Objective: To provide data on the South African adult population's smoking status, their knowledge of the health effects of tobacco and their attitudes towards tobacco control in South Africa.
Methodology: A national representative sample of 2,238 adult (> 18 years) South Africans was surveyed by means of an interviewer-administered questionnaire.
Results: Thirty-four per cent of adult South Africans smoke (52% male, 17% female). There were notable differences in gender smoking rates for Indians (61% of men and only 7% of women smoke) and blacks (53% of men and 10% of women smoke) but not for coloureds (58% of men and 59% of women smoke). Provinces with the highest smoking rates are the Northern Cape (55%), Western Cape (48%) and North-West (46%). Forty-eight per cent of respondents reported that at least one household member smoked. The majority of the respondents (87%) acknowledged the harmful effects of direct smoking. Fifty-eight per cent were aware that cancer is associated with smoking but only 36% associated heart disease with smoking. Sixty per cent of the respondents have tried to quit at least once for reasons such as the protection of their own health, the expense of tobacco products and because of a medical doctor's advice. Confusion existed with regard to the effects of the cigarette constituents described on cigarette packages. Forty-two per cent of adults incorrectly indicated that nicotine causes cancer while 28% correctly indicated that it causes addiction, and 44% correctly indicated that condensate causes cancer. There is substantial support for a total ban of tobacco advertising on radio (61%), for local authorities to regulate smoking in public places (78%), for government assistance to farmers for tobacco crop replacement (53%) and for an increase in tobacco excise tax if the money is used for health purposes (50%).
Conclusion: The extremely high proportion of both male and female coloured smokers is a cause for concern and requires prompt action. Knowledge of the specific effects of tobacco in respect of active and passive smoking needs to be improved and this could be a first step towards facilitating behaviour change. The public support that exists for stronger measures against tobacco use, promotion, pricing and growing provides many opportunities for health promotion action.