|Year : 2018 | Volume
| Issue : 3 | Page : 242-245
Perceptions and practice of tobacco use among adolescents of Mangalore city
Rajani Mary George, Teenu Thomas
Department of Public Health Dentistry, A. J Institute of Dental Sciences, Mangalore, Karnataka, India
|Date of Submission||01-Feb-2018|
|Date of Acceptance||02-Jul-2018|
|Date of Web Publication||6-Aug-2018|
Dr. Teenu Thomas
Department of Public Health Dentistry, A. J Institute of Dental Sciences, Kuntikana, Mangalore - 575 004, Karnataka
Source of Support: None, Conflict of Interest: None
Background: Adolescence is a period, wherein teenagers try various mannerisms to acquire what best suits them. The Global Adult Tobacco Survey, India (2009–2010), reported that among the minors (15–17 years), 9.6% consumed tobacco in some form which cannot be ignored. Thus, there is an utmost need to protect the future generation from the gripping hands of tobacco and plan effective strategies to reduce its intake. Objectives: The aim of this study is to assess the perceptions and practice of tobacco use among the adolescent students of Mangalore city. Materials and Methods: A structured, close-ended questionnaire study was designed, and data on tobacco usage were collected from 407 students aged 15–17 years, studying in various preuniversity colleges of Mangalore city, who had enrolled in Tobacco Free Kids Campaign. Data obtained was analyzed using SPSS version 16.0, and descriptive statistics was applied. Results: Out of the 407 children, 102 (25%) have tried cigarette smoking, while 7.9% have tried smokeless tobacco. Almost 14.3% of them attempted to buy tobacco products and the shopkeepers sold it to them. A major proportion of the adolescents, 81.1% of them, believe that smoking can definitely cause harm to health, while 66.1% of them were aware about the harmful effects of passive smoking. About 73.7% were in favor of the idea of banning smoking in all enclosed public places. Conclusions: The adolescent students of Mangalore city are relatively well aware of the ill effects of tobacco, but a small proportion of them still use tobacco in some form which cannot be ignored.
Keywords: Adolescent, awareness, cigarette smoking, smokeless tobacco, tobacco use
|How to cite this article:|
George RM, Thomas T. Perceptions and practice of tobacco use among adolescents of Mangalore city. J Indian Assoc Public Health Dent 2018;16:242-5
|How to cite this URL:|
George RM, Thomas T. Perceptions and practice of tobacco use among adolescents of Mangalore city. J Indian Assoc Public Health Dent [serial online] 2018 [cited 2018 Nov 17];16:242-5. Available from: http://www.jiaphd.org/text.asp?2018/16/3/242/238585
| Introduction|| |
Tobacco use is an epidemic incapacitating the modern youth and an estimated total of 82,000–99,000 children all worldwide start smoking any given day. Chronic tobacco usage can be attributed to any abrupt and immature decision to experiment tobacco during the early adolescent period. An overwhelming majority of smokers start using tobacco before the age of 19. Even single experimentations have a 50% chance for developing into an addiction and stay proximate till late adult life. The chances for early adoption, its gateway effect leading to more serious drugs, along with the challenges associated in prescribing a standard withdrawal, makes it one of the major cause of death globally. Tobacco has the strength to kill 250 million of children today in the current swing and a person every 6.5 sec globally.
The Global Adult Tobacco Survey, India (2009–2010) reported that among the minors (15–17 years), 9.6% consumed tobacco in some form which cannot be ignored. An estimated total of 5500 adolescents start using tobacco everyday in India. The WHO predicts that deaths due to tobacco habits in India may exceed 1.5 million annually by 2020. Refraining from the use of tobacco can add 20 years to the life of a teenager. Thus, understanding the burden of tobacco use among the adolescents helps in formulation of effective control measures targeting them.
When implemented together, various national, state, and local program activities have shown to reduce and prevent tobacco usage. There are certain social and environmental factors such as religious participation and racial or ethnic pride, which are related to reduced smoking levels among youth. There are also evidences linking youth-smoking with depression, anxiety, and stress. Among the youth, students are more vulnerable to substance abuse as a faulty coping mechanism for dealing with increasing academic stress, uncertain career paths, or peer pressure.
According to the Global Adult Tobacco Survey for Karnataka, (2009–2010), the average age for initiation into daily usage of tobacco is 18.7 years. The state is also credited as one of the most growing tobacco usage hotspot with 28.2% of the population addicted to its daily usage.
Development of an effective strategy to curb tobacco intake requires a deep understanding of the factors responsible for initiating this habit. We were also motivated by a recent study, which reported that 98% of undergraduate medical students, aged 19–21, in a private medical college of Mangalore city, never had any training in tobacco cessation in their curriculum.
Hence, this study was undertaken to estimate the prevalence and practice of tobacco use among the adolescent students of Mangalore city, thereby aiming to provide timely interventions to prevent any initial experimentations with tobacco from developing into an addiction in adulthood.
| Materials and Methods|| |
A cross-sectional questionnaire study was conducted among adolescent students studying in three preuniversity colleges enrolled in Tobacco-Free Kids Campaign organized by A.J. Institute of Dental Sciences, Mangalore.
All the students in the age group of 15–17 years who were present on the days of the campaign were included. Universal sampling was followed and study population thus obtained had 407 students. The study commenced after obtaining permission from Institutional Ethical Committee (AJEC/REV/52/2017) and administrative heads of the respective colleges. The purpose of the study was explained to the students, before the questionnaires were administered. An informed verbal consent was also taken from students before distribution of questionnaires to them and participation by the participants was totally voluntary. The identity of the study participants was not included in the questionnaire form so that the students could respond without any hesitations and also to ensure maximum reliable results. The structured, self-administered questionnaire which was used for the study [Table 1] was constructed using literature reviews of previous studies in the same field. All the 20 questions were close ended, and there was no skip pattern so that all questions were to be answered. Piloting was conducted before the actual data collection surveys in order to improve the questionnaire's content and necessary changes were made accordingly.
|Table 1: Questions regarding perceptions and practice of study participants|
Click here to view
Data was analyzed using SPSS Version 16.0. (SPSS Inc, Chicago, USA) and descriptive statistics which included percentages and frequencies were applied.
| Results|| |
Among the 407 students who participated in the study, 25.1% have ever tried smoking and 7.9% have tried smokeless form of tobacco although just for experimentation. Despite the legislation banning the sale of tobacco products to the minors, 14.3% of the participants reported that the shopkeepers readily sold them tobacco products, when they tried to buy it. It is comforting to find that 82.8% of them did not buy or try to buy tobacco products. A majority of the students, 89.2% of them, were reported themselves as current nonsmokers, while 10.8% reported current usage of cigarettes as well as smokeless tobacco.
Parental use of tobacco was assessed among the participants, wherein 82.3% of the students' immediate family members were not into the habit. When asked whether the students would smoke/chew tobacco if offered by their best friends, 72.2% reported that they would refrain from the habit, while a 5.2% of them were definitely sure of taking up the habit if their friends' insist.
300 (73.7%) students were in favor of banning tobacco in all enclosed places(no exception), 54 (13.3%) were in favor of banning tobacco in all enclosed places (with exception), whereas 53 (13%) supported no ban on tobacco.
22 (5.4%) students perceived that there will be weight gain and 282 (69.3%) students perceived that there will be loss of weight with tobacco usage. 57 (14%) students perceived that smoking makes them look more attractive and 251 (61.7%) perceived that smoking makes them look less attractive [Table 2].
The students' awareness about passive smoking was analyzed by asking whether they thought smoke from another person's cigarette was harmful. Around 83.1% of the study participants thought, it harmful to inhale the smoke from another's cigarette [Graph 1].
| Discussion|| |
According to the present study, 10.9% of study participants admitted that they were current users of tobacco products, which is in accordance with study conducted by Mohan et al., in Kerala state. The Global Youth Tobacco Survey Karnataka and Jayakrishnan et al. reported a lower prevalence of tobacco usage among adolescents.
Vuckovic et al. and Sharma et al. found that parental smoking role models, peer influence, and the desire to fit in with peers can be attributed as the major reasons for start of adolescent smoking. In the present study, 7.4% students reported tobacco usage by their parents, while 3.7% reported usage by their siblings. This is contradictory to alarming prevalence stated by Gupta et al. in his study where 71% of students' immediate family members used tobacco products. Multani et al., Makanwala et al., Singh et al., and Shashidhar et al. have also reported a positive relation with smoking and peer or parental influence in their studies.
The laws prohibiting the sale of tobacco products to the minors seem to have been openly flouted. Around 14% of the students reported that the shopkeepers readily sold them tobacco products in this study, which is in concurrence with a study conducted by Madan et al.
In the present study, only 14% of the adolescents thought that smoking makes them more attractive and 69.3% were positive that smoking can lead to weight loss. Although, 41% of the participants believed smoking makes them more attractive according to Mohanan et al.; in other studies by Gupta et al. and Dereje et al., majority of participants disagreed to the statement that smoking makes them more attractive, which is affirmative of current results.
Global Adult Tobacco Survey results suggest that the prevalence of those exposed to passive smoking is too high in Karnataka, with 44.3% of adults at home and 37.2% in public places exposed to it. Majority of the students-87% were in favor of banning smoking at all enclosed places. Similar results were observed by Jayakrishnan et al., Dereje et al. and VyasandPatel.
Limitations of the study
Although piloting was done to test the content validity of the questionnaire, it was not tested statistically. The small sample size of the study cannot be considered as a representative of the adolescent population.
| Conclusion and Recommendations|| |
The adolescent students of Mangalore city are well aware of the ill effects of tobacco, but a small proportion of them use tobacco in some form which cannot be ignored.
Enabling teachers to educate their students in the local language regularly, regarding tobacco usage should be an important step to prevent addiction.
Timely intervention among students can prevent the initial experimentations with tobacco from developing into addiction in adulthood. Restrictions in public places as well as at homes will enable to curb tobacco use by children and adolescents.
Integration of tobacco control programs with other healthcare programs can yield significant results, in the pursuit for a tobacco-free world. Various national, state, and local program activities when implemented together have shown to reduce and prevent youth tobacco intake. The following can be considered in pursuit of a tobacco-free nation such as the prohibition of indoor smoking, involvement of religious leaders in anti-tobacco program, community programs for tobacco counseling and cessation, strict enforcement of Cigarettes and Other Tobacco Products Act laws, and conducting special training programs for teachers and counseling for students in schools.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Singh S, Vijayakumar N, Priyadarshini HR, Jain M. Tobacco use among high school children in Bangalore, India: A study of knowledge, attitude and practice. Indian J Cancer 2015;52:690-3.
] [Full text]
Rawat R, Thakur A. Prevalence of tobacco use among school going adolescents in Bhopal. Religion 2015;12:7-41.
Makanwala NR, Shah VR, Yadav S. A study on prevalence of smoking and tobacco chewing among adolescents in rural areas of Jamnagar district, Gujarat State. JMSR 2007;1;47-9.
Lindsay GB, Rainey J. Psychosocial and pharmacologic explanations of nicotine's “gateway drug” function. J Sch Health 1997;67:123-6.
Mishra GA, Pimple SA, Shastri SS. An overview of the tobacco problem in India. Indian J Med Paediatr Oncol 2012;33:139-45.
] [Full text]
Chadda RK, Sengupta SN. Tobacco use by Indian adolescents. Tob Induc Dis 2003;1:8.
Gupta D, Nagar P, Karim B, Khan IM, Naveen B, Chaturvedi M, et al.
Tobacco abuse amongst the school going students of 15 to 18 years of Almora district, Uttarakhand: A cross sectional study. Oral Health Dent Manag 2014;13:680-6.
Madan Kumar PD, Poorni S, Ramachandran S. Tobacco use among school children in Chennai city, India. Indian J Cancer 2006;43:127-31.
] [Full text]
Shruthi MS, Basha R, Thangaraj S, Rangnath TS. Prevalence of tobacco use among class 10 students in an urban fi eld practice area, Bangalore: A cross sectional study. Med Sci 2013;2:363-73.
Yadiyal A, Mittal S, Shenoy N, Chopra A, Mitra P. Tobacco use among undergraduates of a private medical college in Mangalore-knowledge, attitude and practice. Int J Sci Res Publ 2015;5:1-8.
Mohan S, Sankara Sarma P, Thankappan KR. Access to pocket money and low educational performance predict tobacco use among adolescent boys in Kerala, India. Prev Med 2005;41:685-92.
Shashidhar A, Harish J, Keshavamurthy SR. Adolescent Smoking-A Study of Knowledge, Attitude and Practice in High School Children, Pediatric on Call Child Health Care; 2011; 2012. Available from: http:// Medical_original_articles/smoking. asp
. [Last accessed on 2017 Jan 18].
Jayakrishnan R, Geetha S, Binukumar B, Sreekumar, Lekshmi K. Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala state. Indian J Dent Res 2011;22:195-9.
] [Full text]
Vuckovic N, Polen MR, Hollis JF. The problem is getting us to stop. What teens say about smoking cessation. Prev Med 2003;37:209-18.
Sharma R, Grover VL, Chaturvedi S. Tobacco use among adolescent students and the influence of role models. Indian J Community Med 2010;35:272-5.
] [Full text]
Multani S, Reddy JJ, Bhat N, Sharma A. Assessment of knowledge, attitude, behaviour and interpersonal factors related to the use of tobacco among youth of Udaipur city, Rajasthan, India: A Cross-sectional study. Addict Health 2012;4:142-50.
Mohanan P, Swain S, Sanah N, Sharma V, Ghosh D. A study on the prevalence of alcohol consumption, tobacco use and sexual behaviour among adolescents in urban areas of the Udupi district, Karnataka, India. Sultan Qaboos Univ Med J 2014;14:e104-12.
Dereje N, Abazinab S, Girma A. Prevalence and predictors of cigarette smoking among adolescents of Ethiopia: School based cross sectional survey. J Child Adolesc Behav 2015;3:182.
Vyas MJ, Patel AB. A KAP study on tobacco use among school children of Ahmadabad. Int J Res Med 2016;5:84-7.
[Table 1], [Table 2]