DOI QR코드

DOI QR Code

Evaluation of a Specially Designed Tobacco Control Program to Reduce Tobacco Use among School Children in Kerala

  • Philip, Phinse Mappalakayil (Malabar Cancer Centre) ;
  • Parambil, Neetu Ambali (Malabar Cancer Centre) ;
  • Bhaskarapillai, Binukumar (Centre for Chronic Disease Control) ;
  • Balasubramanian, Satheesan (Malabar Cancer Centre)
  • Published : 2013.06.30

Abstract

Background: Smoking and smokeless tobacco use are almost always initiated and established during adolescence. More than 80% of adult smokers begin smoking before 18 years of age. The main objective of the present study is to assess the feasibility of preventing adolescent tobacco use with the help of a specially designed tobacco control program. Materials and Methods: A cross sectional survey on tobacco use and related health effects was conducted using a structured questionnaire in 13 randomly selected schools in Kannur district of Kerala. These students were followed for a period of one academic year with multiple spaced interventions such as anti-tobacco awareness classes, formation of anti-tobacco task forces, inter-school competitions, supplying IEC (information, education and communication) materials and providing a handbook on tobacco control for school personnel. Final evaluation was at the end of one year. Results: There were 4,144 school children who participated in the first phase of the study. The prevalence of tobacco smoking and chewing habits were 9.85% and 2.24% respectively. Ninety-one percent had parental advice against tobacco use and only 3.79% expressed desire for future tobacco use. The final evaluation witnessed a sharp decline in the current tobacco use as 4.68%. We observed a statistically significant difference towards the future use of tobacco (p<0.001) and awareness about the ill effects of passive smoking (p<0.001) among boys and girls. Further a significantly increased knowledge was observed among boys compared to girls about tobacco and oral cancer (p=0.046). Conclusions: The comprehensive school based tobacco control project significantly reduced the tobacco use pattern in the target population. School tobacco projects incorporating frequent follow ups and multiple interventions appear more effective than projects with single intervention.

Keywords

Tobacco use;smoking;prevalence;intervention

References

  1. Campaign for Tobacco-Free Kids (2009). The path to smoking Addiction Starts at Very Young Ages. Washington: Campaign for Tobacco-Free Kids.
  2. Centers for Disease Control and Prevention (2002). Annual smoking-attributable mortality, years of potential life lost, and productivity losses-United States, 1995-1999. Morbidity and Mortality Weekly Report, 51, 300-3.
  3. Centers for Disease Control and Prevention (2003). Cigarette smoking attributable morbidity- US, 2000. Morbidity and Mortality Weekly Report, 52, 842-4.
  4. Centers for Disease Control and Prevention (2010). Tobacco use among middle and high school students- United States, 2000-2009. Morbidity and Mortality Weekly Report, 59, 1063-8
  5. Cleary PD, Hitchcock JL, Semmer N, Flinchbaugh LJ, Pinney JM (1998). Adolescent smoking: research and health policy. Mil-bank Q, 66, 137-71.
  6. GYTS 2009. Available at http://www.who.int/fctc/reporting/annexoneindia.pdf last accessed on January18, 2013
  7. GATS 2010. Available at http://whoindia.org/en/Section20/Section25_1861.htm last accessed on January 18, 2013.
  8. Jayakrishnan R, Geetha S, Binukumar B, Sreekumar, Lekshmi K (2011). Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State. Indian J Dent Res, 22, 195-9. https://doi.org/10.4103/0970-9290.84280
  9. Azhar A, Alsayed N (2012). Prevalence of smoking among female medical students in Saudia Arabia. Asian Pac J Cancer Prev, 13, 4245-8. https://doi.org/10.7314/APJCP.2012.13.9.4245
  10. Armitage P, Berry G (1994). Statistical methods in medical research. Oxford: Blackwell Scientific Publication.
  11. Jayakrishnan R, Mathew A, Uutela A, Auvinen A, Sebastian P (2013). Multiple approaches and participation rate for a community based smoking cessation intervention trial in Rural Kerala, India. Asian Pac J Cancer Prev, 14, 2891-6. https://doi.org/10.7314/APJCP.2013.14.5.2891
  12. Kandel DB, Yamaguchi K, Chen K (1992). Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. J Stud Alcohol, 53, 447-57.
  13. Odukoya OO, Odeyemi KA, Oyeyemi AS, Upadhyay RP (2013). Determinants of smoking initiation and susceptibility to future smoking among School-Going Adolescents in Lagos State, Nigeria. Asian Pac J Cancer Prev, 14, 1747-53. https://doi.org/10.7314/APJCP.2013.14.3.1747
  14. Perry CL, Stigler MH, Arora M, Reddy KS (2009). Preventing tobacco use among young people in India: project MYTHRI. Am J Public Health, 99, 899-906. https://doi.org/10.2105/AJPH.2008.145433
  15. Reddy KS, Gupta PC (2004). Report on Tobacco Control in India. Ministry of Health and Family Welfare, Government of India.
  16. Reddy KS, Shah B, Varghese C, et al (2005). Responding to the threat of chronic diseases in India. Lancet, 366, 1744-9. https://doi.org/10.1016/S0140-6736(05)67343-6
  17. Soldz S, Kreiner P, Clark TW, Krakow M (2000). Tobacco use among Massachusetts youth: is tobacco control working? Prev Med, 31, 287-95. https://doi.org/10.1006/pmed.2000.0727
  18. US Department of Health and Human Services (1994). Preventing Tobacco Use among Young People: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health.
  19. US Department of Health and Human Services (2000).Reducing Tobacco Use: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health, [accessed 2012 Feb 14].
  20. WHO (2008). WHO report on global tobacco epidemic (2008), The MPOWER package.
  21. www.who.int/tobacco/mpower/mpower_report_full_2008. pdf[accessed on 12-12-12]

Cited by

  1. Dental Practitioners Self Reported Performance of Tobacco Cessation Counseling Interventions: A Cross Sectional Study vol.14, pp.10, 2013, https://doi.org/10.7314/APJCP.2013.14.10.6141
  2. Smoking Prevention for Adolescents in Romanian Schools vol.14, pp.11, 2013, https://doi.org/10.7314/APJCP.2013.14.11.7017
  3. Prisoners' Perception of Tobacco Use and Cessation in Chhatisgarh, India - The Truth from Behind the Bars vol.15, pp.1, 2014, https://doi.org/10.7314/APJCP.2014.15.1.413
  4. Integration of Tobacco Control in Masters of Public Health Curricula of India vol.15, pp.14, 2014, https://doi.org/10.7314/APJCP.2014.15.14.5611
  5. Modification of a Smoking Motivation Questionnaire for Chinese Medical Students vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2707
  6. Knowledge, Attitude and Practice of Tobacco Use and Its Impact on Oral Health Status of 12 and 15 Year-Old School Children of Chhattisgarh, India vol.15, pp.23, 2015, https://doi.org/10.7314/APJCP.2014.15.23.10129
  7. Attitude and Practices Among Dentists and Senior Dental Students in Iran Toward Tobacco Cessation as an Effort to Prevent Oral Cancer vol.16, pp.1, 2015, https://doi.org/10.7314/APJCP.2015.16.1.333
  8. Oral Cancer Knowledge and Practice among Dental Patients and their Attitude Towards Tobacco Cessation in Iran vol.16, pp.13, 2015, https://doi.org/10.7314/APJCP.2015.16.13.5439
  9. Effects of Perceived Smoking-Cancer Relationship and Cardiovascular Health Attitudes on Childrens' Views of Smoking vol.16, pp.7, 2015, https://doi.org/10.7314/APJCP.2015.16.7.2801
  10. International Approaches to Tobacco Prevention and Cessation Programming and Policy among Adolescents in India vol.5, pp.1, 2018, https://doi.org/10.1007/s40429-018-0185-z
  11. Betel and tobacco chewing habit and its relation to risk factors for periodontal disease vol.24, pp.5, 2018, https://doi.org/10.1111/odi.12820