Tobacco Smoking, Cigarette Butt Smoking: Markers for Early Intervention in Adolescents at School Level.

ABSTRACT

Introduction: Tobacco use in children and adolescents is reaching pandemic levels. The World Bank has reported that nearly 82,000-99,000 children and adolescents all over the world begin smoking every day. WHO Fact Sheet May 2010 reported the annual death toll of five million could rise to eight million by 2030 unless an urgent action is taken to control this “epidemic”. Preventive strategies are needed to be initiated on urgent basis focused towards adolescents. There is difficulty to enforce the laws and implementing preventive programs in the developing countries like India. Due to some constraints the Tobacco Free Initiative (TFI) is facing defeat in the third world. This study was conducted in high school students of Hapur, Ghaziabad (Dist.) of U.P. to identify the various correlates which induce these impressionable young adolescent minds to indulge in the use of tobacco. Material & Methods: Eight hundred seven high school children aged 12-18 years were surveyed by using an anonymous pre-tested self-report questionnaire. Personal indulgence in tobacco use over the period of one year was measured. A three point scale (yes / no / don’t know) was used. Consent / assent were duly taken from the student / teachers / principal. Results were tabulated and analysed. Results: The overall prevalence of smoking was found to be 31.97%. The use rate of tobacco was 53.53%. Among the tobacco users 59.72% were smokers. The prevalence of current smoking among tobacco users is 59.72%. The prevalence of smoking was 76.74% among male students and 23.25% amongst girls. Age of smoking initiation in both genders was mostly in 14+- 16 years. Parental (father) influence of smoking was noted to the extent of 36.04% in boys and 13.95% in girls, influence of teacher’s smoking was 39.90% in males but much less in females (23.25%). Poor academic performance and prolonged TV watching was noted as factor in both the genders. Even 13.95% females without pocket money indulged in the habit by using discarded cigarette butts (75%) which are freely available. Butt smoking was also found in boys (40%). They were aware that this habit was bad, yet indulged in it, indicating that curiosity (55% F) and peer pressure (56.56% M) and addictive nature of substance. Advertisements and promotional campaigns, mimicking their role model, were an important source of initiation of habit in both genders. Feeling of freedom from inhibitions and in females possible weight reduction to improve the looks also accounted for the habit was also noted. Our study highlights behavioural pattern of smoking as also the various factors identifying the first use and its perpetration up to habituation/ addiction. Monetary considerations and low availability of pocket money were found to be circumvented by the habit of using the discarded cigarette butts which are available for free, avoids detection, contains ash, partially burnt tobacco and paper, carbon particles, filter tissue, cellulose acetate etc. with harmful effects on lungs and other yet unidentified adverse health effects. The butt use was found in males (41.93%) and females (62.5%) and save them from deleterious effects of tobacco smoking. Conclusion: The markers thus identified in this study provide basis for early appropriate intervention of vulnerable school population and help in identification of modifiable risk factors and psychosocial clusters to provide the basis for intervention.