Exposure to the number of tobacco control policies and tobacco use cessation among adults in Sub-Saharan Africa
Hadii Mamudu 1  
,   Liang Wang 2,   Daniel Owusu 3,   Rijo John 4,   Bossman Asare 5,   Abdallah Ibrahim 5,   Edward Brenya 6,   Ahmed Ouma 7
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East Tennessee State University, Health Services Management and Policy, United States of America
East Tennessee State University, United States of America
Georgia State University, United States of America
Independent Consultant, India
University of Ghana, Ghana
Kwame Nkrumah University of Science and Technology, Ghana
World Health Organisation HQ, Switzerland
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A582
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Tobacco use and tobacco-induced diseases are rapidly increasing in Sub-Saharan Africa (SSA). Addressing this problem requires both tobacco use prevention and cessation. This study examined the rate of smoking cessation and assessed effects of tobacco control policies (TCPs) on cessation among adults in SSA.

During 2012 and 2014, Global Adult Tobacco Survey data were collected in Cameroon, Kenya, Nigeria, and Uganda and analyzed, with smoking cessation as the outcome. The exposure variable consisted of a composite index of the number of TCPs that participants have been exposed to. Covariates included participants' characteristic, knowledge of tobacco harm, exposure to anti-smoking messages, and tobacco industry promotions. Descriptive analyses were conducted for prevalence of smokers who had quit in the past year (i.e., ex-smokers) for each country and pooled data. A multivariable logistic regression was used to examine whether the number of TCPs a participant has been exposed to increase the likelihood of cessation. The odds ratios and associated 95% confidence intervals were ascertained.

Of 27,952 participants, 48%, 32.1%, 17.5%, 81.2% had been exposed to anti-smoking media messages, health warning labels, smoke-free workplace, and smoke-free homes, respectively. Approximately 14.1% of the participants were ex-smokers, of which 7.1%, 6.1%, 5.0%, and 10.6% had been exposed to anti-smoking media messages, health warning labels, and smoke-free workplace, and smoke-free homes, respectively. Preliminary logistic regression analyses suggest that likelihood of smoking cessation increases with increase in exposure to TCPs.

As of 2014, only 41 countries had comprehensive tobacco control programs, with < 10 of the 47 SSA countries having national tobacco control laws. This study suggests that the number of TCPs in a country facilitates smoking cessation, suggesting that achieving the WHO FCTC goal of reduced tobacco use requires adoption of many TCPs, even in absence of a national law.