Awareness, Attitudes and Current Practices Related to Uganda’s Tobacco Control Act 2015 Prior to its Enforcement in Restaurants and Bars in Kampala City
Authors: 1*Steven Ndugwa Kabwama, 1Daniel Kadobera, 2Sheila Ndyanabangi, 3David Guwatudde; Affiliations: 1Public Health Fellowship Program, Field Epidemiology Track, Ministry of Health 2Mental Health and Control of Substance Abuse, Ministry of Health 3Makerere University School of Public Health, Department of Epidemiology and Biostatistics
Summary: On 19 September 2015 the President of Uganda signed the Tobacco Control Bill 2014 into the Tobacco Control Act 2015. We assessed attitudes and awareness about the Act and current practices related to tobacco use and tobacco smoke exposure prior to implementation. The study involved 216 interviews and observations from 218 randomly selected estabishments around Kampala City. 61.5% of respondents were either unaware about the law or had a misconstrued message. Among respondents that self-acknowledged having sufficient information, 70.2% got it from media such as Radio, TV and print media. 39.4% agreed that the law would lead to financial losses. 63% of establishments that allowed for tobacco use on premises had designated smoking zones. 26.6% had in-door smoking and 11% had visible tobacco promotion and sponsorship signs. Although the new law has come into effect, the public is still not aware about it. We recommend dissemination and advocacy of the law to business owners and the public.
Introduction: On 19 September 2015 the President of Uganda signed the Tobacco Control Bill 2014 into the Tobacco Control Act 2015. Prior to enforcement, we carried out a study to describe awareness, attitudes and practices related to the Act.
Methods: We interviewed personnel in 216 establishments and observations from 218 randomly selected establishments around Kampala City. A structured questionnaire was used to guide observations and interviews.
Results: 61.5% of respondents were either unaware or had a misconstrued message. Among respondents that self-acknowledged to have sufficient information, 70.2% got it from media such as Radio, TV and print media. 28.3% agreed that the law would lead to financial losses at their own establishment. In 50% of the establishments, tobacco products were allowed to be smoked on the premises and 63% of these had a designated smoking area. In the 50% that did not allow for tobacco products to be smoked on their premises, only 17% had noticeable no-smoking signs. In 26.6% of establishments, there was observation of in-door smoking and 11% had visible tobacco advertising signs and products.
Discussion and Conclusions: The study found that 61.5% of respondents were either unaware about law or had a misconstrued message about the law.
There is a need for the government to disseminate the law. Although the public has responsibility of being aware about new legislation, an effective information program will ensure that owners of public places and clients are appropriately informed and not left vulnerable to the penal ramifications of violating the law [2]. Among those who felt adequately informed, most (70.2%) got it from media such as radio, television and newspapers. According the Uganda Demo- graphic Health Survey [3], in Kampala, 41.1% of women and 57.7% of men read a newspaper at least once a week, 77.4% of women and 88.7% of men watch television at least once a week and 73.5% of women and 86.1% of men listen to radio at least once a week. This high level of media access presents an opportunity for how the new legislation can be disseminated.
The study also found that although 50% of establishments did not allow for products to be smoked on premises, only 17% had notice- able no-smoking signs. No-smoking signs deter initiation of smoking where it is prohibited [2]. Although some studies have found No-smoking signs deter initiation of smoking where it is prohibited [2].
Although some studies have found minimal changes in smoke exposure after placement of no-smoking signs [8, 9], others have found evidence of less smoking [10]. As the new legislation is being disseminated, owners of public places need to be informed of their responsibility to place no- smoking signs.
11% said they conducted tobacco product promotion. Tobacco product marketing promotes the initiation, continuation and re-uptake of smoking [14].
It has been shown that regulation of tobacco product marketing significantly decreases smokers’ awareness of pro- smoking cues [15]
Recommendations:
The National Tobacco Control Program should utilize media to disseminate and publicize the Tobacco Control Act.
References:
1. Poluyi EO, Odukoya OO, Aina B, Faseru B. Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria. Pharmacy practice. 2015;13(1). 2. Goodin M, McAllister I. Evaluating compliance with Australia's first smoke-free public places legislation. Tobacco Control. 1997;6(4):326-31. 3. Inc UBoSaII. The Uganda Demographic and Health Survey 2011. Kampala Uganda: UBOS and Calverton, Maryland: ICF International Inc, 2012. 4. Simpson D. Smoke-free laws do not harm profits: new global report. Tobacco control. 2005;14(4):220 5.Dearlove JV, Bialous SA, Glantz SA. Tobacco industry manipulation of the hospitality industry to maintain smoking in public places. Tobacco control. 2002;11(2):94-104. 6. WHOFCTC WHOFCoTC. Guidelines for implementation of article 8. Guidelines on the protection from exposure to tobacco smoke. 2015
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