Cigarette Prevalence in South Africa
Smoking prevalence among South African adults (aged 15 years and over) increased from 19% in 2017 to 24% in 2021.
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%.
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.
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.
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.
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).
Globally, tobacco prevalence has generally been declining over time.
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.
Sub-Saharan Africa: In 2018, tobacco use prevalence in Sub-Saharan Africa ranged from 4.5% in Ghana to 46% in Lesotho.
Worldwide: Globally, smoking prevalence among people aged 15 and over has fallen from 22.7% to 17.5%.