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Tobacco Use and Secondhand Smoke Exposure Among Women in Aleta Wondo, Ethiopia: An Exploratory Study of Knowledge, Attitudes, Beliefs and Behaviors

  • Author(s): Petersen, Anne Berit
  • Advisor(s): Cataldo, Janine K
  • et al.

By 2030, sub-Saharan Africa is projected to be the epicenter of the tobacco epidemic. In Ethiopia there is an opportunity to avert an increase in tobacco-induced diseases; however, local data is needed to inform proactive contextualized tobacco control interventions. This cross-sectional community-base study was conducted to assess the knowledge, attitudes, beliefs, and behaviors (KABs) related to tobacco use and secondhand smoke (SHS) exposure of women in the Aleta Wondo region. A structured interviewer-administered survey was adapted and administered to 353 women of reproductive age (18-55 years) between August and October 2014, using a systematic household sampling plan. Descriptive statistics and logistic regression were performed. Overall levels of awareness of risk associated with tobacco use was high, however understanding of specific tobacco-related diseases was limited. None of the participants reported current tobacco use. Only 7.6% reported living with a tobacco user, however 14.4% reported that smoking occurred daily inside their home. Living with a tobacco user (OR = 9.68, 95% CI [3.31, 28.32]), the absence of a smoking ban in the home (OR = 6.11, 95% CI [2.82, 13.25]), residing in an urban setting (OR = 3.36, 95% CI [1.52, 7.44)]), and reporting exposure to point-of-sale advertising within the last 30 days (OR = 2.66, 95% CI [1.21, 5.83]) were found to be associated with daily occurrence of smoking in the home. A low level of social acceptability of female tobacco use and generalized tobacco-related stigma may limit the reliability of self-report and represent a source of social desirability bias in this type of setting. The Behavioral Ecological Model was used to explore the influence of a number of contextual factors on tobacco-related KABs, including: non-personal uses of tobacco, khat use and acceptability, exposure to pro- and anti-tobacco messaging, religious affiliation, and exposure to solid fuel smoke and perceptions of risk. These findings have implications for policy and program development in Ethiopia, particularly in relation to the promotion of smoke-free homes. However, more research is needed to fully understand the role that each of these factors may play in the prevention of tobacco use and SHS exposure among women in Ethiopia.

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