INTRODUCTION:

“Snow and adolescence are the only problems that disappear if you ignore them long enough.”

-Earl Wilson^1.

Adolescence is most important and sensitive period of one’s life. According to World Health Organization expert committee, adolescence is defined as a period between 10 to 19 years means the second decade of life. Adolescence is an age group usually leads to be subsumed under the categories of either youth or children. ²

Smoking is the primary cause of avoidable deaths in developing countries. It is the principle cause of many illnesses and is risk factor or aggravated cause. Cigarettes have direct or indirect toxicity effects on practically every organ. The induced diseases are cardiovascular, cancer, respiratory complaints and many consequences less well known but often serious.³

Smoking is a major problem among adolescents. Smoking among adolescent is a major concern because smoking long term posses many health hazards most all adolescent know the long term effects of smoking are and many do not care, because they are not concern with what might happened to them 40 to 50 years down the road. Adolescent smoking is a global issue because there is not a single country around the world where teen are not smoking. Smoking affects all subset of adolescent.⁴

NEED FOR THE STUDY:

India is the second most popular country in the world with total population of over 1081 million. Adolescent (10-19yrs) form a large section of population about 22.5% of the total population. The total population of young people (10-24yrs) is approximately 331 million comprising nearly 30% of the total population of India.⁵

Adolescence is a phase of rapid physical, psychological development and sexual transformation. Adolescent do have a range of health problems that cause a lot of morbidity as well as definite mortality among that substance abuse plays a vital role.²

Globally, approximately 47% of males and 12% of females are smokers. In developing countries 48% of males and 7% of females smoke. Whereas, in developed countries 42% of males and 24% of females have smoketive diseases.⁶

Globally, nearly 50 lakh person die annually from tobacco related illnesses and many more suffer from smoking related morbidity. There is therefore, need to identify relevant factors associated with smoking among adolescents in order to better tailor public health intervention aimed at preventing smoking. The WHO, provide certain estimates that India will have the fastest rate of rise in death attributable tobacco in the first two decades of 21^st century.⁷

The global youth tobacco survey (GYTS) in 2009 indicated that the national prevalence of current tobacco use among adolescents (between 13 to 15yrs) was 14% and had not changed significantly from the global youth tobacco survey 2006 (16.9%). Nationwide, 20% of high school students were smoking cigarettes in 2010. The most recent survey of middle school student shows that about 5% were smoking cigarette.⁸

South-East Asian Regional Office (WHO-SEARO) and Indian Council Of Medical Research provided detailed population based tobacco use prevalence data for youth in the age group of 10 to 14 years in two states- Uttar Pradesh (boys 3%) and Karnataka (boys 1.3%).⁹

STATEMENT OF THE PROBLEM:

“A descriptive study to assess the knowledge regarding the ill effects of smoking among the adolescent boys in Pre-university College, Belgaum”

OBJECTIVE OF THE STUDY:

To assess the knowledge regarding ill effects of smoking among adolescent boys studying in Pre-university College, Belgaum.

ASSUMPTIONS:

Adolescent boys may have some knowledge regarding ill effects of smoking.

OPERATIONAL DEFINITIONS:

Knowledge:

It refers to awareness regarding ill effects of smoking among adolescent boys.

Smoking:

It is the act or habit of smoking cigarettes.

Adolescent:

It is the period between puberty and maturing; in the males 14 to 25 years and in females 12 to 21 years.

VARIABLES:

A variable in attribute of a person that varies and it takes on different values.

Research Variables:

Knowledge of adolescent regarding ill effects of smoking.

Demographic Variables:

Selected demographic variables such as age, education, family income per month, religion, type of family and residential area.

DELIMITATION:

The study is limited to adolescent boys studying in pre-university college ,Belgaum.

REVIEW OF LITERATURE:

A descriptive study was conducted on tobacco smoking affects teens brains in India in 2011. A total of 25 smokers and 25 non-smokers between the ages of 15 to21 were asked to perform a test that activated the prefrontal cortex and required them to inhibit responding. The test, called the stop-signal task, was done while participants were undergoing functional magnetic resonance imaging. The stop-singal task involes pressing a button as quickly as possible every time a lighted arrow appears unless an auditory tone is played, in which case the participants must prevent himself from pressing the button. The result showed that among smokers, the researchers found that the higher the teen smoked- the lesser the activity in the prefrontal cortex.¹⁰

An experimental study was conducted to assess the effectiveness of structured teaching programme on knowledge, attitude and practice in high school children in Banglore in 2011. Study was conducted in 2 randomly selected schools in Banglore south. A total of 501 students participated in the study. The data was collected by questionnaire followed by a structured teaching programme. The results showed that the prevalence of smoking was 6%. Smoking was predominantly a male feature and about half were occasional smokers. Peer influence was cited as the most common initiating factor and the 1^st puff was taken most commonly at mean age of 13 years. Majority of non-smokers cited “bad for health” as the primary reason for not smoking. The study also provided the results of significant improvement in knowledge, attitude and practice of the study samples. More than half the children had a smoker in the house and about 40% had no idea about dangers of smoking. Majority of participants had never been taught about smoking either in school or at home and more than half obtained information about smoking from television.¹¹

A descriptive study was conducted on colorectal cancer occurs earlier in those exposed to tobacco smoke in USA in 2008. By using convenient sampling technique 3,540 cases of colorectal cancer subjects included. Data were collected by questionnaire method, individuals who smoked less than a pack/day were diagnosed with colorectal cancer almost 3 years (p<0.01) before never smokers; those who smoked 1 pack/day were diagnosed 3 years (p<0.01) earlier than never smokers, and those who smoked more than 1 pack/day were diagnosed almost 5 years (p<0.01) before their never smoking counterparts.¹²

A descriptive study was conducted on effects of active tobacco smoking on the prevalence of asthma- like symptoms in adolescents in Switzerland in 2007. A random sample of 4738 adolescents aged 13.4 ± 1.05 years who responded the Isaac video questionnaires plus questions on tobacco smoking. The prevalence of tobacco smoking in the last 12 months was 16.2%, with significant female predominance. The persistent smokers had a significantly higher prevalence of asthma-like symptoms ever and in the last 12 months than ex-smokers and non-smokers. More than 27% of asthma symptoms in our adolescents are attributable to active tobacco consumption.¹³

A survey was conducted on passive smoking as a risk factor of anemia in adolescents in Jordan in 2007. 740 children aged 12-18 years were selected by using random sampling technique and tested for haemoglobin levels. Data were collected by using health survey. Multivariate logistic regression method was used to analyze the effect of passive smoking on anemia in older children. Results indicated that anemia in adolescent was strongly positively associated with exposure to passive smoking from both parents (p <0.01). Severely undernourished children were at higher risk of anemia independent of passive smoking and other risk factor (p<0.05).¹⁴

A cross-sectional study was conducted on active smoking in adolescents of Karachi, Pakistan in 2010. A total of 875 teenage male students from different schools, colleges and universities of the city were selected by random sampling technique. All the responses were scored on nominal an ordinal scales. The result showed that, 41.30% students were facilitated by the media advertisement by different tobacco industries. Once addicted, smokers find it difficult to quit. The majority of respondents (72.86%) were well aware of the factors and consequences of smoking on health and they believed that smoking is neither good for their own health nor for the public around them. Only 25.8% of the respondents wanted to quit smoking and among them, only 12.9% had ever tried to quit smoking. Parents have an influence on whether or not their children will develop smoking habits. 29.75% of students had developed smoking habits as disciple of their fathers. Hence, 55.79% thought that smoking in public places is not a cultured practice. However, a majority of the students continued to smoke on roads, in restaurants, markets and malls.¹⁵

A review of studies focused on determinants of adolescents smoking behavior published between 1990-2000 is presented. Determinants were divided into three groups: individual factors, social factors and societal factors. Individual factors include knowledge, intentions, attitudes, health-related behavior, personality characteristics and school-related variables. Social factors include smoking behavior of parents, siblings, peers and significant adults, but also family characteristics, social support and socio-economic status. Societal factors include restrictions on smoking, tobacco advertisement and smoking behavior of adolescent’s role model.¹⁶

RESEARCH METHODOLOGY:

This chapter deals with the description of the research methodology adopted by investigator¹⁷ related to the smoking ill effects in adolescents. The Various steps that undertaken to conduct the study includes research approach design, setting, population, sample and sampling techniques, description of the tool, pilot study, procedures for data collection and plan for data analysis.

Research Approach:

Looking at the nature of research problem for the present study and objectives to be filled, a descriptive approach was considered to carry out the study.

Descriptive approach describes data and characteristic about the population or phenomenon being studied.¹⁸ Descriptive research was undertaken with aim of collection of information by providing questionnaire to the subjects.

Research Design:

A research design is the blue print for conducting the study and is concerned with turning a research question into project. The purpose of a research design is to provide a plan of study that permits accurate assessment of cause and effect relationship between independent and dependent variables.¹⁹

Since the study undertaken was aimed to identify the knowledge level of the adolescence regarding ill effects of smoking. Descriptive Survey Research Design was used.

Variables:

The research variables are factors that can be manipulated and measured.²⁰

Two types of variables were identified in this study.

1. Research Variables:

Knowledge questionnaires regarding the smoking ill effects in adolescents.

2. Demographical Variable:

Selected demographic variables such as age, education, family income per month, religion, type of family and residential area.

Research Setting:

The research setting is the environment within which studies are conducted. Setting are the most specific places where data collection occurs based an nature of research questions and the type of information needed to address it.²¹ The present study was conducted in Lingaraj PU Collage .

Population:

A research population is generally a large collection of individual or objects that are the main focus of a scientific query known to have similar characteristics.²²Population consist of 40 adolescents people in selected Lingaraj PU Collage.

Sample:

A sample is a subset of a population that is used to represent the entire group as a whole.²³

Criteria for Sample Selection:

The criteria for selecting were based on availability, practical concern, design and the subject’s interest to participate in the study. The study had two criteria namely inclusion and exclusion criteria

Inclusion Criteria:

· Those who are studying in pre-university college.

· Those who are available at the time of data collection.

Exclusion Criteria:

· Person not willing to participate.

· Person were absent on that day.

Data Collection Instrument:

^·Data collection tools are the instrument used by the researcher to observe or measure the key variables in the research problem.²¹In this study data collection were:

· Socio-demographic pro-forma

· Knowledge questionnaires regarding ill effects of smoking

Procedure for Data Collection:

Formal permission was obtained from the Principal, KLE University’s institute of nursing sciences, Belgaum and Lingaraj PU Collage Belgaum.

RESULTS:

In this study, data is collected to assess the knowledge regarding ill effects of smoking among 40 adolescent boys. The investigator administered structured questionnaire to collect data. The collected data was analyzed according to the plan of data analysis which includes both descriptive and inferential statistics. The data findings have been tabulated according to the plan of data analysis and interpreted under the following objectives.

OBJECTIVES:

To assess the knowledge regarding ill effects of smoking among adolescent boys.

PRESENTATION OF DATA:

The data was entered into a master sheet for tabulation and statistical processing. The analysis of data was organized and presented under the following headings:

Section I: Findings related to socio-demographic variables.

SECTIONI: Findings related to socio-demographic variables.

Table 1: Frequency distribution of adolescent boys according to Socio-demographic variables. n=40

Sl.No:

Socio-demographic variables

Frequency

Percentage

Age

a.15yrs

b.16yrs

c. 17yrs

d. 18 and above

Education

1.PUC I^stYr

2. PUC II^ndYr

Family income (per month)

1. < 3000

2. 3000 to 7000

3. >7000

Religion

1. Hindu

2. Muslim

Type of family

1.Nuclear

2.Joint

Residential area

1.Urban

2.Rural

2.5

22.5

97.5

2.5

52.5

47.5

Table 1 Indicated that majority of subjects, 22(55 %) were in the age group of 17. Maximum number of subjects, 39 (97.5%) were Hindus. Majority of the subjects, 26(65%) belongs to Nuclear family. Most of the subjects were residing at Urban area (52.5%).

Table 2: Mean, Median, Mode, Standard Deviation and Range of knowledge score of adolescent boys n=40

	Mean	Median	Mode	S.D.	Range
	8.5	7	7	3.4	14

Table 2 depicted that overall mean is 8.5, median and Mode is 7,SD is 3.4 and Range is 14.

Table 3: Frequency and percentage (%) distribution of knowledge scores of Primary school teachers on identification and management of learning disabilities in school children. n=40

Knowledge score

Frequency

Good (16-20)

Average (5-15)

Poor (1-4)

87.5

2.5

Table 3: revealed that in test, majority of the adolescent boys , 35 (87.5%) had average knowledge and 1(2.5%) had poor knowledge.

Graph 1: cylindrical diagram showing percentage distribution of knowledge score of adolescent boys.

DISCUSSION:

The present study was undertaken to assess knowledge regarding the ill effects of smoking among the adolescent boys in Pre-university College Belgaum.

Findings Related to Socio-Demographic Data of the Subjects:

In the present study it was found that majority of subjects, 22(55 %) were in the age group of 17, maximum number of subjects, 39 (97.5%) were Hindus. Majority of the subjects, 26(65%) belongs to Nuclear family. Most of the subjects were residing at Urban area (52.5%).

Findings related to knowledge scores of adolescent boys:

It was found that majority of the adolescent boys, 35 (87.5%) had average knowledge and 1(2.5%) had poor knowledge.

CONCLUSION:

The following conclusions were drawn on the basis of the present study.

· It was found that majority of subjects, 22(55 %) were in the age group of 17, maximum number of subjects, 39 (97.5%) were Hindus. Majority of the subjects, 26(65%) belongs to Nuclear family. Most of the subjects were residing at Urban area (52.5%).

· It was found that majority of the adolescent boys, 35 (87.5%) had average knowledge and 1(2.5%) had poor knowledge.

NURSING IMPLICATIONS:

The study findings have several implications in nursing. They can be categorized under nursing education, nursing practice, nursing research and nursing administration.

NURSING EDUCATION:

The study on assess the knowledge regarding the ill effects of smoking among the adolescent boys will help to prepare guidelines for nurses to understand the factors that are contributing to smoking habits and what are the ill effects of smoking.

NURSING PRACTICE:

The present study will be useful for evaluating the incidence of smoking in adolescent boys. The nurse helps in assessing the smoking habits and their effects in their nursing practice.

NURSING ADMINISTRATION:

Nurse as administrator should plan and organize and identify the smoking habits in adolescent boys population. As a nurse she can teach the ill effects of smoking and the way to adapt by conducting a teaching programme or an interview with the boys.

NURSING RESEARCH:

The present study serves as secondary sources of review of literature for nurse researchers. Nurses can take up the present study as research project based on the recommendations for the future studies. The present study findings could be presented in international, national and state level conferences and help all the nurses to be aware of the findings which will help them to strengthen their nursing research in nursing.

LIMITATIONS:

· The present study was limited to Lingaraj College, Belgaum.

· The study was limited to 40 adolescent boys.

· The study had no intervention.

RECOMMENDATIONS:

· A similar study can be undertaken for a large sample in different settings thus broad generalization will be possible.

· An interventional study can be done to determine the effectiveness of planned teaching program.

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Received on 19.09.2014 Modified on 20.10.2014

Int. J. Nur. Edu. and Research 2(4): Oct.- Dec. 2014; Page 324-328