{
  "abstract": "Objectives The objective of this study was to assess adherence to smoke-free laws at points-of-sale (PoS), that is, retail outlets that sell various goods including tobacco products, and to identify predictors of low adherence.Methods This cross-sectional observational study was conducted in December 2022 across 10 Ethiopian cities covering 1323 PoS such as regular shops, permanent kiosks, khat shops, supermarkets and minimarkets. Sampling was performed using a two-stage cluster design, with random selection of PoS. Data were collected using checklists through covert observations. Logistic regression identified predictors of low adherence.Results More than half of PoS (52.5%) showed good adherence, 23.2% moderate, 20.8% poor or none and only 3.4% met full adherence. Supermarkets/minimarkets had the highest rates of good or full adherence (83.9%), while kiosks and khat shops had the lowest (40.7% and 35.4%, respectively) rates of good or full adherence. Low adherence was higher in kiosks (adjusted OR (aOR)=7.02, 95% CI: 3.76 to 13.13) and khat shops (aOR=6.26, 95% CI: 3.48 to 11.26). Low adherence was also observed in Semera-Logia (aOR=21.27, 95% CI: 13.26 to 34.12) and Gambella (aOR=12.07, 95% CI: 7.64 to 19.08). Predictors of indoor smoking included being a khat shop (aOR=3.13, 95% CI: 1.29 to 7.60), being located in Semera-Logia (aOR=8.47, 95% CI: 3.49 to 26.54), presence of outdoor smoking (aOR=3.38, 95% CI: 2.07 to 5.51) and lighters (aOR=5.26, 95% CI: 3.05 to 9.06).Conclusions The study highlights enforcement gaps at PoS, particularly in khat shops, kiosks, and in Semera-Logia and Gambella cities. Strengthening smoke-free law implementation requires region-specific interventions for high-risk areas and retail outlets.",
  "authors": [
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia",
        "Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Wakgari Deressa"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia",
        "Aklilu Lemma Institute of Health Research, Addis Ababa University, Addis Ababa, Ethiopia"
      ],
      "name": "Selamawit Hirpa"
    },
    {
      "affiliations": [
        "University of Ottawa Heart Institute, Ottawa, Ontario, Canada",
        "Tobacco Control Data Initiative, Development Gateway: An IREX Venture, DC, Washington, USA"
      ],
      "name": "Terefe Gelibo Agerfa"
    },
    {
      "affiliations": [
        "Tobacco Control Data Initiative, Development Gateway: An IREX Venture, DC, Washington, USA"
      ],
      "name": "Selam Abraham Kassa"
    },
    {
      "affiliations": [
        "Health Sciences, University of York, York, UK",
        "Centre for Research in Health and Development, York, UK"
      ],
      "name": "Noreen Dadirai Mdege"
    }
  ],
  "title": "Adherence to smoke-free laws at retail points-of-sale and associated factors in 10 cities in Ethiopia",
  "uid": "a1dd15b0-fcf6-5d8e-ac81-81645bef9fa8"
}