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News Media Coverage of Shisha in Nigeria from 2014 to 2018 Tobacco Induced Diseases Research Paper News media coverage of shisha in Nigeria from 2014 to 2018 Emmanuel A. Abraham1,2, Catherine O. Egbe3,4, Olalekan A. Ayo-Yusuf2 ABSTRACT INTRODUCTION Shisha which was formally popular mostly in the Eastern Mediterranean region is now gaining popularity globally and has become a trending tobacco AFFILIATION product in Nigeria. The increasing popularity of shisha is possibly driven by the 1 Tobacco Control Unit, Non-Communicable Diseases attractive flavours and the misperception that it is safer than traditional cigarettes. Division, Federal Ministry of Since the media plays a significant influence on public awareness, perception Health, Abuja, Nigeria 2 Africa Centre for Tobacco and understanding of various issues, this study sought to explore the coverage of Industry Monitoring and shisha use by five national newspapers in Nigeria. Policy Research, Sefako Makgatho Health Sciences METHODS Five newspapers were selected based on their website traffic (online University, Pretoria, South readership). The software NVIVO 12 was used to organise the content of the Africa articles into themes. 3 Alcohol, Tobacco and Other Drug Research Unit, South RESULTS Between 2014 and 2018, we found 30 relevant publications about shisha. African Medical Research Some newspaper articles reported that shisha smoking was gaining popularity Council, Pretoria, South Africa 4 Faculty of Public Health, among youths, especially in tertiary institutions across the country. Similarly, Sefako Makgatho Health some misconceptions about the safety of smoking shisha among shisha users was Sciences University, Pretoria, reported. Addiction to shisha was also reported as being so common that many South Africa shisha users were no longer satisfied with just visiting nightclubs and shisha cafes CORRESPONDENCE TO but now own the shisha paraphernalia. There were also reports that the tobacco Emmanuel A. Abraham. Tobacco Control Unit, Non- in shisha was in some instances being replaced or mixed with other hard drugs Communicable Diseases like marijuana. Subtle advertisement of shisha lounges, which is a violation of the Division, Federal Ministry of Health, Federal Secretariat Nigeria National Tobacco Control Act, was also observed. Complex, Phase III, Ahmadu CONCLUSIONS There is a need for increased sensitization of the public through the Bello Way, Central Business District, Abuja, Nigeria. E-mail: media on the dangers of shisha smoking and other tobacco product use. There [email protected] is also a need for a national survey to determine the prevalence of shisha use in ORCID ID: https://orcid. Nigeria. org/0000-0001-6565-4126 KEYWORDS Nigeria, shisha, tobacco, newspaper report Received: 24 January 2019 Revised: 3 April 2019 Accepted: 3 April 2019 Tob. Induc. Dis. 2019;17(April):33 https://doi.org/10.18332/tid/106139 INTRODUCTION Health Organization (WHO) reports that every year, Shisha is known by different names depending on the more than 7 million people die as a result of tobacco region. It is also called waterpipe, hookah, narghile, use globally4. Of this figure, more than 6 million are or hubbly bubbly. It is a means of smoking tobacco from direct tobacco use, and close to 0.9 million from in which the vapor passes through water before exposure to secondhand smoke4. Low-income and inhalation1. Tobacco is the main ingredient in shisha2, middle-income countries like Nigeria bear nearly 80% and tobacco use is the most important preventable of the global burden of tobacco-related mortality4. cause of premature death and disease3. The World According to WHO, shisha, which was invented in Published by European Publishing on behalf of the International Society for the Prevention of Tobacco Induced Diseases (ISPTID). © 2019 Abraham EA. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License. (https://creativecommons.org/licenses/by/4.0/) 1 Tobacco Induced Diseases Research Paper India by a physician known as Hakim AbulFath5, has In another study involving 98747 youths in the US, been used to smoke tobacco and other substances Smith et al.14 reported that each ten-article increase by the indigenous people of Africa and Asia for at in newspaper volume over a five-month period was least four centuries5. But there is growing evidence associated with, among others, increased odds of to show that shisha is gaining popularity globally and perceiving great harm from smoking, disapproving is fast becoming a serious threat to public health1. of smoking, and smoking in the past 30 days. A multi-country study conducted among school In Australia, newspaper coverage of tobacco issues children 13–15 years old in several countries in the has assisted tobacco control15. This could likely be Arabian Peninsula (Bahrain, Oman, Qatar, United one of the reasons why Australia is setting the pace Arab Emirates, Kuwait and Yemen) showed that the globally in the implementation of tobacco control prevalence of shisha smoking ranged from 9% to policies such as plain packaging for tobacco products. 15%6. Shisha smoking prevalence in this study was Therefore, this study sought to explore the higher than cigarette smoking6. coverage of shisha use in Nigeria by qualitatively In two cross-sectional studies conducted among analyzing articles published in five of the most read medical students of two universities each in Pakistan online newspapers. and South Africa, the prevalence of shisha smoking was 21.5% and 18.6%, respectively7,8. Another cross-sectional METHODS study involving 427 university students in a private Major newspapers in Nigeria were ranked based University in Kigali City, Rwanda, found the prevalence on their website traffic16. The website traffic of of ever smoking shisha to be 26.1%, and 20.8% for those newspapers was assessed on the Alexa website16. The that smoked in the last 30 days9. Another cross-sectional five most popular newspapers based on their ranking, study conducted among 389 first-year students in a using this web tool, were then selected for the study. university in the Western Cape, South Africa, indicated A similar study on newspaper coverage of the Ebola that 40% of the respondents were current shisha users10. virus disease in Nigeria used four newspapers17. The The mean age for first-time shisha smoking in this study five newspapers selected for this study according to was found to be 15.7 years10. their rankings include: Punch, Vanguard, Premium There is no published study on the prevalence of Times, The Nation, and The Guardian. shisha smoking in Nigeria. However, data from the The websites of each of these newspapers were 2008 Global Youth Tobacco Survey (GYTS) conducted searched between 12 to 28 July 2018 using the in 5 major cities in Nigeria showed the prevalence of search terms: ‘shisha’, ‘Hookah’, and ‘water-pipe’. reported current ‘other tobacco products’ use higher The inclusion criteria were: articles wholly or partly than cigarette smoking11. The consistently higher about shisha, hookah or water-pipe. Articles that did prevalence of other tobacco product use relative to not address shisha smoking as a behavior or were not cigarettes, in each of these cities, suggests that other relevant to tobacco control were excluded in a second tobacco products are becoming more popular than round of assessment. There were 30 articles (Figure 1) cigarettes11. One of these alternative tobacco products available in the Nigerian market is shisha. However, Figure 1. Flowchart showing selection of articles for only limited information is available on the knowledge analysis of health risks, attitudes and perception of Nigerians Articles identified using the search towards shisha smoking. terms 128 The media has a very significant influence on Duplicated articles public awareness, normative believes, perception 44 and understanding of various issues, and information Without duplicated articles relayed to the public through the media clearly 88 Articles whose main focus is not 12 influences health behavior . For example, Friend and shisha and is not relevant to tobacco 13 control Levy , in their review of several studies in the US, 58 reported that mass media campaigns are associated Articles included in the final review 30 with reduced smoking rates among adults and youths. Tob. Induc. Dis. 2019;17(April):33 https://doi.org/10.18332/tid/106139 2 Tobacco Induced Diseases Research Paper that met these inclusion and exclusion criteria. The Nvivo 12. This software was used to organize the first article was published on 13 July 2014 and data into themes following a thematic analysis the last one was published on 20 July 2018. Key procedure by Braun and Clark18. This procedure information from each article was extracted and is includes: familiarising yourself with your data; shown in Table 1. The content of each newspaper generating initial codes; searching for themes; article was extracted into a Word document reviewing themes; defining and naming themes; individually and then exported into the software producing the report18. Table 1. Reports on Shisha in Nigerian newspapers 2014–2018 Journalist Publication Code Title of the media Name of name Intended purpose of the media Newspaper S/N date Name piece media (author) URL/Links piece Section 1 13-Jul-14 PT 1 Out in Abuja: Club Premium Onyinye https://www. A report on a club in Abuja where Entertainment behavior Times Muomah premiumtimesng.com/ ladies were openly smoking entertainment/164861- cigarettes and shisha out-in-abuja-club- behaviour.html 2 2-Oct-14 N 1 Students hooked on The Habeeb http://thenationonlineng. To highlight the growing trend of Education hookah Nation Whyte net/students-hooked-on- shisha smoking among university (Campus Life) hookah/ students in Nigeria 3 7-Sep-15 V 1 I can smoke Shisha Vanguard Ayo Onikoyi https://www.vanguardngr. An actress's shisha smoking News all day, every day, com/2015/09/i-can- behaviour says Ella Mensah smoke-shisha-all-day- everyday-says-ella- mensah/ 4 20-May-16 G1 Uganda bans The N.A.
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