Tobacco Use in South African Emergency Centre Patients: Opportunities for Intervention

  • Claire van der WesthuizenEmail author
  • Megan Malan
  • Tracey Naledi
  • Bronwyn Myers
  • Dan J. Stein
  • Katherine Sorsdahl
Brief Report


Tobacco-attributable deaths in South Africa have increased since 1990, yet data are scanty from healthcare settings. Internationally, emergency centre (EC) visits are increasingly utilised as opportunities for health risk behaviour screening and intervention, but this is not the case in South Africa. Effective advocacy for these services requires data on the prevalence and correlates of tobacco use among South African EC patients. The study objectives were to investigate tobacco prevalence and associated factors in ECs. Demographics, hospital presentation and substance use data were collected as part of a screening and brief intervention programme for alcohol and drugs in three ECs. We conducted descriptive statistics and utilised logistic regression to examine the associations of demographics, presenting complaint and substance use with moderate–high risk-tobacco use as the dependent variable. Of 12,522 patients screened, 37.0% used tobacco and 35.7% showed moderate–high risk for tobacco-related harms. Factors associated with tobacco-related harms included male gender and moderate–high risk for other substances. Of the patients who met criteria and received an intervention for alcohol or drugs, 65.5% were at moderate–high risk for tobacco-related harms. Given the high prevalence of tobacco use among patients attending ECs, intervening on this platform has the potential to reduce risk for non-communicable disease.


Tobacco Screening Brief intervention Screening, brief intervention and referral to treatment Substance use Emergency centres 



This work was supported through the DELTAS Africa Initiative [DEL-15-01]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [DEL-15-01] and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK government.

Compliance with Ethical Standards

Ethical approval for an overall programme evaluation study was granted by the Western Cape Provincial Health Research Committee (WC_2017RP39_880) and the Human Research Ethics Committee at a South African university.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  2. 2.Western Cape Department of HealthCape TownSouth Africa
  3. 3.Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council/Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  4. 4.Department of Psychiatry and Mental HealthUniversity of Cape Town and MRC Unit on Risk and Resilience in Mental DisordersCape TownSouth Africa

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