Tobacco use and COVID-19 in Ghana: generating evidence to support policy and practice

Background The COVID-19 pandemic has affected over 45 million people and caused over a million deaths globally. Tobacco use, a threat to public health worldwide, increases the risk of developing severe COVID-19 disease and death. The hand-to-mouth action, smoking-induced lung diseases, and the sharing of tobacco products such as water pipes, increase a smoker’s vulnerability to COVID-19. Implementation of tobacco control efforts in low- and middle-income countries (LMICs) including sub-Saharan Africa (SSA) is a particular challenge. The aim of this study in Ghana was to produce evidence to support governments to make informed policy decisions about tobacco control interventions in the context of COVID-19. Methods A survey with key stakeholders (conducted online or via face to face interview) and a desk-based mapping of data sources including government reports and online print press. Face-to Face interviews followed the COVID-19 precautionary protocols. Results 40 stakeholders participated in the interviews (28 online and 12 face-to-face). 46 data sources were identified from the mapping of which 16 were eligible for data extraction. Over two fifths of survey respondents (42.9%, n=12) agreed that the relationship between COVID-19 and tobacco use had been discussed in the media, and over half (57%, n=16) reported that public health professionals and other authorities had provided advice to tobacco users during the pandemic. While respondents (89%, n=25) did not see a change in the level of interest in tobacco cessation, less than a quarter (23%, n=6) indicated that the policy response to COVID-19 included a focus on tobacco control issues, but was limited to tobacco cessation. The majority of respondents (77%, n=31) reported a perceived limited impact on the tobacco industry’s operations during the pandemic. Conclusions COVID-19 provides a timely opportunity to strengthen tobacco control efforts by recognizing the role of tobacco use in potentially exacerbating covid-19 health outcomes and promoting cessation.