Attitudes toward tobacco use and interest in tobacco cessation treatment in Soweto, Johannesburg, South Africa
Category: Global Cancer Research
Conference Year: 2020
The overall prevalence of tobacco smoking in South Africa (SA) is 18.4%, but ranges from 6.3% to 44.6%, depending on sex and race. Programs that identify tobacco users and refer them to treatment currently exist only in psychiatric facilities in SA. In early 2019, with collaborators at the Wits Health Consortium in SA, we conducted a pilot study for such a program in Soweto, a largely black and poor township of Johannesburg. Participants aged 18+ were recruited from the waiting rooms of community health clinics and non-government organizations by community health workers. Participants responded to a questionnaire regarding demographic characteristics, insurance coverage, employment status, and tobacco use. Nicotine addiction was assessed using a single question: "How soon after waking do you smoke?" and interest in quitting and number of quit attempts was recorded. Receptiveness to tobacco cessation was evaluated by posing three scenarios: "if your doctor told you to quit, if Chantix was free, and if cessation counseling support was available, would you quit?" Participants were further asked if a provider had ever recommended quitting, or ever prescribed Chantix/nicotine replacement therapy (NRT). Of the 166 smokers, most (83.5%) received government medical care, and only 35.7% were employed. They began smoking at a mean age of 17.6 years [SD 5.6], had been smoking for a mean of 24.4 [SD 13.4] years, and smoked a mean 10.9 [SD 6.1] cigarettes per day. Nearly half (47.0%) were highly addicted (smoked within 5 minutes of waking); about 60% had tried to quit at least once; and 83.7% reported they wanted to stop smoking. Almost three-quarters (72.9%) stated that they would definitely quit if their doctor told them to; 88.6% if Chantix was free, and 80.1% if counseling support was available. About 37% reported having been advised by a provider to stop smoking; 6.6% that they had received a prescription for Chantix to help them stop, and 3.6% that they had been advised to use NRT.SA smokers wished to stop smoking but appeared to receive little support from healthcare providers. Community health worker-administered behavioral counseling may be a potential, low cost solution to supplement SA's overburdened medical system and reduce the tobacco smoking in Soweto.
Keywords: Tobacco smoking; Tobacco cessation; South Africa; Community health workers