Cigarette Prevalence in South Africa

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Smoking prevalence among South African adults (aged 15 years and over) increased from 19% in 2017 to 24% in 2021.

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Smoking prevalence was markedly higher among men (39%) relative to women (10%) in 2021.

Recent data from the Global Adult Tobacco Survey (GATS) factsheet indicate that smoking prevalence has risen in South Africa. In 2017, cigarette smoking prevalence among adults aged 15 years and older was estimated at 19.4%.

This was high relative to similarly situated countries; for example, the prevalence of cigarette smoking among adults aged 15–49 was 8% in Kenya in 2014 and 3.4% in Nigeria in 2018. New estimates indicate that 23.9% of adults (aged 15+) smoked cigarettes in South Africa in 2021. Extrapolating this to the latest national census data, this translates to about 10.4 million South African smokers.

In 2020, as part of the COVID-19 lockdown, the South African government imposed a ban on all tobacco sales. The ban lasted for 20 weeks, beginning 25 March and ending 17 August 2020. Although not nationally representative, data collected during and after the ban suggest that tobacco prevalence fluctuated over this period, since some pre-ban smokers quit during the ban, and then many relapsed after the ban was lifted.

This page explores differences in cigarette prevalence by gender and age in South Africa. Unless otherwise stated, the South African data are derived from the South African Global Adult Tobacco Survey 2021.

This webpage will be updated with more information as additional GATS data become available in 2024 and research exploring ban-related changes in prevalence is published. Data showing cigarette prevalence by race will also be included when the new GATS data becomes available. Currently, we do not include prevalence by race as data is only available up to 2018, which is before the sales ban.

A one page fact sheet with the key information from this page is available here.

To learn more about the data and methods used in this page, click here.

Cigarette smoking is significantly more prevalent among men than women in South Africa.

39.1% of men (about 8.2 million people) and 9.7% of women (about 2.2 million) aged 15 years and over smoked cigarettes in South Africa in 2021. This gender disparity is broadly in line with the global trend, which may be attributed to social disapproval of women who smoke and to men generally having more disposable income with which to buy cigarettes in comparison to women.

This prevalence gap between genders is similarly large in many developing countries. For example, in Kenya, 15.8% of men and 0.4% of women smoked in 2014, and in Nigeria, 5% of men and 0.3% of women smoked in 2018. Further, in a combined study of current smokers in South Africa, Kenya, Ghana, and Burkina Faso, it was found that smoking prevalence among men was 34.5%, in comparison to 2.1% for women. In some countries, this gender difference was very marked. For instance, in Gambia, men were 33 times more likely to smoke tobacco than women, with a prevalence rate of 19.3% for men and 0.65% for women.

Cigarette Prevalence by Gender, 2021

OverallMaleFemale0.0%5.0%10.0%15.0%20.0%25.0%30.0%35.0%40.0%Prevalence (%)23.9%39.1%9.7%

Source: GATS, 2021

Middle-aged people are the most likely to smoke tobacco, compared to the youth and elderly.

Tobacco smoking prevalence (which included manufactured cigarettes and roll-your-own) was highest among middle-aged people: 25–44-year-olds (26.7%) and 45–64-year-olds (28.6%). This age bracket includes the greatest number of South Africans, which means that this bracket also includes the vast majority of smokers (about 8.2 million). For the age groups 15–24 years old and 65+ years old, smoking prevalence rates were 23.9% (2.3 million) and 18.9% (709,000) respectively. Preventing young people from initiating or experimenting with smoking, as well as strictly enforcing the ban on cigarette sales to anyone under the age of 18, is crucial to stopping them from becoming lifelong smokers.

Tobacco Prevalence by Age

15-2425-4445-6465+0.0%2.0%4.0%6.0%8.0%10.0%12.0%14.0%16.0%18.0%20.0%22.0%24.0%26.0%28.0%30.0%Prevalence (%)23.9%26.7%28.6%18.9%

Source: GATS, 2021

The smoking prevalence for men and women generally increases with age.

In 2021, 36.9% of male youth aged 15–24 years (1.8 million), 41.7% of men aged 25–44 years (4.2 million), and 47.4% of men aged 45–64 years (2.2 million) smoked. Smoking prevalence among elderly men (65+ years) was somewhat lower, with a prevalence of 32.0% (~451,000).

A similar age trend was evident for women. In 2021, 10.7% of female youth (~520,000), 11.5% of women aged 25–44 years (1.1 million), 12.6% of women aged 45–64 years (~686,000), and 11.0% of women over 65 years smoked (~258,000).

Gender and Age

FemaleMale0.0%5.0%10.0%15.0%20.0%25.0%30.0%35.0%40.0%45.0%Prevalence (%)10.7%36.9%11.5%41.7%12.6%47.4%11.0%32.0%

Source: GATS, 2021

Globally, tobacco prevalence has generally been declining over time.

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South Africa: Tobacco smoking prevalence among people over 35 declined from 25.0% in 1998 (40.5% in males, 10.9% in females) to 19.4% in 2012 (31.9% in males, 7.9% in females), but plateaued after 2010.

While the limited data released by GATS for 2021 are not perfectly comparable to the study referenced above, the GATS estimates suggest that some of the reductions in smoking prevalence have eroded in recent years, with overall prevalence increasing to 23.9% in 2021.

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Sub-Saharan Africa: In 2018, tobacco use prevalence in Sub-Saharan Africa ranged from 4.5% in Ghana to 46% in Lesotho.

In most Sub-Saharan countries, tobacco prevalence declined markedly from 2003–2018. The World Health Organization target of a 30% decrease in smoking was achieved for male participants in eight African countries: Rwanda, Nigeria, Ethiopia, Benin, Liberia, Tanzania, Burundi, and Cameroon; the target was achieved for female participants in fifteen countries: Cameroon, Namibia, Mozambique, Mali, Liberia, Nigeria, Burundi, Tanzania, Malawi, Kenya, Rwanda, Zimbabwe, Ethiopia, Burkina Faso, and Zambia.

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Worldwide: Globally, smoking prevalence among people aged 15 and over has fallen from 22.7% to 17.5%.