Frequency of indoor tobacco smoking and its determinants in Madagascar

Indoor tobacco smoking exposes non-smokers to second-hand smoke (SHS), which poses serious health risk. Although many countries have environmental health policies that restrict tobacco smoking in public places, enforcing such measures remains difficult, particularly within the private confines of individual households. This paper analyzed the determinants of indoor tobacco smoking frequencies in Madagascar.

The study utilized the Demographic and Health Survey (DHS), comprising 20,510 households. An Ordered Probit regression was utilized for data analysis.

The results indicated that 43.5 % of household members got exposed to SHS, compared to 42.0 % at the household level. Daily exposure rates were 23.25 % for household members and 21.57 % for households. The Ordered Probit regression revealed that indoor smoking was significantly and positively associated (p < 0.05) with primary or secondary education, larger household size, male headship, married status, widowhood, divorce, and residence in Sofia, Melaky, and Menabe regions, while the likelihood was negatively and significantly (p < 0.05) associated with increasing age of household heads, number of under-5 children, higher wealth index, and residence in Vakinankaratra, Itasy, Bongolava, Betsiboka, Atsimo Andrefana, and Androy regions.

The findings suggest that interventions to curb indoor smoking should emphasize educational programmes on the health risks of smoking and adopt region-specific, and gender-sensitive strategies that account for marital status and household wealth levels.