The Public Health Challenge of Smoking in Nigeria/Africa

This dissertation is situated in the context of what knowledge counts in health and tobacco control regulation in Nigeria. The use of critical realism and critical ethnography is to highlight the responses of smokers and public health professionals in Nigeria and identify the connectedness of ideas in ways that smoking in Nigeria can be addressed effectively. The broader topic for the dissertation is the Public Health Challenge of Smoking in Nigeria (Africa). Under this broad topic, three manuscripts emerged from the study. The first manuscript is Critical Realism (CR)---a practical ontology to explain the complexities of smoking and tobacco control in different resource settings. The second manuscript is Critical Ethnography---a useful methodology in exploring the public health challenge of smoking in different resource settings. The third manuscript is the systematic review of the strength of evidence that Western tobacco control policies work in Nigeria (Africa). The study adds to the body of literature on global tobacco control research. The unequivocal position from this study is to have tobacco control policies tailored specifically to the needs of the Nigerian population. Clearly, there is a need for effective public education campaigns against smoking in Nigeria. Many of the smokers interviewed had limited knowledge on the adverse health effects of smoking and highly underestimated the dangers of cigarette smoking. In qualitative research, studies are not conceptualized according to a hypothesis; instead a general question is explored. The research, the public health challenge of smoking in Nigeria, was undertaken and analyzed through a critical ethnography lens using critical realism as a philosophical underpinning. The study relied upon the following components; original field work in Nigeria that included participant observation of smokers, in depth interviews and focus groups with smokers and in depth interviews with health professionals working in the area of tobacco control in Nigeria.