AUA CHSR / KAP Tobacco Control Policy Follow Up Survey - 2007 AMERICAN UNIVERSITY OF ARMENIA CENTER FOR HEALTH SERVICES RESEARCH AND DEVELOPMENT KNOWLEDGE, ATTITUDES AND PRACTICES ON TOBACCO CONTROL POLICIES IN ADULT POPULATION IN ARMENIA A FOLLOW-UP SURVEY The research was conducted with support from the International Development Research Centre, Ottawa, Canada May - June 2007 Prepared by Narine Movsisyan , MD, MPH Project Manager, CHSR Karine Sahakyan , MD, MPH Data Manager/Analyst, CHSR Varduhi Petrosyan , MS, PhD Director, CHSR Yerevan, Armenia April 2008 1 AUA CHSR / KAP Tobacco Control Policy Follow Up Survey - 2007 Acknowledgements We are thankful to the Goris Youth Union NGO for assisting with interviewer training and survey implementation in Syunik marz and to the Young Men’s Christian Association (YMCA), “Ozone”, Gyumri, for assisting with interviewer training and survey implementation in Shirak marz. This research project has been funded under the auspices of the Small Grants Research Program to Support and Inform the Ratification, Implementation and Enforcement of the Framework Convention on Tobacco Control (round 3), supported by the Research for International Tobacco Control (RITC) program of the International Development Research Centre, the Canadian Tobacco Control Research Initiative (CTCRI), the American Cancer Society (ACS), Cancer Research UK, the “Institut National du Cancer” of France and the Department for International Development, UK (DFID). 2 AUA CHSR / KAP Tobacco Control Policy Follow Up Survey - 2007 Table of Content Executive Summary ....................................................................................................................................................... 5 1. Introduction ................................................................................................................................................................ 7 2. Methods....................................................................................................................................................................... 8 2.1. Research objectives .............................................................................................................................................. 8 2.2. Sample size and sample distribution..................................................................................................................... 8 2.3. Study design.......................................................................................................................................................... 9 2.4. Study population................................................................................................................................................... 9 2.5. Sampling strategy ................................................................................................................................................. 9 2.6. Survey instrument ............................................................................................................................................... 10 2.7. Interviewers training .......................................................................................................................................... 11 2.8. Data collection ................................................................................................................................................... 11 2.9. Ethical considerations ........................................................................................................................................ 11 2.10. Data processing and analysis........................................................................................................................... 11 3. Results ....................................................................................................................................................................... 11 3.1. Response rate...................................................................................................................................................... 11 3.2. Socio-demographic characteristics and smoking status..................................................................................... 12 3.3. Knowledge on health effects of smoking............................................................................................................. 13 3.3.1. Effects of direct smoking ............................................................................................................................ 13 3.3.2. Effects of passive smoking ......................................................................................................................... 14 3.4. Beliefs about cigars and light cigarettes ............................................................................................................ 14 3.5. Tobacco advertising and marketing.................................................................................................................... 14 3.5.1. Knowledge on tobacco advertising effects and its regulation..................................................................... 14 3.5.2. Attitudes towards tobacco marketing strategies.......................................................................................... 14 3.5.3. Exposure to tobacco industry marketing..................................................................................................... 15 3.6. Tobacco sales ..................................................................................................................................................... 16 3.7. Cost of tobacco products .................................................................................................................................... 17 3.8. Smoking restrictions ........................................................................................................................................... 18 3.8.1. Attitudes toward smoking restrictions ........................................................................................................ 18 3.8.2. Household smoking practices ..................................................................................................................... 19 3.8.3. Readiness to ask for not smoking................................................................................................................ 19 3.8.4. Worksite smoking practices........................................................................................................................ 19 3.8.5. Attitudes toward and awareness of the law................................................................................................. 20 3.9. Packaging/Labeling of tobacco products ........................................................................................................... 20 4. Comparative analysis of the baseline and follow up survey results ..................................................................... 21 4.1. Survey sample..................................................................................................................................................... 21 4.2. Knowledge on health effects of smoking............................................................................................................. 21 4.3. Tobacco advertising and marketing.................................................................................................................... 21 4.4. Tobacco sales and tobacco cost.......................................................................................................................... 22 4.5. Smoking restrictions ........................................................................................................................................... 22 4.6. Awareness of the law restricting smoking in public places ................................................................................ 22 5. Conclusion................................................................................................................................................................. 22 3 AUA CHSR / KAP Tobacco Control Policy Follow Up Survey - 2007 REFERENCES ............................................................................................................................................................. 24 TABLES 1-27................................................................................................................................................................ 25 FIGURES 1-2................................................................................................................................................................ 41 ATTACHMENT 1........................................................................................................................................................ 42 4 AUA CHSR / KAP Tobacco Control Policy Follow Up Survey - 2007 Executive Summary Armenia joined the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) on November 29 of 2004, followed by the adoption of the national tobacco control law “On Restrictions of Tobacco Sales, Consumption, and Use”. Both, the international treaty and the national law were enacted early in 2005. In May-June 2005, the Center for Health Services Research and Development (CHSR) at the American University of Armenia (AUA) conducted a baseline population-based survey within the framework of a larger tobacco