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.

Rural-urban Disparities in Maternal Immunization Knowledge and Childhood Health-Seeking Behavior in Nigeria: a Mixed Method Study

Background: Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths. Objectives: To compare maternal knowledge about immunization; use of growth chart and childhood health-seeking behavior in rural and urban areas. Methods: A cross-sectional comparative study done in Lagos; Nigeria. Questionnaire survey and focus group discussions were done. 300 respondents were selected by multi-stage sampling while discussants were purposively selected. Results: Awareness of immunization was high but knowledge of vaccine preventable diseases (VPDs) was poor in both areas. Urban women utilized preventive services more; growth monitoring (p0.001) and immunization (p0.001) while higher proportions of rural women utilized nutritional counseling (p