Knowledge, attitude, and practice of tobacco control law among tobacco retailers of Dhaka City Corporation

Abstract

Background: Tobacco retailers (TRs) play a crucial role in enforcing tobacco control laws (TCL), directly impacting public health efforts. Their knowledge, attitude, and practice (KAP) regarding TCL influence compliance and effectiveness. This study aims to assess TRs’ KAP to identify gaps and strengthen enforcement strategies. Methods: A cross-sectional survey, using a multistage sampling approach, was conducted among 420 TRs in all the 10 zones of Dhaka North City Corporation from August to September 2020. Data was collected using a semi-structured questionnaire and a checklist, which was adapted, based on the global adult tobacco survey (GATS) questionnaire and literature searches. Furthermore, five key informants’ interviews (KII) were conducted using the guidelines. Mean, percentages, and Chi-square tests were applied for relevant variables and a thematic approach was used for qualitative data. Results: Among 420 participants, mean age of the respondents was 35.9 (±11.5) years and 59% had the business of tobacco as the main product. Though 60% of respondents had heard the term ‘Tobacco control law’, 61% knew about advertisement restrictions at point of sales (POSs). Knowledge of other specific sections of TCL was overall minimal. More than three-quarters of the respondents had positive attitudes on the prohibition of smoking at public places and transport. With respect to other sections of TCL, positive attitude response was dominant. TR had impaired practices regarding selling smoking (73%) and smokeless (57%) products to minors. Few variations were found between TR’s verbal responses and short time observation during the interview. Education level also showed a significant (P>0.05) association with the attitude and practice of TCL. Qualitative data explored that, TR’s impaired practice, unclarity about TCL and tobacco industries’ persuasions are the foremost causes of violation of TCL. Conclusions: Although impaired behavior was common and TR knew very little about TCL, attitudes against tobacco sales and use were shifting. Governments, non-governmental organizations (NGOs), and volunteer groups can improve the route of tobacco use reduction by putting in a concentrated effort in community participation.