Abstract

Njoumemi Z, Epo Ngah B, Ngah A

Objectives: To determine the tobacco smoking status and cigarette expenditures among low, middle and high income households and to estimate the effects of tobacco smoking on basic needs across different income groups in urban slums of Yaoundé in Cameroon. Methods: A cross-sectional survey of 372 households with 1,488 individual’s members aged 10-64 years was conducted in twenty urban slums of two health districts in 2009. Cross tabulations and the ordinary least squares regression model were used to assess tobacco smoking status and the effects of tobacco smoking expenditures on basic needs between low, middle and high income smoking households. Results: In urban slums, the majority (64.5%) of households surveyed were cigarette smoking households. The percentage of either income or expenditures allocates to cigarette smoking was higher (9.8% of income and 10.1% of expenditures) for low income households, following the middle income households (6.4% of income and 7.1 of expenditures) than for the high income households (4.2% of income and 5.8% of expenditures). The trends in cigarette expenditures were reflected in both the quantity of packs of cigarette smoked and the average price per pack paid by different income levels. Cigarette smoking by household’s members had an important opportunity cost by restricting the household limited budget available to spend on basic needs (food, water, housing, health care, clothing, electricity, transport, sport and leisure). Increasing cigarette price by raising tobacco tax rates would reduce consumption more among low income households than among high income households. Conclusion: The actual monthly expenditures on cigarettes against expenditures on basic needs shows that all income groups would significantly improved their livelihood if they do not spend any money on cigarettes. Any country specific tobacco taxation policy aiming to increase the price of cigarettes without any consideration for the changes in households’ income, might not be most effective in reducing cigarette smoking across different income groups. Government interventions from outside the health sector – specifically – in social protection, poverty reduction, urban planning and economic regulations have the potential to strengthen tobacco control in Cameroon.