Tobacco Use and Associations with Alcohol Consumption and Socio-Demographic Factors Among Cambodian Men Aged 15-49 Years: Evidence from the Cambodia Demographic and Health Survey 2021-2022

Tobacco use remains a leading preventable cause of illness and death globally, contributing to significant public health, environmental, and socio-economic challenges. This study aimed to investigate associations of tobacco use with alcohol consumption and socio-demographic factors among Cambodian men aged 15-49 years. This study used mens data from the Cambodia Demographic and Health Survey 2021-2022. A total of 8,825 men aged 15-49 years were included in the final analysis. The outcome variable was tobacco use, which was further categorized into smoked tobacco and smokeless tobacco use. Multiple logistic regression was performed to identify determinants of tobacco use, smoking tobacco, and smokeless tobacco use. The overall prevalence of any tobacco use, smoked tobacco, and smokeless tobacco use was 21.5% (95% CI: 20.2-22.9), 20.1% (95% CI: 18.9-21.4), and 0.93% (95% CI: 0.7-1.2), respectively. The highest rates of any tobacco use were observed in Stung Treng (40.7%), followed by Mondulkiri and Ratanak Kiri, each at 39%. Similarly, the prevalence of smoked tobacco is highest in Mondul Kiri (36.5%), Ratanak Kiri (34.5%), Stung Treng (32.5%), and Kratie (30.4%). Meanwhile, smokeless tobacco use is relatively low across most provinces, with the highest rates in Mondulkiri (19.1%), Stung Treng, and Pailin (each at 6%). Several independently significant predictors of any tobacco use, smoked tobacco use, and smokeless tobacco use were higher in young adult men aged 19-24 years, no or limited education, agricultural/domestic and unskilled or skilled manual jobs, poor wealth, and alcohol consumption. Public health promotion programs need to strengthen tobacco control, particularly among the younger age groups, and can take inspiration from successful tobacco control initiatives implemented in other countries. Social determinants of health, which themselves influence health outcomes, should be addressed. Policies integrating actions to control both tobacco and alcohol can be considered.