Knowledge, attitudes and perceptions of workers in indoor bars, beer halls and discotheques towards exposure to second-hand smoking in the two cities in Swaziland

Second-hand smoking is a serious health hazard causing approximately 41000 deaths from lung cancer, respiratory infections, asthma, coronary heart disease and stroke globally each year. Evidence suggests that workers in bars, beer halls and discotheques are more exposed to second- hand smoking compared to other workers in general. Protection of these workers through enactment of smoke-free legislation and attitudes of these workers towards such legislation are key variables of compliance. This study aimed to describe the knowledge of the adverse effects of second-hand smoking, attitudes and perceptions of workers towards the practice. The results suggest that most workers knew what second-hand smoking was and that it could cause lung cancer, coronary heart disease and asthma but undermined the fact that continued exposure or exposure to low levels could lead to severe disease or death. Fifty-four percent of the respondents showed good knowledge and 36% showed fair knowledge of the adverse effects of exposure to second-hand smoke. Respondents mentioned lung cancer (100%), increased coughing (90%), asthma (60%) and heart disease (30%) as possible adverse effects. The knowledge was not different among workers who smoked and those who did not smoke (never smoked or ex- smokers) (p=0.1041). However, both smokers and non-smokers did not believe that exposure to second-hand smoke could lead to early death (p=0.8864). The suggestions that smoking should be banned in all indoor workplaces was accepted by non-smokers but rejected by smokers (p=0.0001). So was the suggestion of increasing tax on cigarettes (p<0.0001). Legislation banning smoking in indoor workplaces is contained in the Swaziland Tobacco Products Control Act (2013) that is still waiting to be enforced and as such, indoor smoking is not banned in the country. Sixty-seven per cent of the participants were not aware of the existence of legislation aimed at protecting them against exposure to second-hand smoke in indoor workplaces. It is suggested that the enforcement of the Swaziland Tobacco Control Act (2013), which purports to impose a comprehensive ban of indoor smoking be speeded up so that indoor air quality could improve. Mechanisms to monitor adherence to the complete ban are likely to speed up improvement of the health of many indoor workers in bars, beer halls and discotheques that are exposed for lengthy periods. Enforcement of the Act should include creation of programmes to create awareness of the risks faced by the workers.