Association between tobacco consumption and alcohol, vegetable and fruit intake across urban and rural areas in Mozambique

Abstract

Background Smoking, alcohol consumption and unhealthy diet are known to cluster, but evidence from developing countries at the early phases of the tobacco epidemics and with markedly different cultures, lifestyles and forms of tobacco use is scarce. The objective of this study was to quantify the association between tobacco consumption (manufactured cigarettes, hand-rolled cigarettes and smokeless tobacco) and alcohol, fruit and vegetable intake in Mozambique according to place of residence (urban/rural). Methods A representative sample of 12 902 Mozambicans aged 25-64 years was evaluated in a national household survey conducted in 2003 using a structured questionnaire. Age-and education-adjusted ORs were computed to estimate the association between tobacco consumption and alcohol, fruit and vegetable intake. Results Tobacco use and overall alcohol drinking were positively associated, regardless of type of tobacco consumed, but smoking of hand-rolled cigarettes and consumption of smokeless tobacco was negatively associated with beer drinking. Smokers of manufactured cigarettes had a less frequent intake of fruit, but smokeless tobacco consumption and hand-rolled cigarette smoking were not inversely related with intake of fruit or vegetables. This pattern was relatively consistent across genders and urban/rural areas, with the observed differences likely to be explained either by random variation or heterogeneity in tobacco consumption patterns across genders or places of residence. Conclusion Strong associations between tobacco consumption and the intake of alcoholic beverages, vegetable and fruit intake are found, but not consistently for all forms of tobacco use.