Knowledge and Attitude toward Smoke-Free Legislation and Second-Hand Smoking Exposure among Workers in Indoor Bars, Beer Parlors and Discotheques in Osun State of Nigeria

Document Type: Original Article

Authors

1 Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria

2 Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria

Abstract

Background
One of the requirements of the Osun State smoke-free legislation is to ensure smoke-free enclosed and partially enclosed workplaces. This survey was conducted to assess the knowledge and attitude of workers in indoor bars, beer parlors and discotheques to smoke-free legislation in general and the Osun State smoke-free law in particular.
 
Methods
A convenience sampling of 36 hospitality centers was conducted. Interviewer-administered questionnaires were used to elicit responses about the objectives from non-smoking workers. The questionnaires had sections on knowledge of the Osun State smoke-free law, attitude toward the law and smoke-free legislation in general and exposure to second-hand tobacco smoke by the workers. Questions were also asked about the secondhand tobacco smoking status of these workers. The data were analyzed using SPSS version 15.0.
 
Results
We had 154 participants recruited into the study. There were 75 males (48.0%) and 79 females (52.0%). On the overall, respondents had a good knowledge of the effects of second-hand smoke on health (70.2%) with 75.0% of them being aware of the general smoke-free law and 67.3% being aware of the Osun State smoke-free law although none of them had ever seen a copy of the law. A high proportion (60.0%) was in support of the Osun smoke-free law although all of them think that the implementation of the law could reduce patronage and jeopardize their income. Attitude toward second-hand smoking was generally positive with 72.0% of them having no tolerance for second-hand tobacco smoke in their homes. Most participants (95.5%) had been exposed to tobacco smoke in the workplace within the past week.
 
Conclusion
Despite the high level of awareness of the respondents about the dangers of second hand smoke and their positive attitude to smoke-free laws, nearly all were constantly being exposed to second hand smoke at work. This calls for policy level interventions to improve the implementation of the smoke-free law.

Keywords

Main Subjects


  1. US Environmental Protection Agency. Respiratory health effects of passive smoking: lung cancer and other disorders. Washington, DC: US Environmental Protection Agency, Office of Air and Radiation; 1992.
  2. Siegel M. Involuntary smoking in the restaurant workplace. A review of employee exposure and health effects. JAMA 1993; 270: 490-3. doi: 10.1001/jama.1993.03510040094036
  3. Maskarinec MP, Jenkins RA, Counts RW, Dindal AB. Determination of exposure to environmental tobacco smoke in restaurant and tavern workers in one US city. J Expo Anal Environ Epidemiol 2000; 10: 36-49. doi: 10.1038/sj.jea.7500069
  4. Alesci NL, Forster JL, Blaine T. Smoking visibility, perceived acceptability, and frequency in various locations among youth and adults. Prev Med 2003; 36: 272-81. doi: 10.1016/s0091-7435(02)00029-4
  5. Tang H, Cowling DW, Stevens CM, Lloyd JC. Changes of knowledge, attitudes, beliefs, and preference of bar owner and staff in response to a smoke-free bar law. Tob Control 2004;13: 87-9. doi: 10.1136/tc.2003.004390
  6. Eisner MD, Smith AK, Blanc PD. Bartenders’ respiratory health after establishment of smoke-free bars and taverns. JAMA 1998; 280: 1909-14.  doi: 10.1001/jama.280.22.1909
  7. Pursell L, Allwright S, O’Donovan D, Paul G, Kelly A, Mullally BJ, et al. Before and after study of bar workers’ perceptions of the impact of smoke-free workplace legislation in the Republic of Ireland. BMC Public Health 2007;7: 131. doi: 10.1186/1471-2458-7-131
  8. Rayens MK, Hahn EJ, Langley RE, Hedgecock S, Butler KM, Greathouse-Maggio L. Public opinion and smoke-free laws. Policy Polit Nurs Pract 2007; 8: 262-70.  doi: 10.1177/1527154407312736
  9. Tang H, Cowling DW, Lloyd JC, Rogers T, Koumjian KL, Stevens C. Changes of attitudes and patronage behaviors in response to a smoke-free bar law. Am J Public Health 2003; 93: 611-7doi: 10.2105/ajph.93.4.611
  10. World Health Organization (WHO). WHO Framework Convention on Tobacco Control. Geneva; WHO; 2005
  11. Surgeon General of the United States. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. [updated 2006 June 27; cited 2013 February 12]. Available from: http://www.surgeongeneral.gov/library/reports/secondhandsmoke/fullreport.pdf
  12. Salawu F, Danburam A, Agbo J, Onye-eri K. Awareness of the risks of cigarette smoking among patients in northeast Nigeria. Sahel Medical Journal 2007; 10: 29-33. doi: 10.4314/smj2.v10i1.12927
  13. Ibeh CC, Ele PU. Prevalence of cigarette smoking in young Nigerian females. Afr J Med Med Sci 2003; 32: 335-8.
  14. Salawu F, Danburam A, Isa B, Agbo J. Cigarette smoking habits among adolescents in northeast Nigeria. Int J Epidemiol 2010; 8(1). Available from: https://ispub.com/IJE/8/1/4789
  15. Faseru B, Barengo NC, Sandström HP, Omokhodion F. Smoking behavior and perception of risk among medical students in Ibadan, Nigeria. Global Heart 2006; 2: 103-9. doi: 10.1016/j.precon.2006.10.001
  16. Elegbeleye OO, Femi-Pearse D. Incidence and variables contributing to onset of cigarette smoking among secondary school children and medical students in Lagos, Nigeria. Br J Prev Soc Med 1976; 30: 66-70. doi: 10.1136/jech.30.1.66
  17. Omokhodion FO, Faseru BO. Perception of cigarette smoking and advertisement among senior secondary school students in Ibadan, Nigeria. West Afr J Med 2001; 26: 206-9. doi: 10.4314/wajm.v26i3.28310
  18. National Population Commission (NPC). Nigerian Population Facts and Figures 2005 [internet]. [cited 2013 May 12]. Available from: http://www.population.gov.ng
  19. Owusu-Dabo E, Lewis S, McNeill A, Gilmore A, Britton J. Support for smoke-free policy, and awareness of tobacco health effects and use of smoking cessation therapy in a developing country. BMC Public Health 2011; 11: 572.  doi: 10.1186/1471-2458-11-572
  20. Scollo M, Lal A, Hyland A, Glantz S. Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tob Control 2003, 12: 13-20.  doi: 10.1136/tc.12.1.13
  21. Alpert HR, Carpenter CM, Travers MJ, Connolly GN. Environmental and economic evaluation of the Massachusetts smoke-free workplace law. J Community Health 2007; 32: 269-81. doi: 10.1007/s10900-007-9048-6
  22. Eriksen M, Chaloupka F. The economic impact of Clean Indoor Air Laws. CA Cancer J Clin 2007; 57: 367-78.  doi: 10.3322/ca.57.6.367
  23. Luk R, Ferrence R, Gmel G. The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada. Addiction 2006; 101: 738-45. doi: 10.1111/j.1360-0443.2006.01434.x
  24. Melberg HO, Lund KE. Do smoke free laws affect revenues in pubs and restaurants? Eur J Health Econ 2012; 13: 93-9.  doi: 10.1007/s10198-010-0287-6
  25. World Health Organization (WHO). Tobacco or Health: a global status report. Geneva: WHO; 1997.
  26. Pilkington P, Gray S, Gilmore A, Daykin N.Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers. J Public Health 2006; 28: 104-10.  doi: 10.1093/pubmed/fdi086
  27. Hilton S, Semple S, Miller BG, MacCalman L, Petticrew M, Dempsey S, et al. Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland. BMC Public Health 2007; 7: 206. doi: 10.1186/1471-2458-7-206
  28. Hyland A, Higbee C, Borland R, Travers M, Hastings G, Fong GT, et al.Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: Findings from the International Tobacco Control Four Country Survey. Nicotine and Tobacco Research 2009; 11: 642-9. doi: 10.1093/ntr/ntp063
  29. Travers M, Cummings K, Hyland A, Repace J, Babb S, Caraballo R. Indoor Air Quality in Hospitality Venues Before and After the Implementation of a Clean Indoor Air Law – Western New York. MMWR 2003; 53: 1038-41. doi: 10.1097/01.cot.0000291669.36813.6f
  30. Akhtar PC, Haw SJ, Levin KA, Currie DB, Zachary R, Currie CE. Socioeconomic differences in second-hand smoke exposure among children in Scotland after introduction of the smoke-free legislation. J Epidemiol Community Health 2010; 64: 341-6. doi: 10.1136/jech.2008.084178
  31. Bohac DL, Hewett MJ, Kapphahn KI, Grimsrud DT, Apte MG, Gundel LA. Change in indoor particle levels after a smoking ban in Minnesota bars and restaurants. Am J Prev Med 2010; 39: S3-9. doi: 10.1016/j.amepre.2010.09.012
  32. Brennan E, Cameron M, Warne C, Durkin S, Borland R, Travers MJ, et al. Secondhand smoke drift: Examining the influence of indoor smoking bans on indoor and outdoor air quality at pubs and bars. Nicotine Tob Res 2010; 12: 271-7.