The 13th World Conference on Tobacco OR Health

Objective: To examine trends in the prevalence of smoking habits in the Seychelles, a middle-income country that has implemented strong interventions against tobacco use.

Methods: Population based surveys were conducted in 1989 and 2004 using sex- and age-stratified random samples of the population aged 25-64. The surveys were attended by 1081 persons in 1989 (86.4% participation rate) and 1255 in 2004 (80.2%). Smoking habits were assessed with similar face-to-face structured interviews in both surveys.

Results: Comparing 2004 to 1989, age-standardized prevalence of regular smoking (>1 cigarette per day) decreased markedly in men (51% to 31%, p<0.001) and women (11% to 4%, p<0.001). "Occasional smoking" increased (overall prevalence: 4.9% vs. 2.1%). "Ex-smoking" decreased (14.7% to 11.3%; but increased at age 55-64) and "never-smoking" increased (53% to 60%; similar proportionate increase in all age categories). Prevalence of other tobacco products (cigars, bidis, rolled cigarettes or chewing) was <1%.

Conclusions. The marked difference of smoking in 2004 vs. 1989 suggests a true decrease in the interval, consistent with stringent tobacco control programs and policy in Seychelles. However, the lower prevalence of reported "ex-smoking" and higher prevalence of "never-smoking" in 2004 vs. 1989 suggests social desirability bias and some underestimation of smoking prevalence in 2004 vs. 1989. More generally, trends in reported tobacco consumption should be interpreted carefully when social norms against tobacco use are becoming more stringent.