Patterns of smoking in Bulgaria

Background-Although the rate of smoking-related deaths in Bulgaria is still relatively low, in international terms, it has been rising rapidly. This is likely to become worse in the future as Bulgaria faces growing pressure from transnational tobacco companies. There is, however, little information on patterns of smoking, which is necessary for development of effective policies to tackle tobacco consumption. Objective-To describe the pattern of smoking in Bulgaria and its relationship with sociodemographic factors. Design-Multivariate analysis of data on patterns of tobacco consumption from a multi-stage nationwide survey of 1550 adults. Setting-Bulgaria, in 1997. Main outcome measure-Prevalence of current cigarette smoking. Results-38.4% of men and 16.7% of women smoke. Smoking rates are strongly associated with age, with 58% of men and 30% of women aged 30-39 smoking whereas only 5% of men aged 70 years and older and almost no women of this age smoke. Smoking is more common in cities, among those who are widowed or divorced, or who do not own their home. There is no clear association with household income or, for men, with education, although there is a suggestion that smoking may be more common among more highly educated women. Conclusions-The observed pattern of smoking indicates the need for a robust policy to tackle smoking in Bulgaria, especially among the young in large cities, informed by a better understanding of why smoking rates vary among different groups.