Tobacco smoking is a significant public health problem and one of the leading causes of deaths from preventable diseases worldwide. Its negative impact on human capital has considerable repercussions for the real economy; it harms individuals during their most productive years, depriving families of their principal source of income and the nation of essential labour. Despite the fact that smoking incidences have decreased over the last thirty years, South Africa still has a large number of smokers, with female smoking rates on the rise. Given the critical role women play in the society, tobacco smoking can have intergenerational consequences, as women are caregivers and bringers of life. As a result, it is crucial to investigate tobacco consumption's connection with the general well-being of households in South Africa. The study is based on four critical objectives. The first objective examined the relationship between tobacco consumption and mental health behaviours (MHBs). The Heckman selection, double hurdle ``model, and control function technique were used to account for this challenge. The results show that Mental Health Behaviours significantly impact a person's decision to smoke but not the intensity or frequency of their smoking. It can therefore be concluded that mental health behaviours are drivers of tobacco consumption as it might be used as a self-medication strategy.
The second objective examined the association between maternal tobacco use and body weight abnormalities in South African children aged between 0 and 5 years old. The logistic regression model was used to estimate the marginal effect of maternal smoking on childhood overweight prevalence as measured by three anthropometric-based proxies: the risk of being overweight, being overweight, and child obesity. Empirical findings revealed that maternal smoking exhibits a significant probability of weight abnormalities in children. Notably, children of smoking mothers are likely to be obese, overweight or at risk of becoming overweight. Overall, maternal smoking contributes to child overweight and obesity in South Africa.
The third objective investigated the relationship between fertility and maternal smoking. The Poisson regression model was employed in the analysis of maternal and external smoking and its effects on the likelihood of having children. Empirical results confirmed that maternal smoking and external smoking significantly influence fertility negatively in South Africa.
The fourth objective investigated how inequality affects the substitution of essential goods as a result of increase in tobacco expenditure in South Africa. The study made use of already collected data of the first five waves of the NIDS (2008–2017), a household survey conducted by the Southern Africa Labour and Development Research Unit. The study compared the conditional expenditure shares of various types of households using econometric models such as methods of moments quantile regression (MMQR). The study revealed that the substitution effect is most prevalent in low-income or poor households and wealthy households in South Africa and has no effect on the middle-class or middle-income earners. The findings revealed that low-income households whose heads smoke tobacco invest less in their children's education, while well-educated heads of high-income households’ place as much value on their children's education as they do on cigarette expenditure. Also, the study points out that the share of income spent on cigarettes by black household heads is negatively connected to their children's education across all quantiles as compared to non-blacks. Also, low-income households are more likely to experience the substitution impact than high-income households. This study recommends, among other things, that policymakers should prioritize programs to reduce smoking, especially among pregnant women and caregivers, to minimize the risk of being overweight in children; comprehensive action programs, including child support grants and recommendations for treatment plans that address the problems of children who are already overweight, should remain essential; awareness should be created in communities on the harmful effects of smoking; neighbourhood-based intervention program that educate women about the dangers of maternal and external exposure smoking are required.