Updated 20 November 2013

The Great SA Smoking Survey 2013: results

We know the risks, so why are so many of us still doing it? The SA Smoking Survey helps find the answers.

The South African Smoking Survey 2013, the fifth such survey conducted annually among Health24 readers, has again shed light on the country’s smoking habits.

A selection of the key findings:

Tobacco gets its grip on the young

Most smokers start young, in their adolescence or early 20s, when peer pressure is felt most acutely and a sense of “immortality” prevails: 79% of survey respondents say they picked up the habit before age 20. Of these, a disturbing 13% were aged between six and 13 years.

Clearly, it's easy for children and teenagers to access cigarettes, regardless of the fact that selling tobacco products to minors is illegal.

Starting smoking after the period of impressionable youth is unusual: less than 2% picked up the habit past age 30.

Not only lung cancer

Smoking has become synonymous with lung cancer in the public mind. The survey bore this out, with nearly all respondents saying they associated the habit with lung cancer and other respiratory diseases.

But smoking is a total onslaught on the body, sparing no organ system – a grim truth about which there is steadily growing awareness.
Most respondents (74%) were aware that tobacco use is a huge risk factor for heart disease. There was also good awareness (70%) that smoking is implicated in gum disease and tooth decay.

However – and the health media should take note – fewer than half of respondents said linked smoking with these serious conditions: cancers other than lung cancer, infertility, osteoporosis and sexual problems.

Why keep doing it?

There’s good awareness of the associated health problems, and most adult smokers claim they want to quit – so why don’t they?

Most (61%) said they continue to smoke simply because they enjoy it, and also that it’s an important part of social ritual for them (46%). Another important reason nearly half gave, was that they use cigarettes as stress relievers.

The following were considered only slightly important: being rebellious and “cool”; peer pressure; having a partner who smokes; weight control. 

“Best” smoke of the day

Half of respondents said that cigarettes smoked together with a certain routine were those they found most satisfying: that smoke after a meal or with a drink, for example.

Being aware of the power of routine and ritual is important for successful quitting: like most habits, smoking is a behaviour we “learn” by repeatedly doing it in the same way and under the same set of circumstances. Successful quit attempts involve “re-learning” behaviour patterns and overhauling routines.

Vying for second place in the “best” cigarette stakes was the first cigarette of the morning, and the one smoked for relief from stress or upsetting emotions.

Quitting: hang out with non- and ex-smokers for success

Concern about health was the top reason for wanting to quit. Starting a family and the bite smoking takes out of the monthly budget were also important motivations. Most smokers spend R248 – R828 per month on their habit

Sheer willpower was the main method respondents were familiar with and had used in quit attempts, despite the fact that most said they considered smoking an addiction rather than just a bad habit.

Smoking cessation experts generally recommend that smokers use several methods; willpower alone has been shown to be ineffective in most cases.

Survey respondents had heard of most of the following methods, and some had used them in quit attempts: nicotine replacement therapy, prescription medications and electronic cigarettes. Hypnotherapy and support groups were known of and used to a lesser extent.

Having a good support network has been shown to be enormously helpful in quitting, but most respondents favoured “going it alone”. Significantly, though, many said that, even above their doctor and family, they found advice about quitting most helpful when it came from ex-smokers.

The top reason given for relapse was being in the company of others smoking. Other relapse culprits included craving cigarettes and missing the associated enjoyment, as well as cigarettes being entrenched in daily routine.

Smokers who hadn’t made any recent quit attempts (over the past year) said the main reason was, again, that they just enjoyed their cigarettes too much. Others thought quitting too hard, while some had previously tried and failed, and didn’t see the point of another attempt.

Where do you experience smoking most?

This question, aimed at both smokers and non-smokers, found, rather surprisingly considering SA’s progress in restricting smoking in public venues and workplaces, that 41% of respondents said they experienced smoking most when they went out.

Also surprising was that 24% said they experienced smoking most at work; increasingly, our workplaces are going smoke-free. Those that haven’t taken this step yet may legally only allow smoking in a limited, closed-off space.

It seems many people still allow smoking in their homes, as this was where nearly a third of respondents experience smoking most often – despite growing numbers of media reports that tobacco smoke is a major indoor pollutant.

Do we respect smoking laws?

The majority of respondents (81%) said they’d obey smoking laws, and showed good knowledge of those currently in effect:
  • It’s illegal to smoke in a public enclosed/partially enclose area. (94% knew this one)
  • It’s illegal to smoke in a car if a child under 12 is a passenger. (81%).
  • Breaking smoking laws can incur fines from R500-R50 000. (65%)
-    Olivia Rose-Innes, EnviroHealth Editor, November 2013

Note: percentages in this article have been rounded to the nearest unit.

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