Prevalence of the Alcohol and Tobacco risks factors and its associated behavior in Rwanda  

In 2022, the Rwanda Ministry of Health and the Rwanda Biomedical Centre achieved a significant milestone by successfully conducting the first mobile phone survey to assess the prevalence of selected Non-Communicable Diseases (NCDs) risk factors in the country. This groundbreaking initiative demonstrated the feasibility of utilizing innovative methods for research purposes, yielding valuable results that could be compared with those obtained from traditional STEPS surveys.

Building on this success, in 2023 we embarked on a similar endeavor, focusing specifically on studying alcohol and tobacco risk factors, along with associated attitudes and behaviors. The primary objective of this 2nd survey was to gather nationally representative estimates of indicators related to alcohol and tobacco use, as well as attitudes toward their consumption. These findings aimed to inform programmatic recommendations for enhancing prevention and response efforts within the country. Moreover, the results from this survey will be used to complement those obtained from the WHO Stepwise survey and other national surveillance systems, enriching the understanding of key behavioral risk factors. Finally it will boost the ongoing TUNYWELESS campaign in an effort of reducing alcohol consumption in the country.

A total of 3,027 Rwandan adults participated in the survey, all of whom were subscribers to MTN and Airtel. Participants were selected randomly through random digit-dialing methods and were invited to complete the survey using short message service (SMS, text messaging).

Findings revealed that:

• Approximately 6% of Rwandan adults reported being current tobacco users with 3.7% reporting current tobacco smoking and 2.2% reporting current smokeless tobacco use. Men were more likely to report any type of tobacco use than women.
• Very few adult Rwandans reported ever using e-cigarettes (4.5%). Overall, 3% of adult Rwandans reported exposure to tobacco smoke in their home while 13.0% reported exposure at work.
• Overall, two in five (41.9%) reported alcohol consumption in the past year, and 12.5% reported daily use with approximately one in three adult Rwandans reported consuming alcohol in the past 30 days (30.8%).
• Less than 6% of adult Rwandans reported drinking six or more drinks on one occasion, and drinking with friends or family as well as a celebration or party were the primary reasons for consuming multiple drinks at one time.
• Fewer than one in ten adult Rwandans sought treatment for alcohol in the past 12 months with women slightly more likely to seek treatment than men.

• Nine out of ten adult Rwandans thought regular use of alcohol is somewhat-to-very harmful with only 6% reporting that it is not harmful.
• More than half of adult Rwandans reported that an increase in the price of alcohol would make them buy alcohol less often, and approximately 84% had seen or heard information on the dangers of alcohol with radio (36.9%) and television (27.3%) being the most common sources of that information.
• Men were more likely than women to report that alcohol was not harmful, buy alcohol for themselves or others in the household, be asked to show proof of age for alcohol purchases, and to have seen ads promoting alcohol in the past 30 days.

Alcohol and tobacco and their associated risk factors have profound consequences on individuals and Rwandan society at large. The data presented in the Rwanda ATob MPS provide a strong foundation for the development of prevention and response strategies in Rwanda.

Findings from this survey help provide a national baseline on two modifiable NCD risk factors for Rwandan adults aged 18 years and older. Results will inform the Ministry of Health in Rwanda as they improve and enhance alcohol and tobacco prevention and control efforts.