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Socioeconomic inequality in tobacco use in Kenya: a concentration analysis

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Abstract

This paper aims at assessing and exploring socioeconomic inequalities in tobacco use in Kenya. Using the theory of fundamental causes, and concentration index, we investigate the determinants of tobacco use, and whether it disproportionately affects the poor. All data used in this study emanated from the 2014 Global Adult Tobacco Survey implemented in Kenya on a nationally representative sample of men and women aged 15 years and older. Our results suggest a link between tobacco use and socioeconomic inequality. Overall, poorer households are more affected by tobacco use than richer households. This socioeconomic inequality is more evident among men and households living in urban areas. The decomposition of the concentration index indicates that the overall socioeconomic inequality for current tobacco smokers is explained by 69.11% of household wealth. To reduce the prevalence rate of smoking in Kenya, policymakers could design and implement tobacco control programs through the equity lens. Community health workers could be used to promote non-smoking behaviors among the poor.

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Acknowledgement

This work was presented at the Center of Research in Economics and Management (CREM, CNRS 6211)’s seminar in June 2018 at Rennes University (France). We are grateful for the comments received which help to improve the quality of the paper. We are grateful to the two anonymous reviewers for their constructive comments. The usual disclaimer applies.

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  1. African Population Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya

    Hermann Pythagore Pierre Donfouet & Shukri F. Mohamed

  2. CREM UMR CNRS 6211, University of Rennes 1, Rennes, France

    Eric Malin

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  1. Hermann Pythagore Pierre Donfouet
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Fig. 5
figure 5

Construction of the wealth index using principal component analysis, number of components, and percent explained variance. Since these variables are binary outcomes, we use the polychoric principal component analysis (PCA). We choose a total number of two components which explained approximately 65% of the total variance. Sampling weights are used to account for the sampling design of the survey

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Table 6 Household assets used to construct the wealth quintiles
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Table 7 Univariate analysis
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Table 8 Decomposition of the concentration index, daily tobacco smokers
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Table 9 Decomposition of the concentration index, daily cigarette smokers
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Table 10 Decomposition of the concentration index, daily smokeless tobacco users
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Donfouet, H.P.P., Mohamed, S.F. & Malin, E. Socioeconomic inequality in tobacco use in Kenya: a concentration analysis. Int J Health Econ Manag. 21, 247–269 (2021). https://doi.org/10.1007/s10754-020-09292-0

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