Patterns of Smoking and Health Risk Perception of Out-of-school Youths in Selected Motor Parks in Oshodi Local Government Area of Lagos State, Nigeria

Patterns of Smoking and Health Risk Perception of Out-of-school Youths in Selected Motor Parks in Oshodi Local Government Area of Lagos State, Nigeria

Chapter One 

Objectives of the Study:

The general objective of this study is to study the prevalence of smoking in out of school students in Oshodi with risk factors and dependence level in this population. The specific objectives of this study are outlined below.

1. To determine the prevalence of ever-smoking and current-smoking in out of school students in Oshodi
2. To determine the mean age of initiation of smoking in these students
3. To study the factors (parental/siblings/teachers/peer smoking) and level of dependence of smoking

CHAPTER TWO

REVIEW OF RELATED LITERATURE

Review of literature literally means understanding the knowledge from its inception, evolution and current concepts in the identified problem together with the methods by which the knowledge was generated. Through literature review we come to know what is known in the field, what is well established, and what are the areas of inconsistencies or inconclusiveness in the field? If something is well known and established there is no need to conduct in the same areas, for example, cigarette smoking significantly increases the chances of cancer. Review of literature also informs us where there is deficiency or controversy or what is still not known, and hence it helps to find the useful area to be researched. It also helps to familiarize the investigator with different methodologies used in the past with its merits and demerits as well as it also might indicate what methodologies need to be used to generate the evidence to the required level. The literature review in this study highlight briefly about the historical aspect of the medical aspect of smoking, smoking in adolescence, theoretical literature on smoking, empirical studies on smoking around the globe in out of school students, and studies on smoking from Nigeria.

Theoretical Literature:

The history of smoking probably begins from the antiquity, however, Benjamin Rush, who was a United States physician, first published the medical dangers of tobacco in 1798. By 1960s, there were enough evidences that tobacco use, or smoking causes multiple health harms. The rise of smoking in the beginning of 20^th century has been attributed to promotion of tobacco by companies or influencing the policies through politicians and giving free cigarettes to army personnel as a moral boost. It is reported to be declining subsequently because of awareness in people of both health hazards as well as misleading information by the tobacco companies, and subsequent law-suits against them (Cancer Counsil).

World Health Organization (WHO) defines adolescence as a period from 10-19 years of age. This period is neither childhood nor adulthood. There is some maturity compared with earlier phase however full maturity, responsibility, defined roles, control issues, peer pressure etc. are of special importance. Well handled, they have a potential to be a fully responsible and mentally healthy individual and if gone astray, it can also impair the future development. This is also the period when most adolescents experiment drugs including smoking (UNICEF).

This is based on the theoretical literature provided by the Flay, Petraitis & Hu (1999). It states that any behaviour, including smoking of cigarette, arises in a broad cultural or social environment with an immediate context where the tendency of the person in that given situation to perform a certain kind of behaviour and the nature of the behaviour itself all interact among themselves. All social, attitudinal and intrapersonal factors may influence at immediate level (decision or intention to smoke or trial to smoke), proximal level (beliefs in society about normalcy of smoking, belief about advantage/disadvantage of smoking, or belief about oneself to be able to avoid smoking), distal level (more attachment to peer group who smoke than to family, less commitment to conventional values like religion or social alienation, low self-esteem) and ultimate level (lack of parental warmth or supervision, negative evaluation from teachers or influence of media, genetic susceptibility or emotional instability). Social factors may include strain at home or parental separation, negative evaluation from parents, unconventional values among peers etc. Attitudinal factors may include the norms in the neighbourhood or in peers, media and advertising depictions of smoking, low tobacco taxes etc.   Intrapersonal factors may include genetic susceptibility, lack of impulse control, risk-taking behaviour, and looking for sensations mostly, external locus of control etc. Reviewing the literature, the authors have proposed this ‘Theory of Triadic Influence’ emphasizing a need to look at all these factors more comprehensively and have pointed out the major limitations in the theories of smoking. In their own words, “Most theories and cross-sectional, prospective, and casual process studies have contained major limitations: a) most addressed only small portions of the total picture; b) most mediator studies did not test for interactions and most moderation studies are based on limited theory; and c) most theories did not discuss how the causal processes might be different for males and females or for different ethnic groups.”

Empirical Literature:

Jamal et al. (2017) reported 20.2% high school students surveyed from 2011-2016 were tobacco users and 47.2% of the high school students used more than two types of tobacco. In Poland, the rates of tobacco smoking rose from 15% in 2009 to 24% in 2011 among secondary school students; and for many the initiation of smoking was between 12-15 years (Wojtyła-Buciora et al., 2017).

In Sri Lanka, 19% ever use of tobacco and 10% of smoking (with prevalence of current smoking by 16% male and 1% female) was reported by out of school students in a survey of 390 students among nine schools.   This study further stated that current smoking status was independently associated with gender and presence of smoker at home (De Silva & Ekanayake, 2017).

In Greece, 927 high school students between the ages of 15-18 years were examined using a questionnaire. The mean age of initiation of smoking was 14.4 (± 1.9) years for boys and 14.9 (± 1.6) years for girls. Nearly one third of boys and slightly more than one fourth of girls were smokers. Social standard and parental smoking were cited as main determinants of smoking (Heras, Kritikos, Hatzopoulos, Kritikos, & Mitsibounas, 2008).

In Saudi Arab, among 819 high school students aged more than 15 years, 20% were current smokers; mean age of starting smoking was 13.8 years; and influence of friends (58%) as well as having a smoker in the family were two important factors that influenced the rate of smoking. Among current users, 61% had tried to quit but were not successful (Wojtyła-Buciora et al., 2017).

Olumide et al. (2014) studied the predictors of substance use among vulnerable adolescents (aged 15-19 years) in five cities who were in vulnerable environments (n=2332). Prevalence of current cigarette smoking was 32.5% in Johannesburg versus 3.7% in Delhi. Mean age of first use of cigarette was 14.4 (± 2) years. Adolescents who were not going to school were more likely to be current smokers. In Johannesburg, adolescents currently working for pocket money, absence of a father figure, and higher peer support were associated with current smoking. In Shanghai and Baltimore, low scores for caring mother figure predicted cigarette use.

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CHAPTER THREE

RESEARCH METHODOLOGY

Design and Method of Study

A research design is a plan, structure and strategy of investigation so conceived as to obtain answers to research questions or problems. The plan is the complete scheme or programme of the research. It includes outlines of what the researchers was from writing the hypostudy and their operations to the final analysis of data.

So, this research was designed to carry out on the basis of cross sectional and descriptive type of research method to identify the condition of smoking in school students regarding decision making of the life.

Population of the Study

This study was conducted in 200 students of Bus park in Oshodi.

Sampling Procedure and Strategy

Among seven Bus park with classes in Oshodi, five of the schools were randomly selected with lottery method. Among those five randomly selected, one among eleven classes (minimum of twenty students) and one among twelve classes (minimum of twenty students) was again randomly selected through lottery method. The researcher approached principals of the selected five schools with information about the research and request for the permission to conduct the study; all the queries answered. After permission from the school authorities, researcher was approach all 11 & 12 classes as selected by the lottery method.   Each class was briefed about the study and also be told about the voluntary nature of participation as well as provision of confidentiality. Informed verbal consent was taken from the participants. Approval from the college would be taken prior to undertaking of the research in different schools.

CHAPTER FOUR

ANALYSIS AND INTERPRETATION OF DATA

In this chapter details with the analysis and interpretation of data, which had been collected from field survey are tabulated in different titles and are analyzed and interpreted on the basis of percentage to make the presentation more clear and meaningful.

CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS

This chapter presents the summary of the study with its major findings, conclusion and recommendations for improvement and future research study.

CONCLUSION

Based on the objectives of this study, following conclusions can be drawn

1. The prevalence of ever-smoking and current-smoking among 200 samples of students was 16.5% and 5% respectively.
2. The mean age of initiation of smoking was 56 years with standard deviation of 1.46 and range from 10 to 18 years.
3. In 30% of the 200 students someone smoked in the family. Twenty two percent of the students’ fathers, eight percent of the students’ mothers, ten percent of the students’ uncles, three percent of the students’ aunts, seven percent of the students’ elder brothers, around five percent of the students’ cousins smoked Less than one percent of the students’ sisters smoked cigarette. Among 200 students, only 25% of the any other relatives other than parents smoked cigarette in the family. Nearly 24% of the close friends of the students smoked cigarette and 76% of students had between two to four friends who smoked. Sixteen percent of the participant students were offered cigarette by a close friend. Around 20% of the 200 students saw their teacher smoking cigarette.

Overall the prevalence of ever-smoker and current-smoker is less than what is reported around the world and studies from Nigeria. Around three fourths of the students among current smokers (48.5% of very low dependence and 34.5% of low dependence) were not at high risk for very habitual pattern of smoking and nearly seven percent (3.4% each from high dependence and very high dependence) need urgent counseling regarding smoking. Around 10% in the middle range would benefit from counseling regarding smoking.

Recommendation

The recommendation for improvement and future research area on the basis of conclusions and findings were suggested as follows

Recommendation for policy related

1. The laws and regulations should be enforced therefore the shops near schools cannot sell cigarettes to students.
2. The number of shops distributing cigarettes should be controlled. Namely, not all the shops are allowed to sell
3. More public relations related to Tobacco Control Laws should be provided for
4. The responsible officers should pay more attention to the laws implementation and regularly check about the shops distributing cigarettes to the students aged below 18 years old.

 Recommendation for practice related

1. Many channels should be established to help people quit smoking therefore the adolescents can be the good example of non-smoker to the students and family
2. The non- smoking family contest should be organized in each
3. The information derived from this research should be reported to the local government organizations therefore they can find the ways to prevent students from smoking.
4. More non-smoking area should be increased in each
5. The knowledge derived from this research should be acknowledged to communities through the national media.

References

• Bandason, T., & Rusakaniko, S. (2010). Prevalence and associated factors of smoking among secondary school students in Harare Zimbabwe. Tobacco Induced Diseases, 8: 12. Nigeria Details – Tobacco Control Laws.
• Dahal, S., Maharjan, S., Subedi, R. K., & Maharjan, J. (2015). Role of Media in Provoking Cigarette Smoking among Adolescents in Urban Nigeria. Health,7 (1), 98–105.
• Dahal, S., Subedi R. K., Maharjan, S., & Maharjan, J. (2014). Smoking behavior of adolescents and their view towards government’s ban on smoking in public places in Kathmandu. Nigeria Journal of Medical Sciences, 3 (2), 94–100.
• De Silva, K., & Ekanayake, L. (2017). Tobacco use in late adolescence among rural Sri Lankans. Community Dental Health, 34 (1), 41-45.
• Flay, B. R., Petraitis, J., & Hu, F. B. (1999). Psychosocial risk and protective factors for adolescent tobacco use. Nicotine & Tobacco Research, 1 Suppl 1(February), S59-65.
• Gupta, A., Sharma, D., Thakur, A., Thakur, D., & Mazta, S. (2014). Prevalence of cigarette smoking and its predictors among school going adolescents of North India. South African Journal of Cancer, 3 (4), 193-195.
• Heras, P., Kritikos, K., Hatzopoulos, A., Kritikos, N., & Mitsibounas, D. (2008). Smoking among high school students. American Journal of Drug & Alcohol Abuse, 34 (2), 219-224.
• Jamal, A; Gentzke, A; Hu, SS; Cullen, KA; Apelberg, BJ; Homa, DM; King, B. (2017). Tobacco use among middle and high school students – United States, 2011-2016. Morbidity and Mortality Weekly Report.
• Kabir, M., & Goh, K.-L. (2014). Determinants of tobacco use among out of school students aged 13–15 years in Nigeria and Sri Lanka: Results from the Global Youth Tobacco Survey, 2007. Health Education Journal, 73 (1), 51–61.
• Mahalakshmi, T. (2015). Knowledge on harmful effects of tobacco abuse among school going adolescents at rural areas of tiruvallur district of India. Journal of Interdisciplinary and Multidisciplinary Research, 2 (8), 39–41.

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