Date Published: December , 2017
Publisher: Makerere Medical School
Author(s): Obianuju B Ozoh, Maxwell O Akanbi, Casmir E Amadi, William M Vollmer, Nigel G Bruce.
Factors associated with tobacco smoking are useful in designing tobacco control programs.
To estimate the prevalence of and factors associated with tobacco smoking among long-distance drivers.
A cross-sectional study. Stratified cluster sampling approach was used to select drivers based on if they received annual health screening (AHS) or not (non-AHS). We used a structured questionnaire to obtain information and weighted the resulting observations to derive population based estimates. Association between tobacco smoking and socio-demographic factors was explored in multivariate models.
A total of 414 male drivers, with a mean age of 43.6 (standard error 0.6) years were studied. Population weighted prevalence of current smoking was 18.9% (95% CI: 14.3–23.4) all drivers, 6.5% (95% CI: 2.6–10.4) of AHS drivers and 19.5 (95% CI: 14.7–24.2) of non-AHS drivers (p<0.001). In multivariate models, having close friends that smoked (OR= 6.36, 95% CI= 2.49 – 16.20) cargo driving (OR= 2.58, 95% CI= 1.29 – 5.15) and lower education levels (OR for post-secondary education vs. Primary education or less= 0.17, 95% CI= 0.04 – 0.81) were associated with current smoking. Prevalence of tobacco smoking is higher among non-AHS compared to AHS drivers. Having close friends that smoked, cargo driving, and lower education levels were associated with current smoking.
Tobacco use is a public health problem, with the worldwide tobacco-attributable deaths projected to be 8.3 million in 20301. It also poses a substantial economic burden on the individuals who consume it and on the healthcare system2.
This was a cross-sectional study. The Health Research Ethics Committee of the Lagos University Teaching Hospital, Lagos, Nigeria approved all study procedures. We obtained permission and endorsement for the study from the heads of motor parks and transport companies and informed consent from all participants
Table 1 describes the population characteristics of long distance drivers both overall and by AHS status. The mean age of the drivers was 44 years and ranged from 22 years to 76 years. The mean duration of driving was 19 years and ranged from 2 to 55 years. Non-AHS drivers were significantly less educated (p<0.001), but earned significantly more (p<0.001) than the AHS drivers. All cargo drivers were non-AHS drivers (p<0.001). Despite a similar awareness of the tobacco control law, more AHS drivers had a good understanding of the law (p=0.009). Knowledge of harmful health effects of smoking was modest for most conditions (65%–75%), except for respiratory illnesses and infertility (17%–38%) and generally did not differ significantly between the groups. Only one third of the drivers knew that cigarette smoking affects others who do not smoke. Perception of a negative community attitude towards tobacco smoking did not differ significantly between the groups but perception of a negative religious attitude towards smoking was significantly higher among AHS drivers (p<0.001). The overall prevalence of cigarette smoking among long-distance drivers in Lagos, Nigeria is high compared to reported prevalence in the general population. However, when considered by AHS status, the prevalence among AHS drivers is similar to that in the general population. Although the AHS drivers had significantly lower likelihood of being current smokers, this benefit was no longer significant after adjusting for confounders. Having close friends who smoke, cargo driving, and lower education levels were independently associated with higher odds of current smoking. The estimated population based prevalence of cigarette smoking is high among long distance drivers operating from Lagos, Nigeria. Drivers who participated in annual health screening had significantly lower likelihood of being current smokers, although this benefit was no longer significant after adjusting for confounders. It is unclear to what extent the lower smoking prevalence seen in AHS drivers was due to the health screenings and education they receive as opposed to other factors that distinguish this group from the non AHS drivers. For instance none of the AHS drivers was a cargo driver. That does not necessarily mean that the health education and screenings did not matter, rather, they may have been influenced by some of the other factors adjusted for in the multivariate model. In multivariate models, having close friends who smoke, cargo driving, and lower education levels were independently associated with higher odds of current smoking. This study highlights that long distance drivers are an important target group for tobacco control interventions. Strategies to provide regular health screening may provide additional benefits by influencing smoking behavior and is worth exploring in future studies. Source: http://doi.org/10.4314/ahs.v17i4.19