Implementation of 100% smoke-free law in Uganda: a qualitative study exploring civil society’s perspective
No Thumbnail Available
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Public Health
Abstract
Background: In 2016, Uganda became one of few sub-Saharan African countries to implement comprehensive
national smoke-free legislation. Since the World Health Organisation recommends Civil Society Organisation’s (CSO)
involvement to support compliance with smoke-free laws, we explored CSOs’ perceptions of law implementation in
Kampala, Uganda, and the challenges and opportunities for achieving compliance. Since hospitality workers tend to
have the greatest level of exposure to second-hand smoke, we focussed on implementation in respect to
hospitality venues (bars/pubs and restaurants).
Methods: In August 2016, three months after law implementation, we invited key Kampala-based CSOs to
participate in face-to-face semi-structured interviews. Interviews probed participants’ perceptions about law
implementation, barriers impeding compliance, opportunities to enhance compliance, and the role of CSOs in
supporting law implementation. Interviews were recorded and transcribed. Qualitative content analysis was
conducted using the interview transcripts.
Results: Fourteen individuals, comprising mainly senior managers from CSOs, participated and reported poor
compliance with the smoke-free law in hospitality venues. Respondents noted that contributing factors included
low awareness of the law amongst the general public and hospitality staff, limited implementation activities due to
scarce resources and lack of coordinated enforcement. Opportunities for improving compliance included capacity
building for enforcement agency staff, routine monitoring, rigorous enactment of penalties, and education about
the smoke-free law aimed at hospitality venue staff and the general public. Allegations of tobacco industry
misinformation were said to have undermined compliance. Civil Society Organisations saw their role as supporting
law implementation through education, stakeholder engagement, and evidence-based advocacy.
Conclusions: This study suggests that the process of smoke-free law implementation in Uganda has not
aligned with World Health Organisation (WHO) guidelines for implementing smoke-free laws, and highlights
that low-income countries may need additional support to enable them to effectively plan for policy implementation
and resist industry interference.