Comparative Analysis of Prevalence, Attitudes, and Determinants of Cigarette Smoking among Young Adults in Rural and Urban area of Kano State, Nigeria.Comparative Analysis of Prevalence, Attitudes, and Determinants of Cigarette Smoking among Young Adults in Rural and Urban area of Kano State, Nigeria.

Abstract

Background: Cigarette smoking remains a major public health concern, especially among young adults who often initiate the habit early in life. In Nigeria, disparities exist in smoking behaviors between rural and urban settings, yet limited data exist for Kano State. Objective: This study aimed to assess and compare the prevalence, attitudes, and determinants of cigarette smoking among young adults in rural and urban communities of Kano State, Nigeria. Methods: A descriptive cross-sectional study using mixed methods was conducted among 894 young adults (aged 18–25 years), equally sampled from one urban (Gwale) and one rural (Dawakin Tofa) Local Government Area using multistage sampling. Data collection involved structured interviewer-administered questionnaires and focus group discussions (FGDs). Quantitative data were analyzed using SPSS with multivariate logistic regression, while qualitative data were analyzed thematically. Results: The overall prevalence of ever smoking was 24.8%, significantly higher in rural (30.3%) than urban (19.4%) areas (p<0.001). Current smoking prevalence was 14.5%, also higher in rural (16.7%) than urban (12.2%) areas, though the difference was not statistically significant (p=0.065). Positive attitudes towards smoking were more common among urban respondents (p<0.05). Predictors of ever smoking included male sex, informal education, and positive smoking attitudes in urban areas, while additional predictors in rural areas included being aged 22–25 and single. For current smoking, additional factors such as peer influence, role models, and possession of cigarette-branded items were identified. Key reasons for smoking included peer pressure and accessibility, while the main barrier to quitting was a persistent positive attitude toward smoking. Conclusion: Smoking prevalence among young adults in Kano remains high, with distinct rural urban variations in attitudes and determinants. Targeted tobacco control interventions addressing peer influence, accessibility, and risk perception are urgently needed, particularly in rural communities.