Practices related to tobacco sale, promotion and protection from tobacco smoke exposure in restaurants and bars in Kampala before implementation of the Uganda tobacco control Act 2015
More details
Hide details
School of Public Health, Makerere University, Kampala, Uganda
Center for Tobacco Control in Africa, Kampala, Uganda
International Tobacco Control Policy Evaluation Project, Waterloo, Canada
University of Otago, Dunedin, New Zealand
Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
Submission date: 2017-01-16
Acceptance date: 2017-04-12
Online publication date: 2017-05-02
Publication date: 2017-06-22
Corresponding author
Steven Ndugwa Kabwama   

School of Public Health, Makerere University, Kampala, Uganda
Tob. Induc. Dis. 2017;15(May):24
The Word Health Organization’s Framework Convention on Tobacco Control calls on parties to implement evidenced-based tobacco control policies, which includes Article 8 (protect the public from exposure to tobacco smoke), and Article 13 (tobacco advertising, promotion and sponsorship (TAPS)). In 2015, Uganda passed the Tobacco Control Act 2015 which includes a comprehensive ban on smoking in all public places and on all forms of TAPS. Prior to implementation, we sought to assess practices related to protection of the public from tobacco smoke exposure, limiting access to tobacco products and TAPS in restaurants and bars in Kampala City to inform implementation of the new law.

This was a cross-sectional study that used an observational checklist to guide observations. Assessments were: whether an establishment allows for tobacco products to be smoked on premises, offer of tobacco products for sale, observation of tobacco products for sale, tobacco advertising posters, illuminated tobacco advertisements, tobacco promotional items, presence of designated smoking zones, no-smoking signs and posters, and observation of indoor smoking. Managers of establishments were also asked whether they conducted tobacco product sales promotions within establishments. Data were collected in May 2016, immediately prior to implementation of the smoke-free and TAPS laws.

Of the 218 establishments in the study, 17% (n = 37) had no-smoking signs, 50% (n = 108) allowed for tobacco products to be smoked on premises of which, 63% (n = 68) had designated smoking zones. Among the respondents in the study, 33.3% (n = 72) reported having tobacco products available for sale of which 73.6% (n = 53) had manufactured cigarettes as the available tobacco products. Eleven percent (n = 24) of respondents said they conducted tobacco promotion within their establishment while 7.9% (n = 17) had promotional items given to them by tobacco companies.

Hospitality establishments in Kampala are not protecting the public from tobacco smoke exposure nor adequately limiting access to tobacco products. Effective dissemination of the Tobacco Control Act 2015 is important in ensuring that owners of public places are aware of their responsibility of complying with critical tobacco control laws. This would also likely increase self-enforcement among owners of hospitality establishments and public patrons of the no-smoking restrictions.

World Health Organization Framework Convention on Tobacco Control. Guidelines for implementation of article 8. Guidelines on the protection from exposure to tobacco smoke. 2015. Available from: Accessed 12 Jan 2016.
Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev. 2010;4:CD005992. doi:10.1002/14651858.CD005992.pub2.
Blecher E. The impact of tobacco advertising bans on consumption in developing countries. J Health Econ. 2008;27(4):930–42.
World Health Organization Framework Convention on Tobacco Control: Guidelines for Implementation of Article 13: World Health Organization. 2009. Available from: Accessed 17 Jan 2017.
Dearlove JV, Bialous SA, Glantz SA. Tobacco industry manipulation of the hospitality industry to maintain smoking in public places. Tob Control. 2002;11(2):94–104.
Gonzalez M, Glantz SA. Failure of policy regarding smoke-free bars in the Netherlands. Eur J Public Health. 2013;23(1):139–45.
Jin J. Why FCTC policies have not been implemented in China: domestic dynamics and tobacco governance. J Health Polit Policy Law. 2014;39(3):633–66.
Parliament of Uganda. The Tobacco Control Act 2015 2015 [15 June 2016]. Available from: Accessed 12 Jan 2017.
Ministry of Health Uganda, Uganda Bureau of Statistics, World Health Organisation Regional office for Africa, CDC Foundation, Centers for Disease Control. Global Adult Tobacco Survey: Country Report 2013. Kampala, Uganda: Uganda Bureau of Statistics; 2014.
Mpabulungi L, Muula AS. Tobacco use among high shool students in Kampala, Uganda: questionnaire study. Croat Med J. 2004;45(1):80–3.
Muula AS, Mpabulungi L. Cigarette smoking prevalence among school-going adolescents in two African capital cities: Kampala Uganda and Lilongwe Malawi. Afr J Health Sci. 2007;7(1):45–59.
Uganda Bureau of Statistics. National Population and Housing Census 2014 Revised Edition. Kampala: 2014. Available from: Accessed 12 Jan 2016.
Bennett SWT, Liyanage WM, Smith DL. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q. 1991;44(3):98–106.
World Health Organization. The immunization data quality self assessment tool. World health organization department of immunization, vaccines and biologicals CH-1211 Geneva 27. Switzerland: Vaccine Assessment and Monitoring team of the Department of Immunization, Vaccines and Biologicals; 2005.
Kumara R, Goel S, Harriesc AD, Lal P, Singh RJ, Kumar AMV, et al. How good is compliance with smoke-free legislation in India? results of 38 subnational surveys. Int Health. 2014;6(3):189–95.
World Health Organization (WHO). Immunization cluster survey reference manual, in immunization, vaccines and biologicals. Geneva: World Health Organization; 2005.
John Hopkins Bloomberg School of Public Health CfTFK, International Union Against Tuberculosis and Lung Disease. Assessing Compliance with Smoke-free laws..2014. Available from: http://globaltobaccocontrol.or.... Accessed 16 Jan 2017.
John Hopkins Bloomberg School of Public Health CfTFK, International Union Against Tuberculosis and Lung Disease. Assessing Compliance with tobacco advertising, promotion and sponsorship bans. 2013. Available from: http://globaltobaccocontrol.or.... Accessed 16 Jan 2017.
Lambert WE, Samet JM, Spengler JD. Environmental tobacco smoke concentrations in no-smoking and smoking sections of restaurants. Am J Public Health. 1993;83(9):1339–41.
Goodin M, McAllister I. Evaluating compliance with Australia's first smoke-free public places legislation. Tob Control. 1997;6(4):326–31.
Jason LA, Liotta RF. Reduction of cigarette smoking in a university cafeteria. J Appl Behav Anal. 1982;15(4):573–7.
Dawley HH, Morrison J, Carrol S. Compliance behavior in a hospital setting: employee and patients' reactions to no-smoking signs. Addict Behav. 1980;5(4):329–31.
Dawley HH, Morrison J, Carrol S. The effect of differently worded no-smoking signs on smoking behavior. Int J Addict. 1981;16(8):1467–71.
Saffer H, Chaloupka F. The effect of tobacco advertising bans on tobacco consumption. J Health Econ. 2000;19(6):1117–37.
Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007;55(3):165–70.
Lim BL, Lim GH, Seow E. Case of carbon monoxide poisoning after smoking shisha. Int J Emerg Med. 2009;2(2):121–2.
Maziak W, Ward K, Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control. 2004;13(4):327–33.
DiFranza JR, Wellman RJ, Sargent JD, Weitzman M, Hipple BJ, Winickoff JP. Tobacco promotion and the initiation of tobacco use: assessing the evidence for causality. Pediatrics. 2006;117(6):e1237–e48.
Karin A, Kasza AJH, Abraham B, Mohammad S, Hua-Hie Y, McNeill AD, Lin L, Cummings KM. The effectiveness of tobacco marketing regulations on reducing Smokers’ exposure to advertising and promotion: findings from the international tobacco control (ITC) four country survey. Int J Environ Res Public Health. 2011;8(2):320–40.
Assessing the Relationship between Retail Store Tobacco Advertising and Local Tobacco Control Policies: A Massachusetts Case Study
Bukola Usidame, Edward Miller, Joanna Cohen
Journal of Environmental and Public Health
Cancer Risk Studies and Priority Areas for Cancer Risk Appraisal in Uganda
Alfred Jatho, Binh Tran, Jansen Cambia, Miisa Nanyingi, Noleb Mugisha
Annals of Global Health
Motivations for continued tobacco smoking and reasons for quitting among youths in Wakiso district, Uganda: a qualitative study
Alex Daama, Stephen Mugamba, William Ddaaki, Grace Kigozi Nalwoga, Asani Kasango, Fred Nalugoda, Robert Bulamba, James Menya Nkale, Emmanuel Kyasanku, Ritah Bulamu, Gertrude Nakigozi, Godfrey Kigozi, Joseph Kagaayi, Stevens Kisaka
BMC Primary Care
Journals System - logo
Scroll to top