INTRODUCTION
Nigeria became a signatory to the WHO FCTC in 2005, and the Nigerian Tobacco Control Bill was passed in 2011 and signed in 20151. This bill contained provisions for smoke free places, tobacco advertising, promotion and sponsorship, packaging and labelling, as well as sales to minors2.
In ensuring compliance with these provisions, especially regarding point of sale advertisement and sales to minors, retailers are important stakeholders3. Their importance as stakeholders is borne out by tobacco industry investment of about 97.2% of its marketing budget in the retail environment5-7. The tobacco industry sees them as important market stakeholders who help to increase the potential for initiation and in maintaining tobacco use5. Unlike in developed countries, the retail environment is poorly monitored in developing countries such as Nigeria5,8. This often results in poor compliance with tobacco control laws, especially in rural settings. A recent study, by the Nigerian Tobacco Control Research Group across cities in Nigeria, documents the violation of advertising bans at points of sales4. In rural settings, observations suggest that sale of tobacco products to minors and open display of the products, including use of promotional material provided by the tobacco industry, still persist4.
In developing countries, the promise of incentives and attractive profits by the tobacco industry motivates retailers not only to sell and promote tobacco products but also to display promotional material5,9,10. Thus, monitoring the retail activities will go a long way in reducing exposure of minors to tobacco5. In addition, the willingness of retailers to be involved in preventing initiation and promoting cessation activities has not been well explored5. This study was a formative research to assess retailer awareness of tobacco legislation and willingness to be involved in tobacco control activities.
METHODS
The study was conducted in Igbo-Ora and Eruwa, which are two major towns, located 22 km apart in Ibarapa Central and Ibarapa East Local Government Areas in Oyo State, Nigeria. Igbo-Ora and Eruwa are also the administrative headquarters of Ibarapa Central and East, with total populations of 102 979 and 118 226 people, respectively. Igbo-Ora is a rural area while Eruwa is a semi-urban area11. The major occupation for both areas is subsistence farming. Other occupations include traders, artisans, and civil servants (local government, teaching and health). The traders are mostly petty dealers, who have their shops within or adjoining the residential areas.
A cross-sectional design was used to study 218 people in Igbo-Ora and Eruwa, engaged in the retail of cigarettes and other tobacco-related products either alone or with other items. All consenting retailers in these areas were included in the study because of their small numbers, and data collection was completed within 2 weeks.
An interviewer-administered questionnaire was used to obtain information on: socio-demographic characteristics, sale and profitability of tobacco products, awareness of tobacco legislation, and willingness to be involved in tobacco control programs. The instrument was developed from the Global Adult Tobacco Survey (GATS)12, Global Youth Tobacco Survey (GYTS)13, and information obtained through literature review14,15. The questionnaire was translated to Yoruba and back-translated to English, but was administered in Yoruba by trained health assistants. Data were analyzed using the Statistical Package for Social Sciences (SPSS) v2016. Adjusted odds ratio was used to determine association between profitability, income reduction and willingness to participate in tobacco control strategies. Level of significance was set at 5%.
Ethical approval for the study was obtained from the University of Ibadan-Ibarapa Programme Ethical Unit, while informed consent was obtained from the respondents. After the interview, retailers were counseled on the adverse effects of smoking, educated on the laws restricting sale of tobacco to minors and the use of tobacco in public spaces.
RESULTS
Socio-demographic characteristics and work history
The majority of the respondents (95%) were females, most (77%) were married and 44% had primary education. Respondents had sold tobacco products for a median duration of 5 (1-40) years, and more than two-thirds (65.1%) reported it as a profitable venture (Table 1).
Table 1
Awareness and willingness of retailers to participate in tobacco control strategies
The awareness of tobacco control legislation was found to be poor among the respondents. Although only 27% of respondents had seen information on the dangers of tobacco use or on quitting the use of tobacco products, 76% of them said they would be willing to display anti-tobacco messages in their shops (Table 2).
Table 2
Tobacco sales profitability and willingness to participate in control strategies
Retailers who reported that tobacco sale was profitable were about 2 times (OR= 0.432; 95%CI= 0.207-0.901) less likely to express a willingness to display anti-tobacco messages in their shops and 3 times (OR= 0.349; 95%CI= 0.138-0.885) less likely to support tobacco control legislation, compared to retailers who reported non-profitability. Retailers who reported income reduction if tobacco sale was stopped were about 2 times (OR=0.467; 95%CI=0.246-0.889) less likely to be willing to display anti-tobacco messages in their shops and 9 times (OR=0.106; 95%CI=0.045-0.249) less likely to support legislation on the ban of sales to minors (Table 3).
Table 3
VARIABLES (N=218 ) | Willing to support legislation on ban of tobacco sale to minors | Odds ratio | 95% C.I | Willing to display anti-tobacco messages | Odds ratio | 95% C.I | ||
---|---|---|---|---|---|---|---|---|
Yes N (%) | No N (%) | Yes N (%) | No N (%) | |||||
Age | ||||||||
Less than 40 years | 108(90.8) | 11(9.2) | 2.971 | 1.367-6.457* | 98(82.4) | 21(17.6) | 2.029 | 1.073-3.837* |
40 and above | 76(76.8) | 23(23.2) | 69(69.7) | 30(30.3) | ||||
Gender | ||||||||
Male | 6(60.0) | 4(40.0) | 0.253 | 0.067-0.949* | 5(50.0) | 5(50.0) | 0.284 | 0.079-1.023 |
Female | 178(85.6) | 30(14.4) | 162(77.9) | 46(22.1) | ||||
Educational status | ||||||||
No formal education | 32(82.1) | 7(17.9) | 0.812 | 0.325-2.027 | 27(69.2) | 12(30.8) | 0.627 | 0.291-1.350 |
Formal education | 152(84.9) | 27(15.1) | 140(78.2) | 39921.8) | ||||
Feels that tobacco sale is a profitable venture | ||||||||
Yes | 114(80.3) | 28(19.7) | 0.349 | 0.138-0.885* | 102(71.8) | 40(28.2) | 0.432 | 0.207-0.901* |
No | 70(92.1) | 6(7.9) | 65(85.5) | 11914.5) | ||||
Feels income would decrease if he/she stops selling tobacco | ||||||||
Yes | 47(64.4) | 26(35.6) | 0.106 | 0.045-0.249* | 49(67.1) | 24(32.9) | 0.467 | 0.246-0.889* |
No | 137(94.5) | 8(5.5) | 118(81.4) | 27(18.6) |
DISCUSSION
Although the tobacco industry currently views retailers as important stakeholders in the sale and promotion of tobacco products, they can also be potential stakeholders in tobacco control5. This is shown by the present study, where retailers demonstrated a willingness to participate in tobacco control programs. However, two-thirds of the retailers of the study reported tobacco sale as a profitable venture, which is not different from the findings of other high and low-middle income countries15,17. The high profitability, and other monetary and non-monetary gains, from the sale of tobacco products, reported by more than 60% of the retailers, may serve as a challenge for compliance to tobacco control legislation. Retailers who reported that tobacco sales were profitable and thought their income would decline without such sales are likely to be less supportive of tobacco control initiatives that directly affect them. Therefore, retailer-focused tobacco control efforts need to take this into account in advocating a role for retailers in influencing tobacco-use rates.
The Tobacco (Control) Act 1990 stipulates a ban on smoking in specified public places and sales to minors, among other regulations8, however less than half of the retailers were aware of these laws. Although the tobacco industry ensures that its promotional material is compliant by scripting messages like ‘no sale to minors’ on the products, retailers remain oblivious to these laws and still sell tobacco products to minors. This loophole, is capitalized by the tobacco industry to increase smoking initiation10. This study has therefore shown the need to educate tobacco retailers on aspects of this legislation as it applies to them, as well as the need to design easy to understand pictographs on the subject.
Despite economic gains from the sale of tobacco products, most of the retailers were willing to support legislation banning the sale of tobacco products to minors and to counsel smokers on the negative effects of tobacco. It has been generally assumed that retailers might not be willing to participate in any anti-tobacco programs due to financial gains, and have been therefore excluded from health education and awareness programs15. However, some educational interventions have engaged retailers of high profit products that affect health to educate the customers and reduce the use of such products15. Similarly, tobacco control initiatives can use education-based interventions to engage retailers in efforts to control smoking especially in public places (near their stores) and sales to minors, as well as counseling customers who want to quit15. Recently, many Non-Governmental agencies have stepped up their campaigns against tobacco and thus it is not unlikely that the retailers are being encouraged to change their attitude. This may present a golden opportunity to step up campaigns directed at retailers.
Retailer response regarding willingness to support (comply with) legislation might in part be due to social desirability, because they know the dangers of tobacco use and hence provide the ‘answers expected of them’. Notwithstanding their motivation, this could also be an opportunity for action since any successful tobacco reduction programme begins with an acknowledgement of the harms posed by tobacco.
Finding out the content of anti-tobacco messages that retailers were willing to accept could have provided a proxy for understanding the extent to which they would want to be involved in tobacco control activities beyond compliance to tobacco legislation. Unfortunately, this was outside the scope of this study. In addition, ascertaining the proportion of the total income generated from tobacco sales would also have given a clearer picture of the nature of the perceived profitability, i.e. monetary profitability as against non-monetary profitability such as promotional incentives by the tobacco industry.
CONCLUSIONS
Despite a perceived profitability of tobacco sales, retailers were willing to be involved in tobacco control efforts. Therefore, we encourage the incorporation of retailers into smoking cessation campaigns and other tobacco control efforts. Implementation and monitoring of compliance by the retailers with the Tobacco Control Act will go a long way in reducing exposure of minors to tobacco products and their promotion.
However, while the need to educate the retailers on tobacco legislation has come to the fore, further studies still need to be conducted to determine the modalities by which such interventions can be deployed.