Disparities in Tobacco Smoking by Sex and Employment Status: Results from South Africa’s First Global Adult Tobacco Survey

Background/Objectives: Tobacco smoking is a cause of premature death and illness globally. This study examined the prevalence and factors associated with tobacco smoking among South African adults according to sex, education, and employment status among socio-demographic subgroups. Methods: Data were obtained from the 2021 South African Global Adult Tobacco Survey (a nationally representative household survey using a multi-stage stratified cluster random sampling design). The 6311 participants were aged 15+ years. Descriptive statistics, chi-square tests, and multiple logistic regression analysis were used to investigate relationships between current smoking and socio-demographic variables. Results: Smoking prevalence was 25.8% (n = 1573) (41.2% among men, 11.5% among women; 29.9% among working individuals, 23.1% among non-working individuals). The multiple logistic regression results showed that males aged 45–64 were twice as likely to be currently smoking than males aged 15–24. Coloured (of mixed race) males were twice as likely to smoke as Black African males. Males with secondary/post-secondary education were less likely to smoke compared to males with no education. Coloured females were seven times and White females were almost five times more likely to smoke than Black African females. Females with post-secondary education were less likely to smoke than those with no formal education. Females earning an income were more likely to smoke compared to those with no income. Non-working participants aged 25–44 and 45–64 were more likely to smoke compared to those aged 15–24 years. Working and non-working Coloured and working White individuals were three times more likely to smoke than working or non-working Black Africans. Conclusion: Groups with higher identified smoking prevalence may indicate where smoking cessation interventions should be targeted to reduce national smoking prevalence.