Exploring a Road Map to Achieving Tobacco Endgame in sub-Saharan Africa: A Qualitative Study Among Stakeholders From 12 Countries

Figures & Tables

TABLE 1.

Sociodemographic Characteristics of Participants (N=29)

Characteristic	No. (%)
Country
South Africa	5 (17.2)
Nigeria	5 (17.2)
Kenya	4 (13.8)
Ghana	3 (10.3)
Benin	2 (6.9)
Senegal	2 (6.9)
Burkina Faso	2 (6.9)
Ethiopia	2 (6.9)
Togo	1 (3.4)
Zimbabwe	1 (3.4)
Uganda	1 (3.4)
Côte d’Ivoire	1 (3.4)
Sex
Male	22 (75.9)
Female	7 (24.1)
Occupation
Nongovernmental organization	21 (72.4)
Governmental department	4 (13.8)
Research/academia	4 (13.8)

TABLE 2.

Themes and Subthemes From Participant Interviews Related to Tobacco Endgame in sub-Saharan Africa, by Main Category

Categories	Themes	Subthemes
Perception of the endgame concept and its importance for sub-Saharan Africa	Defining the endgame concept	Tobacco-free Africa End of tobacco use (tobacco use/products being nonexistent/zero-smoked cigarettes) Reduced tobacco farming Endgoal of tobacco control
	Defining the endgame concept	Reining in the tobacco industry End of the manufacturing and sale of tobacco in sub-Saharan Africa
	Importance of endgame for the region	Negative impacts of tobacco Economic impact Health impact Environmental impact
	Importance of endgame for the region	Tobacco industry targeting Africa
Perspective on sub-Saharan Africa’s approach to tobacco endgame	Afrocentric strategies sensitive to culture and regional dynamics African Charter on Tobacco Endgame^a Country-specific endgame strategies (national strategies culled from the regional strategies) Clearly defined and systematically organized endgame goals
How to implement tobacco endgame in sub-Saharan Africa	Education and awareness campaigns Use of new media and the entertainment industry for raising awareness Including traditional and religious leaders in advocacy for endgame Conducting reliable and robust local research
Facilitators of the adoption and implementation of tobacco endgame in sub-Saharan Africa	Effective education and awareness campaigns Political will Multisectoral collaboration Availability of funds and other resources Buy-in from the public Tobacco industry monitoring

↵a A regional position or white paper focused on how to end commercial tobacco use in Africa.

TABLE 3.

Strategies Proposed by Participants to Achieve Tobacco Endgame in sub-Saharan Africa, by Policy Category

Policy Category	Proposed Strategies
Product-focused	Making tobacco less addictive Regulating novel products (e-cigarettes and hookah)
User-focused	Instituting smoke-free generation policy Increasing cessation support efforts: cessation services in health care facilities and toll-free national quit line Exploring local remedies for treating nicotine addiction Using sports to promote an end to tobacco use
Market/supply-focused	Licensing tobacco sellers Increasing tobacco taxes Controlling illicit trade Finding alternative sources of income for tobacco farmers
Institutional structure-focused	Monitoring and regulating the tobacco industry
Legislation implementation-focused	Implementing the WHO Framework Convention on Tobacco Control Signing and implementing the Protocol to Eliminate Illicit Trade in Tobacco Products