It takes an intensive investigation by the Food and Drugs Authority to get more information about the facility, where the hookah is offered, and whether it meets regulatory standards. This is a flagrant violation of the tobacco control measures of Ghana`s Public Health Act (Act 851) of 2012, which aims to protect children from tobacco use and exposure. Given that hookah operators are mainly found in pubs and drinking establishments that sell to their customers for consumption, Ms. Amankwah-Marfo urged the public to report pub, restaurant, drinking and other operators who offer it to their customers, as well as shops that trade in them. The Food and Drugs Authority (FDA) has explained why hookah tobacco, popularly known as “shisha tobacco”, is illegal in Ghana. “We therefore call on the Ministry of Health and the FDA to urgently start banning these products in Ghana. Many countries, including Rwanda, Uganda, Kenya, Tanzania, Cameroon, etc., have taken bold steps to ban hookah in their countries because of the public health threat it will pose to its children and youth. Given the health effects of smoking hookah, since research shows that one hookah session is equivalent to smoking more than 100 cigarette sticks, it has therefore become more appropriate to ban it rather than regulate it. Many hookah products are also sold illegally because they do not meet the required standards. In the multivariate analysis, it was found that only unemployment is significantly associated with a higher probability of smoking cigarettes and/or hookah. Other studies28,29 have reported similar results.
A study conducted in Sri Lanka30 found that employment and monthly income are associated with smoking. Similarly, a Korean study found that unemployment is an important risk factor for quitting smoking and relapsing smoking,31 which is consistent with our findings. Since unemployment is an important risk factor for not quitting, it is suggested that those who are not employed smoke more and are less likely to quit. A study conducted in Ghana suggests that public policies to promote higher levels of education and improved incomes are important for reducing and quitting smoking.32 Substance abuse can be difficult for a number of reasons, including addiction to toxic substances, which generally affect health and employment status.33 However, cross-sectional evidence is only associative and does not address causality, so further studies are recommended, particularly longitudinal. In a similar study conducted by Abdel-Hady and El-Gilany34 in Egypt, a link between smoking and education and sex was found that is not consistent with our findings. According to them, lower levels of education are a significant independent predictor of current smoking among older adults, which is also consistent with other studies.35,36 Similarly, in the United States, low-educated adults who are also unemployed or who live near or below the U.S. federal poverty line are considered to be of low socioeconomic status (SES) and are more likely to smoke cigarettes.37 Our study did not establish these associations other than employment, hence the need for further studies. Research conducted by the Ghana Health Service shows that most adolescents in the country have quit smoking traditional tobacco cigarettes for e-cigarettes and hookah. The rate of hookah and e-cigarette smoking among young people rose to 5.3 percent, higher than that of traditional smoking, which stands at 2.8 percent. The prevalence of cigarettes, hookahs and e-cigarettes was 24.9% (95% CI: 20.8-29.5), 34.6% (95% CI: 30.0-39.6) and 15.1% (95% CI: 11.3-19.8), respectively. The distribution of long-term cigarette, hookah and e-cigarette smokers by sex and age is shown in Figure 1.
There was a significant difference in the proportion of respondents who had ever smoked cigarettes, by sex and age. Compared to women, more men have smoked cigarettes. In addition, the percentage of respondents who had ever smoked cigarettes was higher among older participants. The reasons for hookah use were no different from other outcomes where participants believed hookah was a safer alternative to smoking and used it out of curiosity and peer influence.23,24,26,27 Hookah originated in Ghana and has gradually become a public health problem that requires an immediate response from policymakers and must be effectively regulated like any other tobacco product.
Comments are closed.