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Community Knowledge, Attitudes and Preventive Behaviour Towards the Cardiovascular Benefits of Reduced Exposure to Air Pollution in Nigeria: Evidence from the CARDINAL Study Cover

Community Knowledge, Attitudes and Preventive Behaviour Towards the Cardiovascular Benefits of Reduced Exposure to Air Pollution in Nigeria: Evidence from the CARDINAL Study

Open Access
|Oct 2025

Figures & Tables

Table 1

Sociodemographic characteristics of the respondents.

SOCIODEMOGRAPHIC CHARACTERISTICSFREQUENCY (n = 607)PERCENTAGE (%)
Age (years)
      Mean ± SD44.08 ± 17.035.4
      <203332.3
      20–291960.0
      30–39020.1
      40–4912219.4
      50–5911812.9
      60–69786.8
      70–79413.1
      ≥8019
Age (years)
      <5037762.1
      ≥5023037.9
Sex
      Male27845.8
      Female32954.2
Religion
      Christianity18730.8
      Islam41969.0
      Traditional10.2
Ethnicity
      Yoruba53287.6
      Igbo152.5
      Hausa609.9
Marital Status
      Single11619.1
      Married42069.2
      Separated50.8
      Divorced81.3
      Widowed589.6
Type of family
      Monogamy44773.6
      Polygamy16026.4
Highest level of education
      No formal education8614.2
      Primary15826.0
      Secondary30149.6
      Tertiary6210.2
Household size
      <527144.7
      ≥533655.4
Respondent’s income
      <$10055992.1
      ≥$100487.9
Spouse’s income
      <$10058496.2
      ≥ $100233.8
Length of stay in years
      <1172.8
      1–310016.5
      4–68013.2
      ≥741067.5
Figure 1

Air pollution awareness.

Table 2

Knowledge of respondents on the link between air pollution and CVD.

AIR POLLUTION CAN LEAD TO:FREQUENCY (n = 607)PERCENTAGE (%)
Lead to stroke
      No19432.0
      Yes41368.0
Lead to an increase in blood pressure
      No26743.9
      Yes34056.1
Can enter the bloodstream
      No33855.7
      Yes26944.3
Enter lung only without causing CVD
      No25241.5
      Yes35558.5
Result in heart attack
      No29448.4
      Yes31351.6
Exacerbate chronic heart failure
      No28844.3
      Yes39965.7
Lead to sudden cardiac death
      No26944.3
      Yes33855.7
Reduce blood pressure
      No26744.0
      Yes33956.0

[i] CVD: cardiovascular disease.

Table 3

Knowledge of respondents on air pollution reduction strategies.

WHICH OF THE FOLLOWING DO YOU THINK CAN REDUCE AIR POLLUTIONFREQUENCY (n = 607)PERCENTAGE (%)
Use of public transportation
      No32353.2
      Yes28446.8
      Use of charcoal instead of firewood for cooking
      No30750.6
      Yes30049.4
      Tree planting
      No27645.5
      Yes33154.5
Use of air conditioning system at home
      No20233.3
      Yes40566.7
Use of biogas for cooking
      No9115.0
      Yes51685.0
Use of electric stove
      No10417.1
      Yes50382.9
Open burning in the neighbourhood
      No21835.9
      Yes38964.1
Opening of windows while cooking indoors
      No12520.6
      Yes48279.4
Encourage biking
      No30950.7
      Yes29949.3
Regular servicing of motor engines
      No10116.6
      Yes50683.4
Figure 2

A box plot representing the median knowledge (A), attitude (B) and behaviour score (C).

Figure 3

Proportion of respondents with poor vs. good knowledge; negative vs. positive attitude; and unsatisfactory vs. satisfactory behaviour.

Table 4

Attitude of respondents towards air pollution reduction strategies.

FREQUENCY (n = 607)PERCENTAGE (%)
All community members have a role to play in reducing air pollution
      Disagree8013.2
      Undecided142.3
      Agree51384.5
Government banning the use of petrol cars can help reduce air pollution
      Disagree18931.1
      Undecided508.2
      Agree36860.6
The strong enforcement of environmental protection laws that prohibit air pollution is a good way to start preventing it
      Disagree6510.7
      Undecided254.1
      Agree51785.2
Air pollution reduction is strictly Government affair
      Disagree40466.6
      Undecided457.4
      Agree15826.0
Open burning and open dumping should be banned to control air pollution
      Disagree6711.0
      Undecided315.1
      Agree50983.9
The use of firewood for cooking is an ancient cooking method that doesn’t have anything to do with air pollution
      Disagree35533.4
      Undecided498.1
      Agree20333.4
Cutting down trees is a good way to reduce air pollution
      Disagree30149.6
      Undecided6310.4
      Agree24340.0
Periodic servicing of automobile engine has nothing to do with air pollution reduction
      Disagree14373.0
      Undecided213.5
      Agree44323.6
Table 5

Behaviour of respondents relating to air pollution reduction.

BEHAVIOURFREQUENCY(n = 607)PERCENTAGE (%)
Do you know how to perform a seal check on facemask?
      No37962.4
      Yes22837.6
Do you find the use of face mask comfortable during exposure to air pollution?
      No15826.0
      Yes44974.0
Are you ready/willing to substitute biomass fuel (wood, sawdust, kerosene stove) with cleaner fuels such as gas, electric or solar cooker?
      No457.4
      Yes56292.6
Have you received any form of education on the health risks associated with burning solid fuels for cooking and heating?
      No40466.6
      Yes20333.4
Would you rather consider the use of active transport system such as walking or cycling in a bid to reduce air pollution exposure?
      No31852.4
      Yes28947.6
Can your financial capacity allow you to switch from biomass fuel to cleaner fuels?
      No25141.4
      Yes35658.6
Have you considered the use of real-time information on local air quality from sources such as mobile phone applications, news feeds and websites, to guide route and timing for your movement?
      No34156.1
      Yes26643.9
Have you received any form of advice from your local health care workers on local air quality monitoring so as to minimize exposure?
      No38763.8
      Yes22036.2
Do you have any social group/government source educating you on how to reduce exposure to air pollution in your community?
      No47077.4
      Yes13722.6
Will you be willing to reduce exposure to air pollution to improve your health status?
      No548.9
      Yes55391.2
If a cleaner stove is made available, will you be willing to shift from solid fuel to biogas for cooking?
      No498.1
      Yes55891.9
Table 6

Adjusted multivariate analysis of sociodemographic factors associated with KAB.

PREDICTORSPOOR KNOWLEDGE; AOR (95% CI)NEGATIVE ATTITUDE; AOR (95% CI)UNSATISFACTORY BEHAVIOUR; AOR (95% CI)
Awareness about air pollution
      No1.001.001.00
      Yes0.82 (0.57–0.97)0.99 (0.70–1.42)0.44 (0.31–0.64)
Age (years)
      ≤501.001.001.00
      >500.83 (0.55–1.25)0.93 (0.63–1.38)0.96 (0.64–1.44)
Sex
      Male0.94 (0.65–1.36)0.75 (0.53–1.06)0.58 (0.41–0.83)
      Female1.001.001.00
Ethnicity
      Yoruba0.17 (0.01–1.33)0.10 (0.01–0.75)0.91 (0.31–2.71)
      Hausa0.09 (0.01–1.02)0.11 (0.01–0.89)1.16 (0.35–3.86)
      Igbo1.001.001.00
Type of family
      Polygamy1.41 (1.03–2.12)1.54 (1.04–2.30)1.03 (0.68–1.57)
      Monogamy1.001.001.00
Highest level of education
      No formal education1.001.001.00
      Primary0.74 (0.42–1.30)0.62 (0.35–1.10)0.76 (0.49–1.19)
      Secondary1.36 (0.77–2.41)0.74 (0.42–1.31)0.57 (0.32–1.04)
      Tertiary0.67 (0.04–0.92)0.99 (0.48–2.15)0.42 (0.20–0.89)
Household size
      <51.001.001.00
      ≥51.23 (0.85–1.78)1.49 (1.05–2.11)0.85 (0.60–1.21)

[i] KAB: knowledge, attitude and behaviour; CI: confidence interval; aOR: adjusted odds ratio.

DOI: https://doi.org/10.5334/gh.1482 | Journal eISSN: 2211-8179
Language: English
Submitted on: Apr 17, 2025
Accepted on: Sep 22, 2025
Published on: Oct 9, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2025 Adekunle Gregory Fakunle, Temilade Bello, Akintayo Olamide Ogunwale, Oyewale Mayowa Morakinyo, Olubunmi Ayinde, Susan Motunrayo Kebu, Oluwapelumi Peter Arinola, Marvelous Adeoye, Bosede Adebayo, Iretioluwa Mary Bamtefa, Akinkunmi Paul Okekunle, Augustine Odili, Mark R. Miller, Amam C. Mbakwem, Abiodun Moshood Adeoye, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.