Effect of educational intervention in reducing exposure to second hand tobacco smoke among 12-year-old children as determined by their salivary cotinine levels and knowledge, attitude and behavior - a randomized controlled trial.

Background: Tobacco use is one of the most important public health concerns, with approximately 8.7 million tobacco-related deaths each year, primarily in low- and middle-income countries. Even more concerning is the fact that 1.3 million of these deaths are seen in nonsmokers, including babies and children. This study was performed to determine whether a school-based "tobacco-free" educational intervention program among 12-year-old children would be effective in reducing their exposure to second-hand tobacco smoke (SHS) by improving their knowledge, attitude and behavior post intervention and estimating salivary cotinine levels as markers of SHS exposure. Materials and method: A randomized controlled trial was performed by a cluster random sampling technique, with 30 participants each in the experimental and control arms. A knowledge, attitude, avoidance behavior and self-efficacy of avoidance questionnaire was administered, followed by estimation of salivary cotinine levels. The experimental arm received the "tobacco-free" intervention, which comprised a 40-min health education session, with the first follow-up at 15 days and the second at 30 days after the intervention. After the intervention, the questionnaire was readministered, followed by re-estimation of salivary cotinine levels. Results: One month after the intervention, the number of participants who had a smoker who lived with them and the number of people who smoked inside the house were reduced in the experimental group compared to the control group. In the knowledge domain and the attitude domain, 80% and 60% of the items showed a statistically significant improvement in the experimental group compared to the control group. In the avoidance behavior domain and the Self-Efficacy of Avoidance Domain, all the items showed improvement in the experimental group compared to the control group. When the mean salivary cotinine levels were compared pre- and postintervention, it was found that although the mean postintervention salivary cotinine levels increased in both the experimental and control groups, the increase was less in the experimental group than in the control group. Conclusion: The present study has been shown to be effective in improving the knowledge, attitude and avoidance behavior of adolescents toward exposure to secondhand smoke.

Exposure to Second Hand Tobacco Smoke among 12 year old Adolescents in Mangalore, Karnataka - A Descriptive Study.

BACKGROUND: There is no safe level of exposure to second hand tobacco smoke (SHS). The World Health Organization has stressed that 100% smoke-free environments are the only effective way to protect the population from the harmful effects of exposure to SHS. METHODS: A descriptive cross-sectional questionnaire study was done on 1442, 12 year old, adolescents in Mangalore to determine the exposure to SHS and  adolescents' knowledge, attitude, avoidance and self-efficacy of avoidance towards SHS. RESULTS: The percentage of children exposed to SHS at home was 28.6%. A higher number of male students reported that their parent and/or sibling smoked tobacco compared to their female counterparts. About 48% of the participants reported that persons who lived with them smoked in front of children and this was found to be significantly higher among males compared to females. Atleast 46% of the participants had knowledge of second hand tobacco smoke. The avoidance behaviour of the participants was good with most of the participants reporting positive avoidance towards SHS. With respect to their self - efficacy of avoidance of SHS, most of them were confident of avoiding SHS when they were with family or friends but the confidence was less with respect to strangers. Multivariate general linear model analysis showed a significant association between gender and exposure to SHS to 14 items out of the 25 items in the four domains. Males and those not exposed to SHS showed better knowledge, positive attitude, positive avoidance behaviour and positive self efficacy of avoidance to SHS. CONCLUSION: The findings of our study indicate that better knowledge and a positive attitude and avoidance behavior are associated with reduced exposure to SHS and this reinforces the fact that a sustained health education program incorporated into the school curriculum is the need of the hour.
.

Awareness Among Undergraduate Students of Mangalore City Regarding Novel Coronavirus (COVID-19): A Questionnaire Study.

OBJECTIVES: COVID-19 outbreak has surfaced as an imminent threat for the public health. Because India is a populous country, it is important for Indians to be aware of the basic modes of prevention that can diminish the spread of the coronavirus disease 2019 (COVID-19) infection. AIM: The present questionnaire study was carried out among the undergraduate students to assess the awareness regarding the spread and control of COVID-19. METHODS: The questionnaire was circulated among the undergraduate students as a Google form. RESULTS: The study included responses of 868 undergraduate students belonging to 2 university colleges. The majority of the participants were females (63%; n = 547) in the age range of 18-23 y. Approximately 98.3% (853) had awareness regarding COVID-19. Approximately 94.7% (822) were washing their hands after visiting public places, out of which only 90.6% (786) were aware of proper steps to be followed in hand washing. It was concluded that it is required to create awareness among 20.8% (181) of our study participants regarding the importance of hand washing to control COVID-19. CONCLUSIONS: Awareness regarding COVID-19 among study participants was good. However, a small part of the study population is required to be educated on proper steps to be followed in hand washing.

Effectiveness of a School-Based 'Tobacco Free' Intervention on Adolescents' Knowledge and Exposure to Second Hand Tobacco Smoke - A Multiphase Study.

BACKGROUND: There is no safe level of exposure to second hand tobacco smoke (SHS). The World Health Organization has stressed that 100% smoke-free environments are the only effective way to protect the population from the harmful effects of exposure to SHS. DESIGN: A multiphase study with a descriptive cross-sectional questionnaire phase 1  and a phase 2 cluster randomized controlled trial (RCT), conceptualized to determine the effectiveness of a school-based 'tobacco free' health education intervention on adolescents' knowledge and attitude towards SHS. METHODS: Baseline assessment will include a questionnaire followed by estimation of salivary cotinine levels. The experimental arm will receive the 'tobacco free' intervention, which includes 40 min health education session delivered once a week for 3 consecutive weeks. Participants will also be given 'take home brochures' every week containing messages on the effects of tobacco and how to make their homes smoke-free. The sample of 250 participants, for the Phase 2 RCT, with salivary cotinine levels of > 0.1 ng/mL will be selected from the participants of the Phase 1 study. The effect of the intervention will be quantitatively assessed by estimating the salivary cotinine levels after the intervention. Participants in the control arm will receive conventional standard health education once. CONCLUSION: This research will help in assessing if there is any change in the salivary cotinine levels and the knowledge, attitude and behaviour scores after the health educational intervention and help in developing an effective school-based 'tobacco free' intervention program which could be incorporated into the school curriculum. This study has received the Public Health Research Initiative (PHRI) Research Grant of Rs. 18,99,205 and is registered with the Clinical Trial Registry of India (CTRI) with number CTRI/2018/09/015706 (Registered on 13/09/2018). Ethical approval has been obtained from The Institutional Ethics Committee (No.17021 dated 13 march 2017).