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Women’s empowerment and tobacco use: an exploratory analysis of integrated demographic and health series data from India 2005 and Uganda 2011
Authors: E.S. Goldsmith, and E.H. Boyle
Source: Annals of Global Health, 82(3): 387–388; DOI:
Topic(s): Tobacco use
Women’s empowerment
Country: Africa
Published: AUG 2016
Abstract: Background: Empowering women and reducing tobacco use are both included in the newly proposed Sustainable Development Goals (SDGs). Women’s empowerment consists of multiple interrelated factors, however, and history suggests that these goals could work against each other. Previous research suggests that, under some circumstances, greater empowerment is associated with greater tobacco use by women. Using Integrated Demographic and Health Series (IDHS) survey data, we investigate this relationship in India 2005 and Uganda 2011. We also explore how women’s literacy impacts the relationship between empowerment and smoking behavior, hypothesizing that empowerment/tobacco links will be weaker among literate women. Methods: We analyze IDHS survey data for cross-sectional samples of women aged 15-49 in India 2005 (n ¼ 108,455) and Uganda 2011 (n ¼ 8,665). We employ tabular methods, generalized linear models and latent class analysis to assess relationships between tobacco use and indicators of women’s empowerment, including employment, house or land ownership, household decision-making power, attitudes opposing domestic violence, and attitudes supporting sexual autonomy. Using interaction effects, we assess how literacy moderates the relationships between tobacco use and these empowerment indicators. Findings: Our preliminary findings indicate that tobacco use risk is higher among women with greater household decision-making power, and among women who disapprove of domestic violence in various contexts. In some settings, these relationships are stronger for illiterate women. For both literate and illiterate women, approval of sexual autonomy associates with lower tobacco use. Our final results will reveal how different combinations of women’s empowerment are associated with tobacco use. Interpretation: Our preliminary findings for India and Uganda support the hypotheses that some components of women’s empowerment are associated with greater tobacco use, and that literacy moderates these associations under some circumstances. These observational and cross-sectional data analyses can identify associations but not causality. Our results support the need for future research on how measureable indicators of women’s empowerment may interact to affect health-related behaviors and risks, which could inform programs that enable both empowerment and healthful behaviors. Funding: None.