Prevalence and factors associated with tobacco use among patients with tobacco related illness in four national referral hospitals of Kenya

Background Tobacco use is a risk factor for many chronic health conditions. Demonstrating the link between tobacco use and disease burden can strengthen tobacco control. We estimated the prevalence and correlates of tobacco use among patients with tobacco related illnesses (TRI) at four national referral hospitals in Kenya. Methods We conducted a cross-sectional study among patients with four TRI (cancer, cardiovascular diseases, cerebrovascular disease and pulmonary tuberculosis) during January–October 2022. Cases were identified from medical records and a questionnaire used to collect socio-demographic information and tobacco use history. Descriptive statistics were used to estimate prevalence of tobacco use. Multiple logistic regression models were used to identify factors associated tobacco use among patients with TRI. Results We identified 2032 individuals with TRI; 46% (939/2,032) had age ≥60 years, and 61% (1,241/2,032) were male. About 45% (923/2,032) were ever tobacco users (6% percent current and 39% former tobacco users). Comorbidities were present in 28% of the participants. Most (92%) of the patients had been diagnosed with the TRI within the previous five years. The most frequent TRI were oral pharyngeal cancer (36% [725/2,032]), nasopharyngeal cancer (12% [246/2.032]) and lung cancer (10% [202/2,032]). Patients >60 years (aOR 2.24, 95% CI: 1.84, 2.73) and not in a marital union (aOR 1.21, 95% CI: 1.03, 1.42) had higher odds of tobacco use. Female patients (aOR 0.35, 95% CI: 0.30, 0.41) and those with no history of alcohol use (aOR 0.27, 95% CI: 0.23, 0.31), had less odds of tobacco use. Odds of tobacco use increased with age and decreased with increasing education level. Conclusion Prevalence of tobacco use was high among patients with TRI in Kenya, especially among older, male, less educated, unmarried, and alcohol users. We recommend sustained tobacco use screening and cessation programs among patients with TRI as part of clinical care.