News media coverage of shisha in Nigeria from 2014 to 2018

Waterpipe tobacco and public health: a content analysis of media discourse on waterpipe tobacco smoking across Africa

INTRODUCTION

Despite its known health risks, the tobacco epidemic is evolving as waterpipe tobacco smoking (WTS) in Africa increases. This study explores media coverage of WTS in Africa to identify key themes, misinformation and opportunities for public health education.

METHODS

Between October and December 2023, we analysed media articles using Tobacco Watcher, an online surveillance portal that compiles news from over 595 000 web sources. We searched for English-language articles published in Africa that discussed WTS between 2012 and 2023 with Boolean terms (ie, 'shisha OR hookah OR waterpipe OR narghile AND Africa'). Themes identified include WTS regulations, health risks, venues, youth uptake, misconceptions/myths and tobacco industry perspectives.

RESULTS

We found 137 eligible articles from 15 of the 54 African countries. Most articles came from Kenya (n=39), Nigeria (n=21) and Egypt (n=17). 92 (67.1%) discussed the health risks of WTS, 37 (27.0%) referenced youth uptake and 6 (4.4%) discussed tobacco industry views about WTS. Over two-thirds (n=97, 70.8%) of articles discussed proposed or implemented WTS bans, with most from Kenya (n=34). Additionally, 27 (19.7%) discussed misconceptions/myths related to WTS, of which Nigeria (n=7) and Ghana (n=5) had the highest proportion.

CONCLUSION

Findings reveal widespread concern about health risks and strong interest in the regulation of WTS in the media. A significant portion of articles discussed misconceptions about WTS, highlighting the need for targeted education campaigns to dispel myths and protect public health.

Reasons for shisha smoking: Findings from a mixed methods study among adult shisha smokers in Nigeria

Shisha smoking has increased significantly worldwide over the past decade including in developing countries such as Nigeria. We aimed to understand the reasons for shisha smoking in Nigeria in order to address the lack of context-specific evidence to inform the national response to the growing threat posed by shisha smoking. We adopted the Theory of Planned Behaviour to conduct in-depth interviews among 78 purposely sampled current shisha smokers in 13 states (six in each state), and a quantitative survey including a random sample of 611 current shisha smokers in 12 states, across the six geopolitical zones in Nigeria. The in-depth interview data was analysed using thematic analysis whilst the quantitative survey data was analysed descriptively. We triangulated the key findings from the two datasets using a triangulation matrix organised by the three meta-themes: attitude, subjective norms, perceived behavioural control. Positive attitudes towards shisha smoking stem from shisha flavours, perceived pleasure from shisha smoking, curiosity about product attributes, beliefs about health benefits, limited knowledge on the health effects, and weak regulation. Having friends and family members who smoke shisha and the need to belong, particularly during social events, also promote shisha smoking. Negative societal views towards shisha smoking are potentially a protective factor. The availability of and ability to smoke shisha in many places makes shisha more accessible, whilst the high costs of shisha are potentially prohibitive. The findings also indicate that quitting shisha smoking without support is difficult. Restrictions on flavours, strengthening compliance monitoring and enforcement of the tobacco control laws in relation to shisha (e.g., smoke-free environments in indoor and outdoor public places; health warnings in English on shisha products including the pots; and tax and price measures) have the potential to minimise initiation and use, and to protect the health and wellbeing of Nigeria's general public.

Framing the policy debate over tobacco control legislation and tobacco taxation in South Africa

BACKGROUND

In 2018, South Africa opened public consultations on its newly proposed tobacco control bill, resulting in substantial public debate in which a range of arguments, either in favour of or against the Bill, was advanced. These were accompanied by the recurring discussions about the annual adjustments in tobacco taxation. This study uses the concept of framing to examine the public debate in South African print media on the potential effects of the legislation, as well as tobacco tax regulations, between their proponents and detractors.

METHODS

A systematic search of news articles using multiple data sources identified 132 media articles published between January 2018 and September 2019 that met the inclusion criteria.

RESULTS

Seven overarching frames were identified as characterising the media debate, with the three dominant frames being Economic, Harm reduction and vaping, and Health. The leading Economic frame consisted primarily of arguments unsupportive of tobacco control legislation. Economic arguments were promoted by tobacco industry spokespeople, trade unions, organisations of retailers, media celebrities and think tanks-several of which have been identified as front groups or third-party lobbyists for the tobacco industry.

CONCLUSION

The dominance of economic arguments opposing tobacco control legislation risks undermining tobacco control progress. Local and global tobacco control advocates should seek to build relationships with media, as well as collate and disseminate effective counterarguments to those advanced by the industry.

Predictors of substance use disorder symptoms among women in Katsina State, Nigeria

BACKGROUND

Problems associated with substance use are on the rise among women in northern Nigeria, creating a need to understand factors contributing to this trend.

METHOD

Data on substance use, symptoms of substance use disorder (SUD) using DSM-5 criteria, and risk and protective factors associated with SUD symptoms, including adverse childhood experiences (ACE), were collected in a community-based study of young adult women (M age = 25.76, SD = 4.71 years) from Katsina State.

RESULTS

The analytic sample included 360 women with valid SUD symptom data. SUD symptoms were correlated in expected directions with the majority of risk and protective factors, including ACE. A hierarchical linear regression analysis predicting SUD symptoms revealed that age, ACE, and peer drug use were uniquely associated with higher levels of SUD symptoms; more education and endorsing a positive relationship with parents was associated with fewer SUD symptoms. Notably, ACE remained a unique contributor to SUD symptom totals in the context of protective factors and additional risk factors, although the association of ACE and SUD symptoms was attenuated.

CONCLUSIONS

These data illustrate the enduring impact of ACE on risk for SUD symptoms in women, and the protective role that a positive relationship with parents may play in reducing this risk. Further, these patterns of findings reveal the utility of assessing risk and protective factors across multiple life domains to gain a comprehensive picture of risk for SUD symptoms in women.

"Are they trying to control us people?": News media coverage of COVID-19 lockdown tobacco sales ban in South Africa

The South African government imposed one of the strictest lockdowns in the world as part of measures to curb the spread of COVID-19 in the country, including a ban on the sale of tobacco products. This study explored news media coverage of arguments and activities in relation to the South African lockdown tobacco sales ban. We collected media articles published between 26 March to 17 August 2020, which corresponded to the period of the sales ban. Data were sourced via google search and snowball identification of relevant articles. Thematic analysis of data was conducted with the aid of NVivo. We analysed a total of 305 articles relevant to the South African tobacco sales ban during the lockdown. Six major themes were identified in the data: challenges associated with implementing the ban, litigation, and threats of litigation to remove the ban, governance process and politicization of the ban, pro and anti-tobacco sales ban activities and arguments and reactions to the announcement lifting the ban. The initial reason for placing the ban was due to the non-classification of tobacco products as an essential item. Early findings of a link between tobacco smoking and COVID-19 disease severity led to an extension of the ban to protect South Africa's fragile health system. Pro-sales ban arguments included the importance of protecting the health system from collapse due to rising COVID-19 hospitalization, benefit of cessation, and the need for non-smokers to be protected from exposure to secondhand smoke. Anti-sales ban arguments included the adverse effect of nicotine withdrawal symptoms on smokers, loss of jobs and the expansion of the illicit cigarette markets. Litigation against the ban's legality was a strategy used by the tobacco industry to mobilize the public against the ban while promoting their business through the distribution of branded masks and door-to-door delivery which goes against current tobacco regulations. The media could serve as a veritable tool to promote public health if engaged in productive ways to communicate and promote public health regulations to the general population. Engagement with the media should be enhanced as part of health promotion strategies.

Motivators of impulsivity to smoke waterpipe tobacco among Nigerian youth who smoke waterpipe tobacco: the moderating role of social media normalisation of waterpipe tobacco

BACKGROUND

Impulsivity is a formidable cause of waterpipe tobacco smoking among youth, however, it is understudied among African youth. Using PRIME behavioural theory, this study aimed to develop a model that examines the motivators of impulsivity to smoke waterpipe tobacco in linkage to the moderating role of social media normalisation of waterpipe tobacco, specifically among youth in Nigeria who smoke waterpipe tobacco.

METHODS

Data were drawn from 695 respondents who smoke waterpipe tobacco across six Nigerian universities in the South-West zone using the chain-referral sampling procedure. Descriptive analyses of the obtained data were carried out using the Statistical Package for Social Sciences (SPSS) version 25. The constructs in the developed model were validated through Partial Least Squares Structural Equation Modelling (PLS-SEM) in SmartPLS version 3.

RESULTS

Among Nigerian youth who smoke waterpipe tobacco, intention (β = 0.442, P < 0.001) was the strongest motivator of impulsivity to smoke waterpipe tobacco as compared to positive evaluations (β = 0.302, P < 0.001). In addition, social media normalisation of waterpipe tobacco acted as a moderator that strengthened the relationship between intention and impulsivity (β = 0.287, P < 0.01), as well as, between positive evaluations and impulsivity (β = 0.186, P < 0.01) among youth.

CONCLUSION

Intention greatly instigates Nigerian youth's impulsivity to smoke waterpipe tobacco, and social media normalisation of waterpipe tobacco also considerably increases their impulsivity to smoke waterpipe tobacco. Youth-focused educational waterpipe tobacco cessation-oriented programmes that utilise diverse constructive-based learning approaches like illustrative learning and counselling, can help to enlighten and encourage Nigerian youth on the importance of shunning the desirability to smoke waterpipe tobacco.