Knowledge and attitudes of bar attendants towards secondhand smoke and compliance with smoking regulations in bars in Kampala Central Division

Abstract

Introduction/background: Smoking increases the risk of non-communicable diseases, not only to smokers but also for second-hand smokers. Second-hand smoke may adversely affect health and aggravate illness. Tobacco use kills six million people every year. Its consumption is rising worldwide, with 80% increase in low- and middle-income countries. In Uganda, 16% of the households are exposed to smoking daily. The study aims to assess the knowledge and attitude of bar attendants towards second-hand smoke and compliance with the smoking regulations in bars. Methods: The study was conducted in Kampala central division. It was a cross sectional study. Bar attendants were respondents for knowledge and attitudes and bars were observed for compliance. Kish Leslie formula was used to calculate the sample size (n = 286 bar attendants) and all the 261 registered bars were assessed for compliance. Analysis was by determining proportions stratified by demographics characteristics for knowledge and attitudes and determining proportions for compliance. Results: Almost 75% (213/286) of the bar attendants were exposed to secondhand smoke (SHS), 92% knew SHS was harmful to their health. Majority (82.2%) were in favour of banning smoking in bars and 98% wanted non smokers to be provided with a smoke free environment to work. There was a positive association between the number of years worked and respondents’ smoking status (OR =4.0, 95% CI= 1.53-10.49). A meaningful relation was fixed between respondents’ smoking status and his/her being bothered be SHS (X2 = 36.79, P = 0.000), he/she in favour that smoking should be banned in bars (X2 = 22.71, P = 0.000). The study also observed 261 bars for compliance with smoking regulations of which 44% (115/261) were located in restaurants. Only 5% (13/261) had designated smoking areas and 7% (19/261) posted a “No Smoking “sign. Full compliance was seen in 4.2% (11/261) of all the bars. There was no significant association between bar location and compliance level (X2 = 7.37, P = 0.288). Conclusion: The knowledge of bar attendants on the dangers of secondhand smoke was high in general. However, it was higher in nonsmokers than the current smokers. The bar attendants attitudes towards second hand smokers were in favour of a smoke free working environment. Most of them did not like being in contact with second hand smoke. Compliance with smoking regulation was very poor in almost all the bars of Kampala Central Division