Ghana: A study of secondhand smoke exposure in selected public places

This research is published in the March 2011 issue of the Tobacco Control Journal. Its conclusion:

" SHS levels were unacceptably high in public places in Ghana where smoking is allowed, despite a relatively low-smoking prevalence in the country. This is one of the first studies to ascertain SHS and hair nicotine in Africa. Levels were comparable to those measured in American, Asian and European countries without or before smoking bans. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Ghana."

Source: Tobacco Control Journal

• Research paper

Secondhand tobacco smoke exposure in selected public places (PM_2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana

OPEN ACCESS

1. Wilfred Agbenyikey1, 
2. Edith Wellington2, 
3. John Gyapong2, 
4. Mark J Travers3,
5. Patrick N Breysse4, 
6. Kathleen M McCarty1, 
7. Ana Navas-Acien4,5

+Author Affiliations

1. ¹Environmental Health Science Department, Yale University School of Medicine, Department of Epidemiology and Public Health, New Haven, Connecticut, USA
2. ²Research and Development Division, Ghana Health Service, Accra, Ghana
3. ³Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
4. ⁴Department of Environmental Health Sciences and Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
5. ⁵Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

1. Correspondence toAna Navas-Acien, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W7033B, Baltimore, MD 21205, USA; [email protected]

1. Contributors Wilfred Agbenyikey, Edith Wellington and John Gyapong directed the fieldwork in Ghana. Mark J. Travers supervised all the aspects of the fieldwork, data analysis and interpretation related to PM_2.5 measures. Ana Navas-Acien supervised all aspects of the fieldwork, data analysis and interpretation related to air nicotine and hair nicotine measures. Wilfred Agbenyikey, Kathleen M. McCarty and Ana Navas-Acien analysed the data and drafted the initial version of the manuscript. Patrick Breysse is responsible for the air nicotine and hair laboratory analysis, quality control and assurance and interpretation of air and hair nicotine data. Wilfred Agbenyikey, Edith Wellington and John Gyapong are responsible for the interpretation and discussion of the study findings as they pertain to Ghana and the African context. All authors contributed to the interpretation of the study findings and the revision of the manuscript for important intellectual content and final approval.

• Received 2 February 2010
• Accepted 6 August 2010
• Published Online First 7 October 2010

Abstract

Background Secondhand tobacco smoke (SHS) exposure is a global public health problem. Ghana currently has no legislation to prevent smoking in public places. To provide data on SHS levels in hospitality venues in Ghana the authors measured (1) airborne particulate matter <2.5 μm (PM_2.5) and nicotine concentrations and (2) hair nicotine concentrations in non-smoking employees. Quantifying SHS exposure will provide evidence needed to develop tobacco control legislation.

Method PM_2.5 was measured for 30 min in 75 smoking and 13 non-smoking venues. Air nicotine concentrations were measured for 7 days in 8 smoking and 2 non-smoking venues. Additionally, 63 non-smoking employees provided hair samples for nicotine analysis.

Result Compared to non-smoking venues, smoking venues had markedly elevated PM_2.5(median 553 [IQR 259–1038] vs 16.0 [14.0–17.0] μg/m³) and air nicotine (1.83 [0.91–4.25] vs 0.03 [0.02–0.04] μg/m³) concentrations. Hair nicotine concentrations were also higher in non-smoking employees working in smoking venues (median 2.49 [0.46–6.84] ng/mg) compared to those working in non-smoking venues (median 0.16 [0.08–0.79] ng/mg). Hair nicotine concentrations correlated with self-reported hours of SHS exposure (r=0.35), indoor air PM_2.5concentrations (r=0.47) and air nicotine concentrations (r=0.63).

Conclusion SHS levels were unacceptably high in public places in Ghana where smoking is allowed, despite a relatively low-smoking prevalence in the country. This is one of the first studies to ascertain SHS and hair nicotine in Africa. Levels were comparable to those measured in American, Asian and European countries without or before smoking bans. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Ghana.

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