Smoky air in Ghana bars fuels thesis study

While a fellowship-funded, whirlwind tour of more than 90 restaurants, bars and nightclubs might seem like the perfect summer vacation, for Wilfred Agbenyikey SPH ’08, it was three-months of intense thesis research. Staff Reporter Florence Dethy explores.

While pursuing a master’s degree at the Yale School of Public Health, Agbenyikey spent three months gathering data whilst bar-hopping around seven major cities in Ghana. The study, which has recently received considerable attention from governmental and non-governmental agencies, found that public smoking severely polluted the air in the establishments he canvassed and that the average nicotine levels of non-smoking employees working at smoking establishments could pass for those of habitual smokers.

School of Public Health student Wilfred Agbenyikey spent his summer researching the prevalence of secondhand cigarette smoke in Ghanaian bars, nightclubs and restaurants.
Courtesy WilfredAgbenyikey
School of Public Health student Wilfred Agbenyikey spent his summer researching the prevalence of secondhand cigarette smoke in Ghanaian bars, nightclubs and restaurants.

“Every night, [I would go out] to about three to four bars,” he said. “I set out around 8 or 7:30 p.m. to visit restaurants, and then I would move to bars and nightclubs.”

To conduct the study, Agbenyikey measured two components of tobacco smoke: vapor phase nicotine and particulate matter with a diameter of 2.5 microns, and compared it to data collected in a similar manner from non-smoking establishments. At bars and nightclubs, he counted the number of patrons and of lit cigarettes in the establishment every 15 minutes. He also noted the size of the space and any ventilation equipment such as air conditioners that were present. Finally, he collected hair samples from consenting non-smoking employees to ascertain the concentration of nicotine in their systems.

According to his report, non-smoking individuals working at smoking establishments had 27 times more nicotine in their bodies — as much as a regular smoker — than did non-smoking workers at non-smoking establishments. The concentration of vapor-phase nicotine and particulate matter in smoking places were found to be 77 and 44 times the levels found in non-smoking places.

But the experience, Agbenyikey said, was far from all work. He said data collection was a lot of fun, joking that club owners frequently would offer him “lots of beers and stuff.”

“I had a letter from the tourist board that gave me license to go out to all the bars and clubs,” he said, laughing. “When I showed [the bar owners] the letter, they let me in for free.”

Still, there was one experience he would have preferred to have gone the summer without: getting attacked at gunpoint. He explained that while he was out one evening towards the end of his experience, some robbers pulled a gun on him, roughed him up a bit, and then took his wallet and cell phone, though “thankfully, all [his] equipment was safe!”

Agbenyikey said his findings not only affirmed his belief that Ghana’s parliament must pass a public smoking ban but increased his desire to generate awareness among Ghana’s citizens about secondhand smoke’s harmful effects.

“[Agbenyikey] collected data on indoor air quality that will be useful in bringing about a much-needed policy change in Ghana regarding smoking indoors and the protection of workers from occupational exposure,” said Kathleen McCarty, an assistant professor at the Yale School of Public Health and the second reader of Agbenyikey’s thesis.

To accomplish those goals, Agbenyikey said he did more than just gather data. He also developed key relationships with leaders of the country’s health commission.

In May, Robert Apelberg, a professor at the Johns Hopkins University Institute for Global Tobacco Control, went with Agbenyikey to Ghana for the World No Tobacco Day celebration and said it was clear at the event that Agbenyikey had developed “quite good relationships” with officials from both governmental and non-governmental organizations.

Since Agbenyikey finished compiling his report, he has addressed Ghana’s Parliamentary Health Select Committee, senior staff at Ghana’s Environmental and Protection Agency, and participated in an exhibition at Ghana’s Parliamentary house.

While Agbenyikey joked about the “occupational hazard” he faced while gathering his data, Director of Tobacco Related Policy Research at the YSPH Jody Sindelar said it was unlikely he incurred any long-term damage. The nicotine concentrations in the employees sampled were not necessarily harmful to someone measuring them, but were an indicator of the harm that secondhand smoke had inflicted upon non-smokers’ bodies in their places of employment, Sindelar explained.

At present, Ghana does not have any regulations or laws forbidding smoking in public places. But according to the World Health Organization’s May 2003 tobacco control treaty, which Ghana signed, signatory countries are bound to increase the number of smoke-free public places. While many WHO member countries such as England, India, and Norway have enacted such measures, Ghana’s politicians have dragged their feet in enacting such measures, Agbenyikey said.

The only proposed public smoking ban currently near passage is sitting in Ghana’s parliamentary cabinet, and though Agbenyikey said he believes it has parliamentary support, a member of the cabinet must bring it to parliament before it can be ratified — something that should have happened months ago, he said.

Agbenyikey is currently pursing his doctorate in public health at Boston University and is in the process of publishing his thesis paper on the effects of secondhand smoke in Ghana.

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