Exposure to secondhand smoke in hospitality settings in Ghana: Evidence of changes since implementation of smoke-free legislation
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School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
African Centre for Clean Air, Kampala, Uganda
University of Stirling, Stirling, United Kingdom
Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
Faculty of Social Sciences, Tampere University, Tampere, Finland
Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
King’s College London, London, United Kingdom
Arti Singh   

School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Publication date: 2020-05-20
Tob. Induc. Dis. 2020;18(May):44
Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM2.5) in hospitality venues in Ghana.

This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana.

Smoking was observed in a third of the venues visited. The median indoor PM2.5 concentration was 14.6 μg/m3 (range: 5.2–349). PM2.5 concentrations were higher in venues where smoking was observed (28.3 μg/m3) compared to venues where smoking was not observed (12.3 μg/m3) (p<0.001). Hospitality locations in Accra, Ghana’s capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale.

The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.

The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. A. McNeill reports grants from Research Councils UK, as part of the Global Challenges Research Fund, during the conduct of the study.
This work was supported by UK Research and Innovation (UKRI) with funding from the Global Challenges Research Fund (MR/P027946/2). The Tobacco Control Capacity Programme is a programme of capacity development and research coordinated by the University of Edinburgh, Scotland and involves 15 partner institutions from Africa, South Asia and the United Kingdom.
AS directed the fieldwork, analyzed the data, and drafted the initial version of the manuscript. EOD, SS, and GO supervised all aspects of the fieldwork, data analysis, and interpretation related to compliance and air quality measurement. STA assisted with data analysis. KFL and DDL assisted with the fieldwork. EOD, SS, GO, FD, and TIK, were responsible for the interpretation and discussion of the study findings. All authors contributed to the revision of the manuscript for important intellectual content and final approval.
Not commissioned; externally peer reviewed.
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