Profile and predictors of adolescent tobacco use in Ghana: evidence from the 2017 Global Youth Tobacco Survey (GYTS).

BACKGROUND: Understanding the predictive factors for tobacco use, and initiation among the youth is critical for effective intervention and prevention. We, therefore, aimed to determine the profile, associated factors, the regional disparities in the use of tobacco products among the youth in Ghana. METHOD: The study used the 2017 Ghana Global Youth Tobacco Survey (GYTS) to obtain tobacco-related information among the youth in Junior High Schools across the country. The survey used a two-stage cluster randomized sampling technique to obtain nationally representative data. Weighted univariate and multivariate logistic regression analyses were used to assess the association of participant's characteristics and use of tobacco. RESULTS: Out of the 6039 targeted respondents, 5,664 (93.8%) participated, 2,707 males, 2,929 females, and 28 of the participants had missing gender data. The use of any tobacco product (cigarette, smokeless tobacco, electronic cigarette, or waterpipe tobacco) was 28.3, 7.0, and 4.8% in the Savanna/northern zone, middle/forest zone, and Coastal zone respectively. From the univariate analysis, age (p = 0.005), pocket money (p < 0.001), and exposure to secondhand smoke (SHS) at home (p < 0.001) were significantly associated with tobacco use. In the multivariate analysis, age (p = 0.002), pocket money (p < 0.001), exposure to SHS at home (p < 0.001), and being taught about the dangers of tobacco use (p = 0.043) were significantly associated with tobacco use. CONCLUSION: Multiple factors including age, pocket money, exposure to SHS were identified to be associated with tobacco use among the youth in Ghana. Promoting anti-smoking campaigns in early adolescence, as well as programmes targeting early tobacco use can guard the youth against initiating tobacco use.

Waterpipe use among the youth in Ghana: Lessons from the Global Youth Tobacco Survey (GYTS) 2017.

INTRODUCTION: The Global Youth Tobacco Survey's findings have been used to support Ghana's tobacco control legislation, monitor tobacco use among the youth and also used in meeting various Articles of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). These Articles include: Article 8 (Protection for exposure to tobacco smoke); Article 12 (Education, communication, training and public awareness); Article 13 (Tobacco advertising, promotion, and sponsorship); Article 14 (Demand reduction measures concerning tobacco dependence and cessation); and Article 16 (Sales to and by minors). Among the four waves of GYTS in Ghana, the 2017 GYTS was the first to assess waterpipe smoking, through optional questions included in the GYTS questionnaire. We assessed sex, age and regional differentials in waterpipe smoking among the youth in Ghana, and also explored the association between the use of other tobacco products and waterpipe use. METHODS: The GYTS employs a standardized methodology with self-administered questionnaires, consisting of core, optional, and country specific questions. Fourteen questions, out of the seventy-four (74) questions administered for the entire GYTS, assessed waterpipe tobacco smoking (WTS). Chi-squared test was used to assess sex, age, grade/form and regional differentials in waterpipe use. Furthermore, the association between smoking cigarettes, smokeless tobacco, electronic cigarettes and waterpipe smoking, was explored by employing a chi-squared test with a 5% significance level. RESULTS: Of a total of 5664 students who participated in the study, 90.9% were aged 13-15 years. The respondents were almost equally distributed among males and females. Overall, 3.1% of the respondents had ever smoked waterpipe. The overall prevalence of current waterpipe use was 1.7%; with 2.1% in girls (95% CI: 0.9-4.7%) and 0.9% in boys (95% CI: 0.5-1.6%), p=0.033. Additionally, more than half (55.0%) of the current waterpipe users smoked three or more sessions per day. Surprisingly, close to half (46.9%) of the current waterpipe users smoked at home. CONCLUSIONS: Waterpipe use, particularly among the female student population, represents an emerging tobacco epidemic and hence deserves immediate attention from authorities. This study revealed that waterpipe is being used among Junior High students in Ghana. Education on the health implications of waterpipe use should be intensified among the youth, to help minimize its use and to prevent its associated health harms.

Exposure to secondhand smoke in hospitality settings in Ghana: Evidence of changes since implementation of smoke-free legislation.

INTRODUCTION: Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. Evaluation of smoke-free laws is an effective means of measuring progress towards a smoke-free society. This study assessed the level of compliance to the provisions of the current smoke-free policy using air quality measurements for fine particulate matter (PM2.5) in hospitality venues in Ghana. METHODS: This was a cross-sectional observational study conducted in 2019 using a structured observational checklist complemented with air quality measurements using Dylos monitors across 152 randomly selected hospitality venues in three large cities in Ghana. RESULTS: Smoking was observed in a third of the venues visited. The median indoor PM2.5 concentration was 14.6 µg/m3 (range: 5.2-349). PM2.5 concentrations were higher in venues where smoking was observed (28.3 µg/m3) compared to venues where smoking was not observed (12.3 µg/m3) (p<0.001). Hospitality locations in Accra, Ghana's capital city, had the lowest compliance levels (59.5%) and poorer air quality compared to the cities of Kumasi and Tamale. CONCLUSIONS: The study shows that while smoking and SHS exposure continues in a substantial number of hospitality venues, there is a marked improvement in PM2.5 concentrations compared to earlier studies in Ghana. There is still a considerable way to go to increase compliance with the law. Efforts are needed to develop an action plan to build upon recent progress in providing smoke-free public spaces in Ghana.