Epidemiology and prevention of tobacco use in Tunisia: a review

Introduction This paper describes trends in tobacco sales and smoking prevalence in the Tunisian population, it estimates the consequences of smoking on mortality of this population and discusses anti-tobacco actions: educational actions, legislative measures, and price increases. Data sources Sales data were collected from the Tunisia tobacco monopoly, smoking prevalence data from surveys conducted by several institutes, and numbers of deaths by causes have been estimated from WHO for 1998 year. Results Tobacco sales increased from 4.96 g per adult per day in 1981 to 6.3 g in 1993, then decreased widely. The proportion of smokers was 30% in 1996, 55% among men versus 5.6% among women. Among 17 to 24 years old young adults, the proportion of smokers was 29.2% in 1994 (50% among men versus 3.9% among women). Mortality attributable to tobacco in Tunisia has been estimated to 6430 deaths in 1997 (5580 among men versus 850 among women). These deaths represent 22% of total male deaths and 4% of female ones. Anti tobacco measures have been reinforced by the enactment of anti tobacco law. Conclusion Proportion of young smokers remaining high, it is expected that the consequences of tobacco addiction in Tunisia in term of mortality will be even heavier in the next two decades if efficient anti tobacco actions are not implemented.