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Mbulo L, Palipudi K, Smith T, Owusu D, Williams F, Dean AK, Mamudu HM. Secondhand Smoke Exposure Inside the Home Among Adults in Eight Countries in Sub-Saharan Africa: Global Adult Tobacco Survey, 2012-2018. Nicotine Tob Res 2023; 25:828-837. [PMID: 36272102 PMCID: PMC10032190 DOI: 10.1093/ntr/ntac247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 10/06/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Secondhand tobacco smoke (SHS) exposure causes diseases and death in adults and children. Evidence indicates that most SHS exposures occur at home and in the workplace. Therefore, home is a major place where adults and children can be effectively protected from SHS. This study examined the magnitude of SHS exposure at home and associated factors in eight sub-Saharan African countries. AIMS AND METHODS We analyzed 2012-2018 Global Adult Tobacco Survey data for Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda. We computed prevalence estimates of self-reported monthly SHS exposure at home reported as anyone smoking inside their home daily, weekly, or monthly. We calculated SHS exposure at home prevalence and applied multivariable logistic regression models to identify related factors. RESULTS Overall median prevalence of SHS exposure at home was 13.8% in the eight countries; ranging from 6.6% (95% CI: 5.7%, 7.6%) in Nigeria to 21.6% (95% CI: 19.4%, 24.0%) in Senegal. In multivariable analysis across the countries, SHS exposure at home was associated with living with a smoker, ranging from an adjusted odds ratio (AOR) of 4.6 (95% CI: 3.6, 5.8) in Botswana to 27.6 (95% CI: 20.1, 37.8) in Nigeria. SHS exposure at home was significantly associated with lower education attainment (Kenya and Ethiopia), and lower wealth index (Uganda, Senegal, and Botswana). CONCLUSIONS SHS exposure in homes was associated with the presence of a smoker in the home and lower socioeconomic status.
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Affiliation(s)
- Lazarous Mbulo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Krishna Palipudi
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tenecia Smith
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel Owusu
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna K Dean
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Noninfectious Diseases Program, CDC Foundation, Atlanta, GA, USA
| | - Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
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Argefa TG, Carnegie T, Kassa SA, Kitonyo-Devotsu R, Mdege ND. Tobacco advertising, promotion, and sponsorship (TAPS) in Ethiopia: a scoping review and narrative synthesis. JOURNAL OF GLOBAL HEALTH REPORTS 2023. [DOI: 10.29392/001c.57372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background Tobacco advertising, promotion and sponsorship (TAPS) has been shown to increase tobacco use in both adults and young people. In Ethiopia, TAPS is recognised as a top priority for the government, and all tobacco advertising, promotion, and sponsorship forms are prohibited. There is recognition that there are gaps in the evidence needed to inform policy and practice on TAPS, but the extent and nature of these gaps have not been explored. This review was aimed at understanding the extent and nature of the evidence gaps on TAPS in Ethiopia and identifying primary research priorities to inform future research direction. Methods Systematic searches were conducted in February 2022 in the following research databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the study reports for eligibility and extracted data from the eligible studies. The extracted data was collated and summarised descriptively and policy, practice, and research recommendations were drawn. Research topics on TAPS in Ethiopia that stakeholders perceived to be priorities for primary research were identified through a consultation workshop. Results 579 research reports were identified, and only six studies were included in the scoping review. The included studies explored the following topics: the use of tobacco imagery in movies/films (two studies); the association between mass media exposure or home internet access and tobacco use (two studies), watching of televised football and tobacco smoking in adolescents (one study), exposure to point-of-sale advertising of tobacco products and daily occurrence of smoking or second-hand smoke exposure in the home among women (one study), and exposure to anti-smoking messages through mass media and disparities in risk perceptions across socio-economic and urban-rural subgroups (one study). None of the included studies investigated tobacco-related sponsorship. The top research priority topics identified by stakeholders in Ethiopia were: 1) barriers and facilitators to TAPS policy implementation, enforcement, and compliance monitoring; and 2) developing and testing effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring. Conclusions There is a need for research evidence to inform policy and practice on TAPS in Ethiopia, particularly on barriers and facilitators to TAPS policy implementation, enforcement, compliance monitoring, and effective, low-cost, and scalable strategies for TAPS enforcement and compliance monitoring.
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Affiliation(s)
- Terefe G. Argefa
- ICAP at Columbia University Mailman School of Public Health, Addis Ababa, Ethiopia
- Development Gateway: an IREX Venture, Washington, DC, United States
| | - Tyryn Carnegie
- Development Gateway: an IREX Venture, Washington, DC, United States
| | - Selam A. Kassa
- Development Gateway: an IREX Venture, Washington, DC, United States
| | | | - Noreen D. Mdege
- Development Gateway: an IREX Venture, Washington, DC, United States
- Department of Health Sciences, University of York, York, United Kingdom
- Centre for Research in Health and Development, Amos Drive, York, United Kingdom
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Bitan M, Steinberg DM, Wilson SR, Kalkbrenner AE, Lanphear B, Hovell MF, Gamliel VM, Rosen LJ. Association between objective measures and parent-reported measures of child tobacco smoke exposure: A secondary data analysis of four trials. Tob Induc Dis 2022; 20:62. [PMID: 35854878 PMCID: PMC9241496 DOI: 10.18332/tid/150296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco smoke exposure (TSE) harms children and adults. Studies of childhood TSE exposure often relies on parental reports, but may benefit from objective measures. The objective of our study was to study the relationship between reported and objective measures of TSE. METHODS We analyzed data from four intervention trials, conducted in clinical or community settings, to identify objective measures most closely associated with parent-reported measures and the optimal set of parent-reported measures for predicting objective measures. We also assessed whether there was a learning curve in reported exposure over time, and the importance of replicate biomarker measures. RESULTS Correlations between objective and parent-reported measures of child TSE were modest at best, ranging from zero to 0.41. Serum cotinine and urinary cotinine were most strongly associated with parental reports. Parental questions most closely related to biomarkers were number of cigarettes and home smoking rules; together these formed the best set of predictive questions. No trial included all objective measures and all questions, precluding definitive statements about relative advantages. Within-subject repeatability of biomarker measures varied across studies, suggesting that direct pilot data are needed to assess the benefit of replicate measurements. CONCLUSIONS Improvements in objective and parent-reported child exposure measurements are needed to accurately monitor child TSE, evaluate efforts to reduce such exposure, and better protect child health.
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Affiliation(s)
- Michal Bitan
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel.,School of Computer Science, The College of Management Academic Studies, Rishon LeZion, Israel
| | - David M Steinberg
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Sandra R Wilson
- Department of Medicine, Stanford University School of Medicine, Palo Alto, United States
| | - Amy E Kalkbrenner
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, United States
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Melbourne F Hovell
- School of Public Health, San Diego State University, San Diego, United States
| | - Vicki Myers Gamliel
- The Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Department of Health Promotion, Tel Aviv University, Tel Aviv, Israel
| | - Laura J Rosen
- Department of Health Promotion, Tel Aviv University, Tel Aviv, Israel
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Second-Hand Tobacco Smoke Exposure and Smoke-Free Environments in Ethiopia: A Scoping Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148404. [PMID: 35886256 PMCID: PMC9324201 DOI: 10.3390/ijerph19148404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 01/27/2023]
Abstract
Ethiopia passed a law prohibiting tobacco smoking in all public places in 2019. We conducted a scoping review to identify gaps in the existing literature on second-hand smoke (SHS) exposure and smoke-free environments in Ethiopia that need to be prioritised for future research to support policy and practice. We conducted systematic searches in January 2022 in the following databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the identified study reports for eligibility and extracted data from the eligible studies. The extracted data was descriptively analysed, and research recommendations were drawn. A stakeholder consultation workshop was held to identify research topics on SHS exposure and smoke-free environments in Ethiopia that they perceived to be priorities for primary research. Of the 388 research reports identified, only nine were included in the scoping review. The topics explored includes prevalence of SHS exposure (six studies); knowledge on SHS exposure (three studies); compliance to smoke-free environments legislation (two studies); and exposure to anti-smoking messages (one study). The stakeholders prioritised further research addressing compliance monitoring and enforcement of the smoke free laws in Ethiopia. There is a need for studies that test new methods for compliance monitoring and enforcement, evaluate strategies to increase knowledge on the harms of SHS exposure and the smoke-free legislation, and evaluate the current smoke-free legislation in Ethiopia.
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Tesfay FH, Backholer K, Zorbas C, Bowe SJ, Alston L, Bennett CM. The Magnitude of NCD Risk Factors in Ethiopia: Meta-Analysis and Systematic Review of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095316. [PMID: 35564716 PMCID: PMC9106049 DOI: 10.3390/ijerph19095316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Background: Non-communicable Diseases (NCDs) and their risk factors are the leading contributors to morbidity and mortality globally, particularly in low- and middle-income countries including Ethiopia. To date, there has been no synthesis of the literature on the relative prevalence of NCD risk factors in Ethiopia. Methodology: We conducted a systematic review and meta-analysis of primary studies reporting on the prevalence of NCD risk factors in Ethiopia published in English from 2012 to July 2020. Pre-tested NCD search terms were applied to Medline, Embase, Scopus, CINAHL, and Global Health. Three reviewers screened and appraised the quality of the identified papers. Data extraction was conducted using a pilot tested proforma. Meta-analysis was conducted using Stata 16 and pooled prevalence estimated with associated 95% confidence intervals. Clinically heterogeneous studies that did not fulfil the eligibility criteria for meta-analysis were narratively synthesised. I2 was used to assess statistical heterogeneity. Results: 47 studies fulfilled the inclusion criteria and contributed 68 NCD risk factor prevalence estimates. Hypertension was the most frequently examined NCD risk factor, with a pooled prevalence of 21% (n = 27 studies). The pooled prevalence percentages for overweight and obesity were 19.2% and 10.3%, respectively (n = 7 studies each), with a combined prevalence of 26.8% (n = 1 study). It was not possible to pool the prevalence of alcohol consumption, smoking, metabolic disorders, or fruit consumption because of heterogeneity across studies. The prevalence of alcohol use, as reported from the included individual studies, ranged from 12.4% to 13.5% (n = 7 studies). More than 90% of participants met the WHO-recommended level of physical activity (n = 5 studies). The prevalence of smoking was highly variable, ranging between 0.8% and 38.6%, as was the prevalence of heavy alcohol drinking (12.4% to 21.1%, n = 6 studies) and metabolic syndrome (4.8% to 9.6%, n = 5 studies). Fruit consumption ranged from 1.5% up to the recommended level, but varied across geographic areas (n = 3 studies). Conclusion and recommendations: The prevalence of NCD risk factors in Ethiopia is relatively high. National NCD risk factor surveillance is required to inform the prioritisation of policies and interventions to reduce the NCD burden in Ethiopia.
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Affiliation(s)
- Fisaha Haile Tesfay
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
- College of Medicine and Health Sciences, School of Public Health, Mekelle University, Mekelle P.O. Box 231, Ethiopia
- Correspondence:
| | - Kathryn Backholer
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Christina Zorbas
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Steven J. Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong 3220, Australia;
| | - Laura Alston
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Catherine M. Bennett
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
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Affiliation(s)
- Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
| | - Şeyda Ünver
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
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Non-Smoker's Exposure to Second-Hand Smoke in South Africa during 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218112. [PMID: 33153154 PMCID: PMC7662655 DOI: 10.3390/ijerph17218112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 02/08/2023]
Abstract
Current South African tobacco control law allows for 25% designated smoking areas in some indoor public places. This study investigates non-smokers’ exposure to second-hand smoke (SHS) in workplaces, homes, cafés/restaurants, and shebeens (local bars) using data from the 2017 South African Social Attitude Survey. Factors associated with any level of exposure were explored using multiple-variable-adjusted logistic regression analysis. The sample of 3063 participants (16+ years old), comprised 51.7% females and 78.5% Black Africans. The current smoking prevalence from this study was 21.5%. About 47% of non-smokers reported exposure to SHS in at least one location. Females were significantly less likely to be exposed to SHS in all locations except at home compared to males. Adjusted logistic regression analysis showed that females, adults aged 45–54 years, 55–64 years, and 65+ years were significantly less likely to be exposed to SHS (adjusted odds ratio (AOR) = 0.63, 0.60, 0.55, and 0.24, respectively) than males and those aged 16–24 years. Those who identified as Coloureds were significantly more likely to be exposed to SHS (AOR = 1.69) than Black Africans. This study found that nearly half of non-smokers reported exposure to SHS. A 100% smoke-free policy consistent with the World Health Organisation (WHO) Framework Convention on Tobacco Control would protect more people from exposure to SHS in South Africa.
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Chen J, Li X, Fang P. Influence of family resources on secondhand smoking in pregnant women: a cross-sectional study in the border and minority urban areas of Northwest China. BMC Pregnancy Childbirth 2020; 20:642. [PMID: 33087094 PMCID: PMC7579793 DOI: 10.1186/s12884-020-03251-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 09/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnant women's exposure to secondhand smoke is a very serious health issue in China. The purpose of our research is to identify factors that predict the probability of exposure to secondhand smoke among pregnant women from the perspective of a family-based open system. METHODS From September 2014 to August 2015, Urumqi City, Shihezi City, and Shawan County-level City were sampled according to population characteristics. A revised structured questionnaire based on family resources was adapted for use in this study. Questionnaires were collected via convenience sampling at the hospitals with the largest number of local antenatal clients. A total of 1249 pregnant women of age 18-51 years were investigated. Descriptive statistics were calculated to characterize the participants and study variables. Binary logistic regression was performed to assess the impact of family resources corresponding variables on the likelihood that participants would be exposed to SHS. Both unadjusted and adjusted odds ratios (OR/AOR) [with 95% confidence intervals (CI)] were reported. RESULTS The secondhand smoke exposure rate found in this study was 54.6%. Having good knowledge of the dangers of secondhand smoke had no effect on reducing the prevalence of exposure (P > 0.05). Even pregnant women whose husbands who did not use tobacco or never smoked nearby had a risk of exposure to secondhand smoke [adjusted odds ratio (AOR) 1.568, 95% CI 1.205-2.041] when the data were adjusted for age, gravidity, gestational weeks, knowledge of the dangers of secondhand smoke, location, and work status. Home smoking bans were confirmed to be an important protective factor (AOR 1.710, 95% CI 1.549-1.918); however, only one-third (33.5%) of participants reported having a smoking ban at home. Religion (mainly Islam), as a special external family resource, was a protective factor that reduced secondhand smoke exposure in pregnant women (AOR 0.399, 95% CI 0.312-0.510). CONCLUSIONS The effect of family resources on tobacco control should be considered in the development of effective and enduring strategies for indoor smoking bans and smoking cessation.
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Affiliation(s)
- Jiangyun Chen
- School of Health Services Management, Southern Medical University, No. 1023-1063 Shatai Road, Baiyun District, Guangzhou, 510515 Guangdong China
| | - Xinhui Li
- School of Medicine, Shihezi University, No.221 Beisi Road, Shihezi, Xinjiang, 832002 Uygur Autonomous Region China
| | - Pengqian Fang
- Academy of Health Policy and Management, Huazhong University of Science and Technology (Think tank), No.13 Hangkong Road, Qiaokou District, Wuhan, 430030 Hubei China
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Qiaokou District, Wuhan, 430030 Hubei China
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Chang CY, Hsieh YP, Lan SJ, Ho CS. SHS exposure among high school students in Taiwan. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1652363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan R.O.C
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan R.O.C
| | - Yen-Ping Hsieh
- Department of Long-term Care, National Quemoy University, Kinmen, Taiwan R.O.C
| | - Shou-Jen Lan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, R.O.C
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, R.O.C
| | - Ching-Sung Ho
- Department of Long-term Care, National Quemoy University, Kinmen, Taiwan R.O.C
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Petersen AB, Thompson LM, Dadi GB, Tolcha A, Cataldo JK. An exploratory study of knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke among women in Aleta Wondo, Ethiopia. BMC WOMENS HEALTH 2018; 18:154. [PMID: 30249233 PMCID: PMC6154788 DOI: 10.1186/s12905-018-0640-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 08/28/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND By 2030, the Sub-Saharan African region is projected to be the epicenter of the tobacco epidemic. While smoking prevalence is currently low among women (< 2%), the prevalence among men (7.7% overall and up to 27% depending on region) makes exposure to secondhand smoke a pressing concern for women and children. To prevent the uptake of smoking among women and address tobacco-related risks, including secondhand smoke exposure, a greater understanding of women's related perceptions is needed. The purpose of this study was to explore Ethiopian women's knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke exposure, and the potential influence of contextual factors including; khat use, exposure to pro- and anti-tobacco messaging, and religious affiliation. METHODS A cross-sectional study using a systematic household sampling technique and an adapted interviewer-administered survey was conducted in Southern Ethiopia. The survey was administered to 353 women, 18-55 years of age, in Aleta Wondo town and surrounding districts between August-October 2014 (95.2% cooperation rate). RESULTS General awareness of harm associated with personal tobacco use and exposure to secondhand smoke was high (> 94%); however, specific knowledge of associated health-risks was limited. More than 96% perceived female tobacco use as socially unacceptable. At the same time, more than 70% were able to name potential benefits of using tobacco for both personal consumption and non-personal use. Respondents reported greater experimentation with khat versus tobacco and 73% reported that their religion significantly influenced their tobacco-related attitudes. Overall, there were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging, in the last 30 days. CONCLUSIONS The high level of awareness of health risks associated with tobacco use and SHS exposure and the high exposure to anti-tobacco messaging are community-level strengths that can proactively be built on to prevent the projected disease burden associated with tobacco. Findings have implications for the development of contextualized gender-specific tobacco control interventions, particularly in relation to the promotion of smoke-free homes.
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Affiliation(s)
- Anne Berit Petersen
- School of Nursing, Loma Linda University, West Hall, 11262 Campus Street, Loma Linda, CA, 92350, USA. .,Department of Physiological Nursing and Center for Tobacco Control Research and Education, University of California, San Francisco, 2 Koret Way, N611Q, San Francisco, CA, 94143, USA.
| | - Lisa M Thompson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Suite 226, Atlanta, GA, 30322, USA
| | - Gezahegn Bekele Dadi
- School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, PO Box 1560, Hawassa, Ethiopia
| | - Alemu Tolcha
- School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, PO Box 1560, Hawassa, Ethiopia
| | - Janine K Cataldo
- Department of Physiological Nursing and Center for Tobacco Control Research and Education, University of California, San Francisco, 2 Koret Way, N611Q, San Francisco, CA, 94143, USA
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Bekalu MA, Viswanath K. Smoking portrayal in Ethiopian movies: a theory-based content analysis. Health Promot Int 2018; 34:687-696. [DOI: 10.1093/heapro/day013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Considerable research from high-income countries has characterized the amount, nature and effects of movie smoking depiction. However, in low- and middle-income countries (LMICs) where tobacco use and tobacco-related diseases are growing, little research has investigated smoking imagery in movies. This study examined the extent and nature of smoking portrayal in locally produced Ethiopian movies, and estimated the number of tobacco impressions movies delivered. Sample movies were taken from YouTube. Keyword searches were conducted using ‘Ethiopian movies’ and ‘Ethiopian drama’ on 18 September 2016. In each search, the first 100 most viewed movies were examined. Excluding repeated results, a total of 123 movies were selected for content analysis. Three coders participated. Results indicated that 86 (69.9%, 95% CI 63–78%) of the 123 most viewed movies contain at least one tobacco incident (TI). The movies depict a total of 403 TIs, with an average of 4.7 (95% CI 3.7–5.6) TIs in each movie. The average length of TIs is 1 min and 11 s. On average, the movies were viewed more than half a million times by September 2016, and received more ‘likes’ than ‘dislikes’, z = −8.05, p = 0.00. They delivered over 194 million tobacco impressions via YouTube alone from July 2012 through September 2016. Most TIs portray smoking as a socially acceptable behavior with no negative health consequences. The findings suggest that as with transnational Western movies, locally produced movies in LMICs should be scrutinized for compliance with national and international regulatory efforts.
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Affiliation(s)
- Mesfin Awoke Bekalu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA, and Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - K Viswanath
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA, and Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
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