Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria
Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies.
Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria.
Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria.
Results: The quantitative survey revealed that the majority (72.1%) of the respondents were aged between 20 and 40 years, predominantly male (60.8%), Yoruba (50.2%) or Igbo (40.3%) ethnicity and had been practicing pharmacy for ten years or less (72.2%). A majority (90.1%) of respondents were aware that tobacco is harmful to health. Slightly less (75.8%) were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4%) and esophageal (68.9%) cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%), chronic obstructive pulmonary disease (27.8%), bladder cancer (47.2%), peripheral vascular disease (35.8%) and sudden death (31.1%). Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). A little over half of the respondents (53.8%) were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%), in public places (79.2%), and in restaurants, nightclubs and bars (73.6%). For every additional client attended to daily, knowledge scores increased by 0.022 points. Current smokers were 1.3 times less likely to support smoke-free policies compared with non-smokers. The findings emanating from the focus group discussion reinforced the fact that the pharmacists were in support of smoke-free policies particularly in homes and public places. It also demonstrated that most of them were aware of the health risks associated with tobacco use and second hand smoke however some misconceptions seemed to exist.
Conclusion: The pharmacists surveyed expressed support of smoke-free policies and most of them were aware of the health risks associated with tobacco use. However, awareness of WHO FCTC and country-level tobacco legislation was low. Current smokers were less likely to support smoke-free policies. Community pharmacists should therefore be considered worth engaging for the promotion of smoke-free policies. Efforts should also be made to educate pharmacists about country level smoke-free laws.
2. Erickson M, Mackay J, Ross H. The Tobacco Atlas. Available at http://www.tobaccoatlas.org/uploads/Images/PDFs/Tobacco_Atlas_2ndPrint.pdf (accessed June 1, 2014).
3. Federal Ministry of Health. Global Adult tobacco Survey 2012 Country report. Available at http://nigerianstat.gov.ng/pages/download/157 (accessed June 1, 2014).
4. Desalu OO, Onyedum CC, Adewole OO, Fawibe AE, Salami AK. Secondhand smoke exposure among non-smoking adults in two Nigerian cities. Ann Afr Med. 2011;10(2):103-111. doi: 10.4103/1596-3519.82069
5. United states Center for disease control. Second hand smoke. Available at http://www.cdc.gov/tobacco/basic_information/secondhand_smoke/ (accessed June 1, 2014).
6. Institute of Medicine. Second hand smoke exposure and cardiovascular effects: Making sense of the evidence. Available at http://www.iom.edu/~/media/Files/Report%20Files/2009/Secondhand-Smoke-Exposure-and-Cardiovascular-Effects-Making-Sense-of-the-Evidence/Secondhand%20Smoke%20%20Report%20Brief%203.pdf (accessed June 1, 2014).
7. Centers for Disease Control and Prevention. Vital signs: nonsmokers' exposure to secondhand smoke --- United States, 1999-2008. MMWR Morb Mortal Wkly Rep. 2010;59(35):1141-1146.
8. World health organization. WHO Framework Convention for Tobacco Control. Available at http://whqlibdoc.who.int/publications/2003/9241591013.pdf?ua=1 (accessed June 1, 2014).
9. Drope J. Tobacco Control in Africa. People, Politics and Policies. Available at http://www.idrc.ca/EN/Resources/Publications/openebooks/510-6/index.html#page_29 (accessed June 1, 2014).
10. Fichtenberg CM, Glantz SA. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ. 2002;325(7357):188.
11. Lightwood JM, Glantz SA. Declines in Acute Myocardial Infarction After Smokefree Laws and Individual Risk Attributable to Secondhand Smoke. Circulation. 2009;120(14):1373-1379. doi: 10.1161/CIRCULATIONAHA.109.870691
12. Meyers DG, Neuberger JS, He J. Cardiovascular effect of bans on smoking in public places: a systematic review and meta-analysis. J Am Coll Cardiol. 2009;54(14):1249-1255. doi: 10.1016/j.jacc.2009.07.022
13. Tee GH, Hairi NN, Hairi F. Attitudes towards smoking and tobacco control among pre-clinical medical students in Malaysia. Int J Tuberc Lung Dis. 2012;16(8):1126-1128. doi: 10.5588/ijtld.11.0254
14. Bruckman D, Allan T, Stefanak M, Chandran Pillai A, Drabousky AS, Borawski EA, Frank S. Enforcement of Ohio's Smoke Free Workplace Law through the lens of public health practice. Public Health Rep. 2013 Jan-Feb;128(1):54-63.
15. Movsisyan NK, Varduhi P, Arusyak H, Diana P, Armen M, Frances SA. Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia. BMC Public Health. 2012;12:1028. doi: 10.1186/1471-2458-12-1028
16. Sychareun V, Phengsavanh A, Hansana V, Phommachanh S, Mayxay M, Tomson T. Health policymakers' knowledge and opinions of physicians smoking and tobacco policy control in Lao PDR. BMC Public Health. 2012;12:816. doi: 10.1186/1471-2458-12-816
17. Lewis KE, Shin D, Davies G. Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students. Int J Tuberc Lung Dis. 2011;15(8):1122-1126. doi: 10.5588/ijtld.10.0783
18. Kaleta D1, Polańska K, Dziankowska-Zaborszczyk E, Bak-Romaniszyn L, Czarnecka K, Drygas W. [Smoke-free environment--nurse attitudes towards smoke-free regulations]. Przegl Lek. 2009;66(10):844-847.
19. Oparah AC, Okojie OO. Health promotion perceptions among community pharmacists in Nigeria, Int J Pharm Pract. 2005;13(3):213-221.
20. Shen X, Bachyrycz A, Anderson JR, Tinker D, Raisch DW. Quitting patterns and predictors of success among participants in a tobacco cessation program provided by pharmacists in New Mexico. J Manag Care Spec Pharm. 2014;20(6):579-587.
21. Dobrinas M, Blanc AL, Rouiller F, Christen G, Coronado M, Tagan D, Schäli C. Clinical pharmacist's role in implementing a smoking cessation intervention in a Swiss regional hospital: an exploratory study. Int J Clin Pharm. 2014;36(3):526-534. doi: 10.1007/s11096-014-9927-8
22. El Hajj MS, Al Nakeeb RR, Al-Qudah RA. Smoking cessation counseling in Qatar: community pharmacists' attitudes, role perceptions and practices. Int J Clin Pharm. 2012;34(4):667-676. doi: 10.1007/s11096-012-9663-x
23. Radwan GN, Loffredo CA, Aziz R, Abdel-Aziz N, Labib N. Implementation, barriers and challenges of smoke-free policies in hospitals in Egypt. BMC Res Notes. 2012;5:568. doi: 10.1186/1756-0500-5-568
24. Yan J, Xiao S, Ouyang D, Jiang D, He C, Yi S. Smoking behavior, knowledge, attitudes and practice among health care providers in Changsha city, China. Nicotine Tob Res. 2008;10(4):737-744. doi: 10.1080/14622200801901930
25. Desalu OO, Adekoya AO, Elegbede AO, Dosunmu A, Kolawole TF, Nwogu KC. Knowledge of and practices related to smoking cessation among physicians in Nigeria. J Bras Pneumol. 2009;35(12):1198-1203.
26. Aina BA, Onajole AT, Lawal BM, Oyerinde OO. Promoting cessation and a tobacco free future: willingness of pharmacy students at the University of Lagos, Nigeria. Tob Induc Dis. 2009;5:13. doi: 10.1186/1617-9625-5-13
27. Ravara SB, Calheiros JM, Aguiar P, Barata LT. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban. BMC Public Health. 2011;11:720. doi: 10.1186/1471-2458-11-720
The authors hereby transfer, assign or otherwise convey to Pharmacy Practice (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print or epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Author Self-Archiving Policy
Pharmacy Practice permits and encourages authors to post and archive the final PDFs of their respective articles submitted to the journal on personal websites or institutional repositories after publication, while providing bibliographic details that credit its publication in this journal.