HIGHLIGHTS

• Tobacco use is rising exponentially among adolescent girls in Ghana, particularly the use of shisha pipes.
• ideas42 is working to assess the impact and cost-effectiveness of a mass media campaign, developed by Good Business and Now Available Africa, on tobacco use and related norms in Ghana, and determine which interventions and behavioral insights are most important to influence smoking behavior.

The Challenge

Tobacco use is rising exponentially among adolescent girls in Ghana, particularly the use of shisha pipes [1] . There is limited evidence as to what works to prevent tobacco use among this population, and rigorous evidence is needed in order to assess the impact of media-based programming on tobacco-related behaviors.

Our Approach

With funding from the Bill and Melinda Gates Foundation, we are working to:

1. Produce an independent assessment of the impact and cost-effectiveness of a mass-media campaign called SKY Girls, designed by the UK-based Good Business and implemented by Now Available Africa. The campaign seeks to influence tobacco use and related norms.
2. Provide insights on the causal pathway of tobacco use, including which interventions and behavioral insights are most important to influence smoking behavior.

We conducted formative research in the cities of Accra and Kumasi, interviewing teenage girls and their parents and partners in order to further refine our understanding of the causal pathway of tobacco use among Ghanaian girls. We identified key influencers within teenage girls’ context, including parents and male partners who influence both their perceptions of tobacco use and the opportunities they have to smoke. We also found that girls with different social circles and contexts trigger opposing perceptions of the acceptability of tobacco use, with girls in very low or very high socioeconomic circumstances more likely to smoke—and to have friends who smoke—compared to their middle-class peers. 

Based on these insights, we are currently conducting a cluster randomized controlled trial (RCT) in two regions in Ghana to assess the impact of the SKY Girls campaign on tobacco use and associated intermediate outcomes, including self-efficacy, use of refusal skills, and perceptions of tobacco users.

Interested in our work applying behavioral science to global health? Email gh@ideas42.org or tweet at @ideas42 to join the conversation.

[1] Logo, D. D., Kyei-Faried, S., Oppong, F. B., Ae-Ngibise, K. A., Ansong, J., Amenyaglo, S. … Owusu-Dabo, E. (2020). Waterpipe use among the youth in Ghana: Lessons from the Global Youth Tobacco Survey (GYTS) 2017. Tobacco Induced Diseases, 18(May), 47. https://doi.org/10.18332/tid/120937