Interview data for study on TC implementation in Kenya_Anthony Muthemba et al

Abstract

ABSTRACTBackground: Tobacco use and exposure to secondhand smoke (SHS) is one of the leading risk factors for non-communicable diseases (NCDs) and leads to health complications to the individuals and economic implications on healthcare spending in prevention and mitigation of NCDs associated with tobacco use. Tobacco use is a major public health threat globally and a preventable cause of morbidity and mortality.Despite Kenya having comprehensive tobacco control laws and various policies to mitigate the tobacco problem, these laws are not comprehensively implemented and sometimes not implemented at all in multiple counties within Kenya. This include the legal requirement that prohibits single-stick cigarette sales that promotes easy access to cigarettesStudy aim: This study sought to explore the level of awareness of law enforcers and policy implementers about Kenya’s existing tobacco control laws and identified the facilitators and barriers to implementing the ban on sales of single sticks cigarettes in the country.Methodology: The study employed a qualitative research design, where data were collected through KII (key informant interviews) guided by a semi-structured interview schedule. Respondents who are currently engaged in the implementation and enforcement of tobacco control laws in Kenya were the key informants (N=22). Data were analyzed with the aid of NVivo 12 Software.Results: Majority of the participants were males (n=14).Half of the respondents were implementers (at managerial/supervisory role) and the other half being the enforcers (tobacco control enforcement officers). Among these respondents, 18 had knowledge of the principal tobacco control legislation of Kenya (Tobacco Control Act, 2007) and 21 had little knowledge of the provision banning sale of single stick cigarettes in the said legislation. Results from the study show that institutional and individual factors facilitated implementation of tobacco control laws. Institutional facilitating factors included political will, administrative support and existing structures anchored on both state and non-state agencies/organizations. Individual facilitating factors included the existence of some skilled stakeholders and synergies between their initiatives, and existence of prior training/sensitization on tobacco control. It was also found that tobacco industry interference, political factors and institutional complexities were barriers towards effective tobacco control implementation. Political factors included lack of political goodwill towards tobacco control. Low capacity-building of enforcement officers and advocates was also identified as a barrier. Institutional complexities included lack of tobacco control committees/units or focal persons at the county levels and frustrating legal and bureaucratic processes. Respondents also perceived the enforcement of the ban on single-stick sales as plagued by political and industry interference as well as resistance of vendors and consumers to implementation of the ban.Conclusion: Findings from this study show that the law banning the vending of single sticks in Kenya needs better enforcement, which can be achieved if there is more administrative support and better training of enforcement officers. The law banning the vending of single sticks cigarettes, if effectively implemented, would address the demand and supply of cigarettes hence lower access to and the smoking of cigarettes as well as exposure to second-hand smoke.Recommendations: Formulation of a national policy that clearly maps out and states the roles of each state and non-state tobacco control actors in the implementation of tobacco control laws. This will help to clearly stipulate and synergize the roles played by each stakeholder based on their different capacities for achieving the common goal. County enforcement agencies should enforce implementation of the ban on sale of single stick cigarettes.<br>