Abstract
INTRODUCTIONGhana 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.METHODSThis 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.RESULTSSmoking 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.CONCLUSIONSThe 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.
Highlights
Ghana has a partial smoking ban with smoking allowed in designated smoking areas
With 77% of all smoking-related deaths and 89% of secondhand smoke (SHS) relateddeaths occurring in low- and middle-income countries, it is clear that the burden of the tobacco epidemic has moved from high-income countries (HICs) to LMICs1
Two of the venues from Accra and Kumasi had incomplete information, 152 venues were included in the final analysis
Summary
Ghana has a partial smoking ban with smoking allowed in designated smoking areas. Studies evaluating smoke-free laws are scarce in Sub-Saharan Africa. The WHO African Region advocates that all countries be compliant with the requirements of FCTC Article 8 guidelines, and that 100% smoke-free environments should become the status quo in all societies This includes hospitality venues (such as bars, hotels, restaurants, night clubs, and pubs) where workers have traditionally been exposed to the highest levels of SHS5. While smokefree policies are becoming more common, more than 80% of the world’s population ( in LMICS) is not yet protected by these policies[6,7] This is the scenario in several countries in Sub-Saharan Africa (SSA) where smoke-free policies either do not exist or are in the inceptive stages and studies on the magnitude of SHS-related air quality are poorly described and inadequate[7]
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