Young peoples awareness and support for tobacco control legislation: A study among in-school youth in Lagos, Nigeria.

Background: The increasing awareness of the health risks associated with tobacco use has led many countries to enact tobacco control legislation to protect citizens from the harmful effects of tobacco use. Young people are important stakeholders in many aspects of tobacco control legislation.Objective: This study aims to assess the awareness of existing tobacco control laws among young people, their attitudes towards these laws and the factors associated with youth awareness and support for tobacco control legislation in Nigeria.Methods: A descriptive cross-sectional survey was carried out among 950 students enrolled in six randomly selected public and private schools in the Mushin local government area of Lagos state using a multi stage sampling method. The respondents completed a pre-tested self-administered questionnaire eliciting information on their awareness and support for tobacco control laws in selected thematic areas. Data was analysed using SPSS 17.0 and presented as frequency tables and cross tabulations.Results: Most of the participants were between 14-18 years of age (55.8%) with a mean age of 14.1±2.2 years. There were slightly more male than female respondents. About two-thirds of the respondents were aware that laws exist to regulate tobacco use in Nigeria. Specifically, more than 60% of the students knew that tobacco smoking was outlawed in schools, medical establishment, public vehicles and offices. Many were aware of the advert bans on tobacco products on television, newspapers, radio, magazines and cinemas. The respondents were however less informed of the penalties for violating tobacco restriction laws. Majority supported the law prohibiting cigarette smoking in health facilities (84.3%), schools (83.7%), public transportation (79.5%) and cinemas (76.3%). Relatively fewer (49.6%) respondents felt that smoking should be prohibited in bars, restaurants and nightclubs. A significant proportion believed that young people in Nigeria should not be allowed to buy (76.4%) or sell (76.1%) cigarettes. Few (13.7%) respondents did not support the law banning cigarette advertisement on mass forms of media. Similarly, 12.2% did not support the law allowing cigarette sponsorship and promotions by cigarette companies. Majority (83.7%) of the respondents agreed with the law banning the sale of cigarettes around school premises while 66.2% supported the ban on sales of cigarettes in single sticks. Majority of the students (78.3%) agreed that health warnings should be placed on all cigarette packages while 62.5% agreed that the prices of cigarettes should be increased to discourage buyers. Up to 69.2% agreed that cigarette scenes should be prohibited in movies for kids. In general, majority (94.3%) of the respondents expressed a high level of support for tobacco related legislation. A bi-variate analysis showed students who received pocket money were found to have significantly higher levels of awareness compared with those who did not receive pocket money. (p=0.003). We also found that females were generally less supportive of tobacco control legislation compared to their male counterparts.Conclusion: School based education programs should be carried out to inform and educate students about existing tobacco laws in Nigeria. Policy makers should leverage on the support of key stakeholders like young people for the passage and effective implementation of tobacco control laws.Keywords: Tobacco, legislation, youth, awareness, support, In-schoo