Surreal illustration of Ethiopian woman amidst tobacco smoke and khat leaves.

Unmasking the Risks: Tobacco Use and Secondhand Smoke in Ethiopia

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"Exploring knowledge, attitudes, and beliefs among women in Aleta Wondo."

Tobacco use remains a significant global health threat, with projections estimating 8 million deaths annually by 2030. Low- and middle-income countries (LMICs) bear a disproportionate burden of this epidemic, highlighting the urgent need for targeted interventions, especially in Sub-Saharan Africa.

While smoking prevalence among women in Ethiopia is low, exposure to secondhand smoke remains a pressing concern due to higher rates of smoking among men. To address this, a study was conducted in Aleta Wondo, Southern Ethiopia, to understand Ethiopian women's knowledge, attitudes, and beliefs (KABs) related to tobacco use and secondhand smoke exposure.

This article highlights the key findings from this study, shedding light on the perceptions of rural Ethiopian women, their understanding of associated health risks, and the influence of factors such as khat use, messaging, and religious affiliation on their attitudes.

Key Findings: Knowledge, Attitudes, and Beliefs

Surreal illustration of Ethiopian woman amidst tobacco smoke and khat leaves.

The study revealed a high level of general awareness regarding the harms of personal tobacco use and exposure to secondhand smoke. However, specific knowledge of associated health risks was limited. While over 94% of respondents recognized the general harm, the ability to identify specific diseases like lung cancer or heart disease was significantly lower.

Despite the limited knowledge of specific health risks, there was a strong consensus that female tobacco use is socially unacceptable, with over 96% of respondents agreeing on this point. However, more than 70% were able to identify potential benefits of tobacco use, both for personal consumption and non-personal uses.

Khat vs. Tobacco: Respondents reported greater experimentation with khat compared to tobacco.
Religious Influence: 73% of respondents indicated that their religion significantly influenced their tobacco-related attitudes.
Messaging Exposure: There were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging in the 30 days prior to the study.

The study also highlighted some interesting beliefs regarding tobacco use. Over half of the respondents cited 'medicinal purposes' as a reason for initiating smokeless tobacco use. Additionally, a significant number reported using tobacco for non-personal reasons, such as repelling snakes or treating livestock.

Implications and Future Directions

The high level of awareness of health risks and exposure to anti-tobacco messaging are community-level strengths. These strengths can be built on to prevent the projected disease burden associated with tobacco. However, targeted educational campaigns are needed to increase awareness of specific risks, like those related to addiction and SHS exposure.

Findings underscore the importance of developing contextualized, gender-specific tobacco control interventions, particularly promoting smoke-free homes. These interventions should consider the traditional and non-personal uses of tobacco that perpetuate its perceived need in the community.

Future research should further explore these unique cultural-environmental factors and the potential role of religion in tobacco use prevention. Collaboration with local entities, including faith communities, is crucial to reinforce and expand the dissemination of anti-tobacco messaging.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1186/s12905-018-0640-y, Alternate LINK

Title: An Exploratory Study Of Knowledge, Attitudes, And Beliefs Related To Tobacco Use And Secondhand Smoke Among Women In Aleta Wondo, Ethiopia

Subject: Obstetrics and Gynecology

Journal: BMC Women's Health

Publisher: Springer Science and Business Media LLC

Authors: Anne Berit Petersen, Lisa M. Thompson, Gezahegn Bekele Dadi, Alemu Tolcha, Janine K. Cataldo

Published: 2018-09-24

Everything You Need To Know

What are the main concerns regarding tobacco use in Ethiopia, particularly among women in Aleta Wondo?

While smoking rates among women in Ethiopia are low, the primary concern is their exposure to secondhand smoke due to higher smoking rates among men. A study in Aleta Wondo, Southern Ethiopia, focused on understanding women's knowledge, attitudes, and beliefs (KABs) regarding tobacco use and secondhand smoke exposure to address this pressing concern. The study aimed to shed light on perceptions of rural Ethiopian women, their understanding of associated health risks, and the influence of factors such as khat use, messaging, and religious affiliation on their attitudes. Understanding these factors is crucial for designing effective interventions.

How knowledgeable are women in Aleta Wondo about the specific health risks associated with tobacco use and secondhand smoke?

Women in Aleta Wondo generally show a high level of awareness about the harms of both personal tobacco use and exposure to secondhand smoke. However, their specific knowledge of associated health risks is limited. While over 94% recognize the general harm, significantly fewer can identify specific diseases like lung cancer or heart disease. This gap highlights the need for targeted educational campaigns to improve understanding of specific health consequences.

Besides health risks, what other factors influence attitudes toward tobacco use among women in Aleta Wondo?

Several factors beyond health risks influence attitudes toward tobacco use. The study showed that over 96% of respondents agreed that female tobacco use is socially unacceptable, indicating a strong social stigma. Religion also plays a significant role, with 73% of respondents indicating that their religion significantly influenced their tobacco-related attitudes. Additionally, exposure to anti-tobacco messaging (70%) versus pro-tobacco messaging (49%) in the 30 days prior to the study plays a role. The use of khat compared to tobacco is also relevant, with respondents reporting greater experimentation with khat.

What are some surprising beliefs about tobacco use revealed in the Aleta Wondo study?

The study revealed some interesting beliefs, for instance, over half of the respondents cited 'medicinal purposes' as a reason for initiating smokeless tobacco use. A significant number also reported using tobacco for non-personal reasons, such as repelling snakes or treating livestock. These beliefs indicate that tobacco is sometimes perceived as having beneficial uses beyond personal consumption, which can complicate efforts to discourage its use. These beliefs need to be addressed when educating about the risks of tobacco use.

What are the implications of the study findings for future interventions in Aleta Wondo, Ethiopia?

The study highlights community-level strengths such as high awareness of health risks and exposure to anti-tobacco messaging. These strengths can be leveraged to prevent the projected disease burden associated with tobacco. However, targeted educational campaigns are needed to increase awareness of specific risks, including those related to addiction and secondhand smoke exposure. These interventions should also address the beliefs about medicinal and non-personal uses of tobacco to effectively counter these misconceptions and promote healthier behaviors.