Objectives. I examined demographic and socioeconomic patterns of tobacco use in 2 African nations in the early stages of epidemic.

Methods. I used population-based data from the Demographic Health Surveys of men aged 15–59 years (N=5111) and women aged 15–49 years (N=20809) in Malawi (2000) and Zambia (2001/2002) and multinomial logistic regression models to examine tobacco use (nonsmoker, light cigarette smoker, heavy cigarette smoker, and user of other tobacco) as a function of age, residence, education, occupation, marital status, and religion.

Results. Male tobacco users tend to be less educated, urban, household service or manual workers, formerly married, and non-Christian and non-Muslim. Although tobacco use is less common among women, it relates inversely to their education and occupational status. Tobacco users more often reported drinking, getting drunk, and, among men, paying for sex.

Conclusions. Tobacco use patterns in 2 African nations at the early stages of epidemic suggest the need for public health officials to focus on disadvantaged groups to prevent the worldwide spread of tobacco.