{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:14:06Z","timestamp":1788444846751,"version":"build-2803163510"},"reference-count":41,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,28]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the prevalence and sociodemographic factors associated with tobacco smoking, smokeless tobacco and dual use among adults in Ghana using the 2022 Demographic and Health Survey (GDHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Ghana, nationwide sample of males and females aged \u226515 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a cross-sectional secondary analysis of the 2022 GDHS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>A representative sample of 22\u2009058 individuals (females, 15\u2009014 aged 15\u201349; males, 7044 aged 15\u201359)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Current tobacco smoking, smokeless tobacco use and dual use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prevalence for smoking, smokeless tobacco and dual use was 4.7 (4.1\u20135.4), 1.6 (1.3\u20132.0) and 0.6 (0.4\u20130.9) among males and 1.0 (0.8\u20131.3), 0.08 (0.05\u20130.1) and 0.1 (0.05\u20130.1) among females, respectively. Among males, smoking was associated with higher age (30\u201344 years: AOR: 2.3, 95%\u2009CI 1.7 to 3.1; 45\u201359 years: AOR: 2.6, 95%\u2009CI 1.8 to 3.7). Higher education was protective for both sexes [(males: AOR: 0.4, 95%\u2009CI 0.2 to 0.8)\u2009and (females: AOR: 0.4, 95%\u2009CI 0.2 to 0.8)] compared with their counterparts who had no education. Males in the Coastal zone had higher odds of use (AOR: 1.8, 95%\u2009CI 1.3 to 2.3) compared with males in the Middle zone, while females in the Northern\/Savanna zone had lower odds of tobacco use (AOR: 0.5, 95%\u2009CI 0.3 to 0.8) compared with the Middle zone. Being Christian was associated with lower odds of smoking among males (AOR: 0.3, 95%\u2009CI 0.2 to 0.5) compared with others, while being Mole-Dagbani ethnic is associated with higher odds of smoking among females (AOR: 3.0, 95%\u2009CI 1.7 to 5.4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study provides the first national analysis across Ghana\u2019s 16 regions and investigates patterns of smoking, smokeless tobacco and dual tobacco use. While tobacco use in Ghana remains predominantly smoked and male-driven, the divergent patterns of use across educational, regional and ethnic groups, especially the emerging risk among females, represent a significant public health shift that demands focused gender-sensitive tobacco control interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106957","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:05:17Z","timestamp":1780502717000},"page":"e106957","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tobacco use and associated factors among adults in Ghana: evidence from the 2022 Ghana Demographic and Health Survey"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7742-933X","authenticated-orcid":false,"given":"Divine Darlington","family":"Logo","sequence":"first","affiliation":[{"name":"Research and Development Division, Ghana Health Service, Accra, Ghana"},{"name":"Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash Babu","family":"Kodali","sequence":"additional","affiliation":[{"name":"Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7562-6281","authenticated-orcid":false,"given":"Jerry John","family":"Ouner","sequence":"additional","affiliation":[{"name":"Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Anaman-Torgbor","sequence":"additional","affiliation":[{"name":"Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin W","family":"Chaffee","sequence":"additional","affiliation":[{"name":"Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA"},{"name":"University of California San Francisco School of Dentistry, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella A","family":"Bialous","sequence":"additional","affiliation":[{"name":"Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"2026090306260739000_16.6.e106957.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"},{"key":"2026090306260739000_16.6.e106957.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-021-00423-4"},{"key":"2026090306260739000_16.6.e106957.3","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1177\/08901171221141980","article-title":"Association of Cardiovascular Disease Risk Factors with Exclusive Smokeless Tobacco Use among US Males: Cross-Sectional Analysis of NHANES Data 2003-2018","volume":"37","author":"Mushtaq","year":"2023","journal-title":"Am J Health Promot"},{"key":"2026090306260739000_16.6.e106957.4","unstructured":"Rawat A , Hivre M , Sharma A , et al . 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