Practices of pregnant women regarding tobacco and alcohol use during pregnancy at one primary health care clinic in Southern Namibia

Tobacco and alcohol use during pregnancy has negative consequences for the fetus. The study's purpose was to investigate the practices of pregnant women regarding the use of tobacco and alcohol during pregnancy. A quantita tive research approach with a descriptive, cross sectional, analytical design was used. The population was all pregnant women aged 18 years and above attending antenatal care at the Mariental clinic. Written informed consent was obtained from all respondents prior to data collection. Data was collected from 211 respondents selected through a systematic sampling. Data was analyzed using Statistical Package of the Social Sciences version 27. Descriptive statistics were used for frequencies and percentages. Fisher's Exact test at 0.05 alpha level was used to determine the association between variables. The mean age was 28.8, with a standard deviation of 6.9 years. Most participants, 92 (43.6%), were aged between 18 and 24 years. The majority, 186 (88.15%), were in the third trimester of pregnancy, and 154 (73%) were single. Most, 148 (70.14%), respondents have good practices towards alcohol use during pregnancy. Moreover, 190(90 %) of the respondents were classified as having good practices towards tobacco use in pregnancy. Educational levels showed a significant association with practices towards tobacco smoking (P=0.042). The study concluded good practices among pregnant women on alcohol and tobacco smoking during pregnancy. It is recommended that health facilities should introduce awareness campaigns on the dangers of alcohol and tobacco use during pregnancy. Moreover, educational materials should be developed in local languages and distributed to the community.

Exposure to tobacco advertisements, promotions, and sponsorships among in­school adolescents in Lagos, Nigeria: A cross­sectional study

Background: The Nigerian government implemented the National Tobacco Control Act (NTCA) in 2015, which prohibits tobacco advertising, promotion, and sponsorship (TAPS) exposure to children under 18 years of age. This study was conducted to assess the prevalence of attitudes and exposure to TAPS among in school adolescents in Lagos State, Nigeria, 5 years after the implementation of the Act and to identify the factors associated with TAPS exposure among the adolescents. Materials and Methods: This cross-sectional study was conducted among 968 in school adolescents selected through multistage random sampling. The data were collected using self-administered questionnaires adapted from the Global Youth Tobacco Survey. Results: Overall, 77% had been exposed to at least one form of TAPS in the past 30 days. The most frequently reported channel of exposure was through product placements, with 62% reporting exposure in films, TV, and videos. Up to 15.2% and 12.6% were exposed to TAPS through promotional activities and sponsorships, respectively. The majority (82.3%) had pro tobacco attitudes, while about a third (33.1%) had pro TAPS attitudes. Factors associated with TAPS exposure were having pro TAPS attitudes (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 2.3­5.3), being female (OR: 2, 95% CI: 1.4­2.7), and residing in a rural area (OR: 1.6, 95% CI: 1.2­2.3). Conclusion: Five years after implementing the NTCA, more than two thirds of the adolescents reported exposure to TAPS, mainly through films, TV, and videos. This suggests that the NTCA is poorly enforced. Efforts to ensure the effective implementation of comprehensive TAPS bans are warranted. Gender sensitive strategies that target adolescents' attitudes and school level factors should be emphasized.

Knowledge, practices and beliefs of students regarding health effects of shisha use in Ouagadougou, Burkina Faso: A cross­sectional study

Background.The tobacco epidemic is one of the biggest public health threats the world has ever faced. Shisha use has recently been gaining increased popularity in many developed and developing countries.Objective. To determine the prevalence of shisha use among students in Ouagadougou, Burkina Faso, and associated knowledge, smoking practices and beliefs about health effects.Method. A total of 443 students were selected for this cross-sectional study, using a stratified sampling method. Data on shisha use, knowledge about shisha, shisha smoking practices, and factors associated with use of shisha were collected via a questionnaire. The association between the independent variables and shisha use was assessed using a χ2 test (p<0.05). Binary logistic regression analysis was used to determine variables that were independently associated with shisha smoking.Results.Of the 421 respondents, 162 (38.5%) indicated that they had smoked shisha; 14.0% were regular smokers. We found that 183 students (43.5%) had poor knowledge about the health effects of shisha. The main reasons for shisha smoking were being in the company of friends who were users (57.4%), the pleasant flavour and fragrance of shisha (25.9%), and fashion (22.2%). Ninety-nine shisha smokers (61.1%) also consumed alcohol. Factors associated with shisha smoking included age <20 years (p<0.001), gender (p=0.034), and educational level of the respondent's father (p=0.0001) and mother (p=0.0004).Conclusion. We found a relatively high prevalence of shisha smoking among the students, and that 43.5% of them had poor knowledge about its effects on health. Developing surveillance, intervention and regulatory/policy frameworks specific to shisha has become a public health priority.

Prevalence and correlates of depression and substance use disorders in emergency department populations: A cross-sectional study at East Africa's largest public hospital

Introduction There are persistent gaps in screening, identification, and access to care for common mental disorders in Low- and Middle-Income Countries. An initial step towards reducing this gap is identifying the prevalence, co-morbidities, and context of these disorders in different clinical settings and exploring opportunities for intervention. This study evaluates the prevalence and correlates of depression and substance use disorders among adults presenting to the Emergency Department (ED) of a major national hospital in East Africa. Methods This study utilized the World Health Organization's STEPwise Approach to Surveillance (WHO-STEPS) tool and the Patient Health Questionnaire (PHQ-9) to conduct a cross-sectional survey capturing socio-demographic data, tobacco, and alcohol use and rates of depression in a sample of adults presenting to the ED. Bivariate and multivariate analyses were conducted for each outcome of interest and socio-demographics. Results Of 734 respondents, 298 (40.6%) had a PHQ-9 score in the "moderate" to "severe" range indicative of major depressive disorder. About 17% of respondents endorsed current tobacco use while about 30% reported being daily alcohol users. Those with high PHQ-9 score had higher odds of reporting current tobacco use ("severe range" = adjusted odds ratio (aOR) 1.85, 95% CI 1.05, 3.26). Those with a "severe" PHQ-9 scores were 9 times (aOR 2.3-35.3) more likely to be daily drinkers. Conclusions Screening and identification of people with depression and substance use disorders in the ED of a large national hospital in Kenya is feasible. This offers an opportunity for brief intervention and referral to further treatment

Evolution of attitudes, trends and perceptions of smoking among middle and secondary school students in the Gharb Region, Morocco, 2010­2015

Background: Tobacco use is an important public health issue. Morocco implemented a tobacco control programme, which has been ongoing among students at middle and secondary schools since 2010. Aim: This study aims to compare the trend in smoking among the programme beneficiaries with the results of the initial study conducted prior to the implementation of the programme. Setting: This study was conducted in middle and secondary schools of the Gharb Region in Morocco between 2010 and 2015. Methods: Two cross-sectional studies were conducted in 2010 and 2015 in the middle and secondary schools of the Gharb Region. Multistage cluster sampling was used. The information was collected using a self-administered questionnaire. Results: In the first study in 2010, 5312 students participated, and in the second one in 2015, 4208 students participated. The level of information on smoking and its effects was higher in 2015 (94.0%) than in 2010 (92.5%). In 2010, parents, primary schools and television and radio were more involved in student information on smoking compared to 2015. The proportion of students claiming that tobacco was not a pleasure (86.3%) and that it does not calm nerves (76.5%) was significantly higher in 2015 than in 2010. The prevalence of smoking increased significantly in 2015 (2.9%) against 2010 (1.8%). Conclusion: This study reports the general positive evolution in knowledge about smoking and its effects. Despite that the prevalence of smokers increased in 2015. The results suggest the need to address family influences on adolescent smoking and to investigate participation of schools in education and training students in tobacco dependence prevention

Tobacco Use and Oral Health of Inmates in a Nigerian Prison

Objectives: To determine the effect of tobacco use on oral health status of inmates of a federal prison in Enugu, Nigeria.Materials and Methods: The study involved 230 inmates of the Nigerian Prison in Enugu. An interviewer­administered questionnaire was used to collect data on the demographic characteristics of the participants, oral hygiene methods, and smoking habits. An intra­oral examination to determine their oral health status was done using simplified oral hygiene index (OHI­S) for the oral hygiene status, the modified decayed missing and filled teeth (DMFT) index for caries status, and community periodontal index of treatment needs (CPITN) for the periodontal needs. Statistical Package for Social Sciences software, version 15 was used to analyze data.Results: One hundred and twenty participants (52.2%) were current smokers. Mean DMFT of smokers and nonsmokers were 2.38 ± 0.71 and 2.25 ± 0.83 respectively (P = 0.508) while mean Community Periodontal Index (CPI) scores of smokers and nonsmokers were 4.71 ± 1.26 and 2.27 ± 0.86, respectively (P = 0.276). Oral soft tissue lesions such as mucosal burn, oral leukoplakia­like lesions were found mainly in the tobacco users. Conclusion: Tobacco use had a negative effect on the oral health of the participants as smokers had worse oral health profile than non­smokers. They may benefit from counseling programs with the view to educate them on the effect of tobacco use on oral health and by extension, the general health. The full implementation of the Framework Convention on Tobacco Control (FCTC) treaty in Nigeria could help in curtailing these unwanted consequences of tobacco use

Plasma Concentration of Ascorbic Acid and Some Hematological Parameters in Tobacco Snuffers Among the Igbos of Southeastern Nigeria

Tobacco snuffing; like cigarette smoking; is known to be a common habit among the adults of Igbo communities in Nigeria. In view of the various pharmacological actions of nicotine and other additive constituents of tobacco snuff; there is growing concern that ascorbic acid; which is a vital antioxidant; and blood cell production or morphology may be affected. Objective: To investigate the possible effects of prolonged use of tobacco snuff on plasma ascorbic acid concentrations and some hematological parameters. Materials and Methods: Fifty adults of Igbo extraction (35 males and 15 females) residents in and around Enugu metropolis; who have been snuffing tobacco for 6 years and above; were recruited for the study; after they gave informed consent. Also; 50 apparently healthy; age-matched persons (25 males; 25 females); who do not smoke or take tobacco snuff; served as controls. Spectrophotometric method was adopted for ascorbic acid determination while hematological profiles were assessed by Bain method. Results: The results showed no significant difference in the measured parameters relative to the controls AA (P=0.08); Hb (P=0.19); PCV (P=0.10); RC (P=0.06); PC (P=0.20); WBC (P=0.09). Conclusion: The results of the study suggest that tobacco snuff inhalation may not adversely affect plasma ascorbic acid concentration and hematological parameters in adult humans. The study; however; has not concluded that tobacco snuffing is totally wholesome

Smokeless Tobacco Use in Adult Nigerian Population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola; North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. Out of 1776 interviewed respondents; 133 (7.49) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8). Fifteen (0.9) chewed tobacco while only 2(0.1) both chewed and snuffed tobacco. Social acceptance (21.8) was the major reason for using smokeless tobacco. Males; 5th and 6th decades of life; poor education; lower socioeconomic class; Margi; Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Smokeless Tobacco Use among Adolescents in Ilala Municipality; Tanzania

Smokeless tobacco use is a significant part of the overall world tobacco problem. When the habit is introduced early in life; it increases the chance for permanent addiction and primes adolescents for use of harder drugs; exposing them to higher risk of oral cancer and other adverse effects of tobacco. This baseline study aimed at providing descriptive information on smokeless tobacco knowledge and use among adolescents at a time just before the ban on such products was enforced nationally on 1st December 2006. Six out of 101 primary and four out of 11 secondary schools were randomly selected in Ilala Municipality; Tanzania. A total of 1011 students were randomly selected and interviewed; boys (mean age= 14.5 years) accounted for 50.7and girls (mean age= 13.6 years) 49.3. The prevalence of tobacco use was 5.9(boys= 9; girls= 2.4). Prevalence of smokeless tobacco use was 3.6; about half of all who have ever smoked. Most popular brand of smokeless tobacco reported was Kuberi (44.8) followed by Gutka (6.9). Twelve (41) of the smokeless tobacco users were using the products almost everyday. Among the reasons reported for smokeless tobacco use were pleasure (27.6); smell (17.2) and taste (6.9). However; 48.3of the users did not know why they used the product for the first time. Smokeless tobacco products were branded as nutritional supplements with different tastes and strengths; ideal for enticing the curiosity of adolescents. Given the crafty practice of the tobacco industry and salesmen; there is need for monitoring of availability of these products in circulation and enforcement of the ban nationally and globally to institute measures for effective elimination of this harmful practice

Prevalence and determinants of cigarette smoking among adolescents in Blantyre City; Malawi

Tobacco smoking is a major risk factor for non-communicable diseases such as ischaemic heart disease; stroke; chronic obstructive airways disease and several cancers. There is little data about the prevalence and determinants of smoking among adolescents in southern Africa. This study aimed to determine the prevalence and determinants of cigarette smoking among adolescents in Blantyre City; Malawi. Cross-sectional data were obtained from school-going adolescents in Blantyre in 2001 using the Global Youth Tobacco Survey data collection instrument. Data were analysed to determine prevalence of current and ever cigarette smoking; and predictors of smoking. The prevalence of urrent smoking and ever smoking were 3.0and 15.6; respectively. Predictors of current tobacco smoking included male gender; having friends or parents who smoked; having been exposed to advertisements about tobacco brands on television and having seen a lot of advertisements in newspapers and magazines. School programmes that included being taught about smoking in class and a class discussion on the dangers of tobacco were not associated with reduced current smoking. Intervention programmesaiming to curb tobacco smoking among adolescents should focus on dealing also with parental smoking; peer influence and pay special attention toward male gender. School-based programmes to prevent smoking should be evaluated as some may have little impact in influencing current smoking status

The Smoking Habits; Attitudes Towards Smoking And Knowledge Regarding Anti-Smoking Legislation Of Students In Institutions Of Higher Learning In The Eastern Cape Province Of South Africa

Background: The study aimed to i) investigate the smoking habits of students attending tertiary institutions of learning in the Eastern Cape Province (ECP) and ii) determine the knowledge of the students about the health hazards of smoking and their attitude towards current government anti-smoking legislation.Methods This was a questionnaire-based study involving all seven tertiary institutions of learning in the ECP; viz. the Universities of Transkei; Fort Hare; Port Elizabeth and Rhodes University; and the Border; Eastern Cape and Port Elizabeth technikons. A total of 1 728 students were interviewed out of a student population of 30;080. Stratified random sampling was used to select the students. Two-way tables were used to test the independence of the variables and chi-square tests were applied. A `p' value of below 5was used as a test of significance.ResultsA total of 1 480 students completed the questionnaires (86). The racial classification of the respondents was 79Black; 13White; 7Coloured and 2Indian. Twenty-six per cent of the students were smokers; of which 37were male and 15were female. Forty-five per cent of the Coloured students smoked; while the figures for Whites and Blacks were 26and 25respectively. Seventy per cent of the students smoked less than 10 cigarettes a day. Fifty-two per cent of the smokers said they wanted to stop smoking. Sixty-one per cent had been influenced to start smoking by their friends and only 13were influenced by advertisements. Ninety-four percent agreed that smoking was dangerous to the smoker's health; while 73responded that there was a relationship between mothers who smoke and low birth weight. Thirteen per cent thought the legislation was too tough; while 30said it was good as it was. On measures to reduce smoking; 86favoured restricting smoking in public places.ConclusionThis study has demonstrated that smoking is prevalent in tertiary institutions of learning in the Eastern Cape Province. The demographic profile of the smokers reflects the national picture. The knowledge of the harmful effects of smoking is generally good

Evaluation des connaissances du tabagisme dans la population abidjanaise

Dans le but de contribuer a la lutte contre le tabagisme en Cote d'Ivoire; nous avons effectue une etude transversale prospective dans les communes d'Adjame et du Plateau. Notre objectif etait d'evaluer les connaissances des abidjanais sur le tabagisme; en particulier selon le niveau d'etude et le statut tabagique. Elle s'est deroulee sur 3 mois allant de Novembre a Janvier. Cette etude nous a permis de noter que: -la prevalence du tabagisme etait de 3 6;5pour cent dans la population abidjanaise avec une nette predominance masculine (44;31pour cent contre 12;28pour cent pour les femmes). -La population des frimeurs etait jeune avec un age moyen de 27;44 ans. -les mass medias representaient la principale source d'information. -D'une facon generale; les sujets interroges n'avaient pas une bonne connaissance du tabagisme et ses consequences avec un taux important de fausses reponses (25;3pour cent). -Les pathologies respiratoires notamment le cancer broncho-pulmonaire et les pathologies cardio-vasculaires ont ete les plus citees dans des proportions respectives de 53;1pour cent et 18;1pour cent. En ce qui concerne les composants du tabac; la nicotine represente la substance la plus connue. Elle a ete citee dans une proportion de 92;6pour cent. -Les connaissances des sujets sont influencees par leur niveau d'etude. Les sujets du superieur sont ceux qui connaissent plus les consequences du tabagisme (47pour cent contre 6;9pour cent pour les non scolarises). Il en decoule que les sujets moins instruits soient ceux qui s'adonnent le plus au tabagisme. Pour combattre l'avancee de ce fleau; la population interrogee souhaite que les actions de sensibilisation soient intensifiees

Re-emergence of Traditional Tobacco Products Usage in South Africa: an Unintended Consequence of Existing Tobacco Control Policy

South Africa has made observable and globally acknowledged successes in tobacco control. This paper examines a decade of the response to tobacco control policy in South Africa. It draws on previously published data and preliminary results from a recently conducted national survey of patterns and forms of tobacco products used in South Africa. Results suggest that smoking prevalence has decreased from 34in 1993 to 21.4in 2003; albeit a slower decline in the last five years among males. Similarly; smokeless tobacco (snuff) use has decreased from 12.6in 1998 to 8.4in2003 among black South African women; and from 18.2in 1999 to 14.5in 2002 among adolescents. This is despite the lack of excise tax on snuff. However; the use of snuff; previously used only by the elders; remains high among adolescents. The use of hand-rolled smoked-tobaccos accounted for 19of total tobacco consumption and it is especially common among the socially disadvantaged group in South Africa. The continued prominence of the use of traditional nicotine-delivery vehicles - snuff and hand-rolled smoked tobaccos - may represent consumers' method for compensating for the increases in cigarette prices. Indeed; an unintended consequence of the existing policy environment. The study highlights the need to establish culturally relevant tobacco cessation services and suggests the need for a combination of tax reform and product regulation

How can we improve the management of stroke in Nigeria; Africa?

Stroke is a significant economic; social and medical problem all over the world. This article discusses recent developments in stroke management worldwide. We reviewed and highlighted published clinical guidelines from several countries. The current thoughts on stroke care are discussed and summarized in concise and unambiguous terms. Limitation to optimal management in developing countries as well as areas requiring development and research are highlighted. It should be possible to utilize this in stimulating the development of management strategies for stroke; customized to the unique health structure in Nigeria. The management of stroke in Nigeria is suboptimal as there are significant deficiencies in the provision of diagnostic; treatment; rehabilitation and support services. The limited resources; manpower shortage; lack of organized stroke unit; neuro-imaging facilities; ambulance services; education of patients and general practitioners as well as impracticable use of thrombolytics are contributory. Training of stroke experts in collaboration with experts in the developed world with provision of neuro-imaging facilities would improve the outlook of stroke management in Nigeria. The focus in Nigeria must be on preventive strategies and ways to harness local resources in the acute treatment of stroke patients. Health education of the community with emphasis on control of the predisposing factors would reduce the burden of stroke in the country. Risk factor management should begin in childhood; with emphasis on exercise; nutrition; weight and blood sugar control; avoidance of tobacco and excessive alcohol; as well as effective treatment of hypertension and hyperlipidaemia

Leukokeratosis nicotinica; tobacco/snuff and tobacco smoking-pre-cancerous and malignant potentials

Leukokeratosis nicotinica is keratosis found in the oral mucosa of chronic chain smokers especially pipe smokers and commonest in the palate. There is no sex predilection so far as the smoking habit is chronic. The lesion is also known as nicotine stomatitis and smoker's keratosis. Though leukokeratosis nicotinica is not ranked mainly as precancerous lesion; it may have some degrees of dyplastic changes indicative of premalignancy and in some cases carcinoma in situ