Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study
Abstract Background The prevalence of hypertension is high in Uganda, which places a significant burden on an already strained healthcare system. The behavioural risk factors, such as unhealthy diet, tobacco use, physical inactivity, and heavy drinking, contribute to hypertension development and com...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12889-025-21429-9 |
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| author | Paineto Masengere Nynke Halbesma Rawlance Ndejjo Bonny Enock Balugaba Rhoda K. Wanyenze Fred Nuwaha Hilde Bastiaens Geofrey Musinguzi |
| author_facet | Paineto Masengere Nynke Halbesma Rawlance Ndejjo Bonny Enock Balugaba Rhoda K. Wanyenze Fred Nuwaha Hilde Bastiaens Geofrey Musinguzi |
| author_sort | Paineto Masengere |
| collection | DOAJ |
| description | Abstract Background The prevalence of hypertension is high in Uganda, which places a significant burden on an already strained healthcare system. The behavioural risk factors, such as unhealthy diet, tobacco use, physical inactivity, and heavy drinking, contribute to hypertension development and complications. This study explored the associations of combined tobacco smoking and heavy alcohol consumption with existing hypertension in a community-based cross-sectional study conducted in two rural districts of Uganda. Methods We analysed data collected between December 2018 and January 2019 from 4,372 adults aged 25–70 from 3,689 random households in the Mukono and Buikwe districts, Uganda. Using logistic regression, crude, and adjusted odds ratios were calculated to describe the associations between participant characteristics, smoking, drinking behaviours, and high blood pressure (HBP). To determine effect modification due to combined tobacco smoking and heavy drinking, the relative excess risk due to interaction (RERI) was computed. All analyses were performed via R programming software version 4.2.3. Results HBP was prevalent in 23% of the participants. Smokers were 1.36 times more likely to have HBP than non-smokers (Crude OR, 1.36; 95% CI, 1.04–1.76). Compared with non-drinkers, moderate alcohol drinkers were 1.45 times more likely to have HBP (AOR, 1.45; 95% CI, 1.18–1.79), and heavy drinkers were 2.53 times more likely to have HBP (AOR, 2.53; 95% CI, 1.92–3.32). The RERI indicated an additive interaction effect between smoking and heavy drinking, with conjoint smokers and heavy drinkers having 45% higher odds of having HBP than the summation of the individual risk due to smoking and heavy drinking. Conclusion Tobacco smoke interacts with heavy alcohol consumption to increase the risk of increased blood pressure (BP) when it cooccurs. Integrated intervention strategies targeting both smoking and heavy drinking are essential for reducing the incidence of hypertension in rural Uganda. |
| format | Article |
| id | doaj-art-9735fd49adbd40fdbd209d3593aecc5c |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-9735fd49adbd40fdbd209d3593aecc5c2025-01-26T12:56:20ZengBMCBMC Public Health1471-24582025-01-012511910.1186/s12889-025-21429-9Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional studyPaineto Masengere0Nynke Halbesma1Rawlance Ndejjo2Bonny Enock Balugaba3Rhoda K. Wanyenze4Fred Nuwaha5Hilde Bastiaens6Geofrey Musinguzi7Department of Disease Control and Environmental Health, Makerere University School of Public HealthCentre for Population Health Sciences, Usher Institute, University of EdinburghDepartment of Disease Control and Environmental Health, Makerere University School of Public HealthDepartment of Disease Control and Environmental Health, Makerere University School of Public HealthDepartment of Disease Control and Environmental Health, Makerere University School of Public HealthDepartment of Disease Control and Environmental Health, Makerere University School of Public HealthFaculty of Medicine and Health Sciences, University of AntwerpDepartment of Disease Control and Environmental Health, Makerere University School of Public HealthAbstract Background The prevalence of hypertension is high in Uganda, which places a significant burden on an already strained healthcare system. The behavioural risk factors, such as unhealthy diet, tobacco use, physical inactivity, and heavy drinking, contribute to hypertension development and complications. This study explored the associations of combined tobacco smoking and heavy alcohol consumption with existing hypertension in a community-based cross-sectional study conducted in two rural districts of Uganda. Methods We analysed data collected between December 2018 and January 2019 from 4,372 adults aged 25–70 from 3,689 random households in the Mukono and Buikwe districts, Uganda. Using logistic regression, crude, and adjusted odds ratios were calculated to describe the associations between participant characteristics, smoking, drinking behaviours, and high blood pressure (HBP). To determine effect modification due to combined tobacco smoking and heavy drinking, the relative excess risk due to interaction (RERI) was computed. All analyses were performed via R programming software version 4.2.3. Results HBP was prevalent in 23% of the participants. Smokers were 1.36 times more likely to have HBP than non-smokers (Crude OR, 1.36; 95% CI, 1.04–1.76). Compared with non-drinkers, moderate alcohol drinkers were 1.45 times more likely to have HBP (AOR, 1.45; 95% CI, 1.18–1.79), and heavy drinkers were 2.53 times more likely to have HBP (AOR, 2.53; 95% CI, 1.92–3.32). The RERI indicated an additive interaction effect between smoking and heavy drinking, with conjoint smokers and heavy drinkers having 45% higher odds of having HBP than the summation of the individual risk due to smoking and heavy drinking. Conclusion Tobacco smoke interacts with heavy alcohol consumption to increase the risk of increased blood pressure (BP) when it cooccurs. Integrated intervention strategies targeting both smoking and heavy drinking are essential for reducing the incidence of hypertension in rural Uganda.https://doi.org/10.1186/s12889-025-21429-9Tobacco SmokingAlcohol drinkingInteraction effectHigh blood pressure |
| spellingShingle | Paineto Masengere Nynke Halbesma Rawlance Ndejjo Bonny Enock Balugaba Rhoda K. Wanyenze Fred Nuwaha Hilde Bastiaens Geofrey Musinguzi Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study BMC Public Health Tobacco Smoking Alcohol drinking Interaction effect High blood pressure |
| title | Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study |
| title_full | Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study |
| title_fullStr | Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study |
| title_full_unstemmed | Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study |
| title_short | Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study |
| title_sort | additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural uganda a community based cross sectional study |
| topic | Tobacco Smoking Alcohol drinking Interaction effect High blood pressure |
| url | https://doi.org/10.1186/s12889-025-21429-9 |
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