these behaviours together rather than separately. Alcohol and drug misuse, which include smoking account for three millions deaths in Africa, according to World Health Organisation.
Researchers argue that previous studies may have missed part of the picture. “Existing research often treats these behaviours in isolation, failing to capture their potential interdependencies and shared determinants,” the authors note.
Using advanced statistical modelling, the team compared two approaches: studying alcohol and tobacco use separately, and analysing them jointly in a single model that accounts for their overlap within individuals. The joint approach performed better.
The survey data used for the modeling showed that 47 percent of adults reported current alcohol use, while 8.6 percent reported smoking tobacco. Although smoking was less common, the study identified important shared predictors.
Gender emerged as one of the strongest influences. Women were significantly less likely than men to report either behavior, with the gap particularly large for smoking. Age also mattered: the likelihood of both drinking and smoking increased steadily with age, especially among adults over 45.
Education appeared to protect against substance use. Individuals with secondary or tertiary education were less likely to smoke or drink compared to those with no formal schooling. The findings suggest that greater health awareness or socioeconomic advantages associated with education may reduce risk.
Marital status also played a role. People who were separated, divorced, or widowed had higher odds of smoking than those who were married. Regional differences were observed as well, indicating that local cultural or environmental factors may influence patterns of substance use across the country.
Overall, the researchers concluded: “The joint model supports the hypothesis that tobacco and alcohol use share some common predictors, while also exhibiting distinct patterns of association.”
The study’s implications extend beyond statistics. Uganda, like many countries in sub-Saharan Africa, is facing a growing burden of non-communicable diseases such as heart disease, cancer, and chronic respiratory conditions. Alcohol and tobacco use are major preventable risk factors for these illnesses.
By demonstrating that drinking and smoking are interconnected, the study suggests that prevention strategies could be more effective if designed to address both behaviors simultaneously. Targeting high-risk groups—particularly men, older adults, and individuals with lower levels of education—may yield the greatest impact.
IMAGE CREDIT: CHATGPT