title: Preventing tobacco epidemic in LMICs with low tobacco use - Using Nigeria GATS to review WHO MPOWER tobacco indicators and prevention strategies.
abstract: Tobacco is a major preventable cause of disease and death globally and increasingly shifting its burden to low and middle-income countries (LMICs) including African countries. We use Nigeria Global Adult Tobacco Survey data to examine indications of a potential tobacco epidemic in a LMIC setting and provide potential interventions to prevent the epidemic.
  
  
  
  Global Adult Tobacco Survey data from Nigeria (2012; sample=9765) were analyzed to examine key tobacco indicators. Estimates and confidence intervals for each indicator were computed using SPSS software version 21 for complex samples.
  
  
  
  5.5% of adult Nigerians use any tobacco and exposure to secondhand smoke was mainly high in bars (80.0%) and restaurants (29.3%). Two-thirds of smokers (66.3%) are interested in quitting. Among those who attempted to quit, 15.0% used counseling/advice and 5.2% pharmacotherapy. Awareness was high that tobacco use causes serious illnesses (82.4%), heart attack (76.8%) and lung cancer (73.0%) but only 51.4% for stroke. Awareness that secondhand smoke can cause serious illness was also high (74.5%). Overall 88.5% support tobacco products tax increase.
  
  
  
  Although tobacco use is relatively low in Nigeria as in other African countries, high smoking rate among men compared to women might indicate potential increase in prevalence. Challenges to preventing increasing smoking rate include limited use of evidence-based cessation methods among quit attempters, social acceptability of smoking particularly in bars and restaurants, and gap in knowledge on tobacco-related diseases. However, ratification of WHO FCTC and signing into law of the Tobacco Control law provide the impetus to implement evidence-based interventions.
authors.affiliation: Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA. Electronic address: vyp7@cdc.gov.
authors.forename: Lazarous
authors.initials: L
authors.lastname: Mbulo
authors.affiliation: Nigeria Federal Ministry of Health, Abuja, Nigeria.
authors.forename: Nwokocha
authors.initials: N
authors.lastname: Ogbonna
authors.affiliation: Nigeria National Bureau of Statistics (NBS), Abuja, Nigeria.
authors.forename: Isiaka
authors.initials: I
authors.lastname: Olarewaju
authors.affiliation: World Health Organization, Country Office, Abuja, Nigeria.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Musa
authors.affiliation: Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA.
authors.forename: Simone
authors.initials: S
authors.lastname: Salandy
authors.affiliation: Africa Regional Office, World Health Organization, Brazzaville, Congo.
authors.forename: Nivo
authors.initials: N
authors.lastname: Ramanandraibe
authors.affiliation: Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia, USA.
authors.forename: Krishna
authors.initials: K
authors.lastname: Palipudi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D011203:Poverty; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000517:prevention & control / Q000706:statistics & numerical data*; D014026:Nicotiana
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Tobacco control and WHO MPOWER — Nigeria; Tobacco control — Africa; Tobacco control — Low income countries; Tobacco control — Nigeria