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THE EFFECT OF AN ANTI SMOKING AWARENESS PROGRAM ON THE KNOWLEDGE, ATTITUDE AND PRACTICE OF SECONDARY SCHOOL STUDENTS IN LAGOS STATE
Abstract
Introduction: Cigarette smoking is one of the leading causes of preventable deaths in the world today. Majority of smokers start before the age of eighteen years. The aim of this study was to assess the effect of a school based anti-smoking intervention program on the knowledge, attitude and practice regarding cigarette smoking among students in secondary schools in Lagos state.
Materials and methods: A non-randomized, controlled intervention study was carried out among students in six secondary schools in Lagos state. Respondents were selected in the intervention and control groups using a multi-stage sampling method. Baseline data was collected using a pre-tested, semi-structured questionnaire adopted from the global youth tobacco survey instrument. An anti-smoking awareness programme was carried out among students in the intervention group using health talks, information leaflets and posters. Post-intervention data collection took place three months later. Epi-info 2008 version was employed in the data analysis.
Results: Nine hundred and seventy three students from six secondary schools participated in baseline study. The level of knowledge of the respondents regarding cigarette smoking was relatively poor with up to 108(22.6%) and 115(23.2%) in the intervention and control groups respectively having a poor level of knowledge at baseline. Only 89(18.6%) students in the intervention group and 86(17.4%) in the control group had a good level of knowledge regarding cigarette smoking at baseline. Up to 194(40.6%) respondents in the intervention group and 205(41.4%) in the control group had a good anti-smoking attitude at baseline. The students in the private schools were significantly more knowledgeable and had better
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attitudes than those in the public schools. Up to 34(7.1%) students in the intervention group and 37(7.5%) in the control group were ever-smokers. Only 15(3.4%) respondents in the intervention group and 19(3.0%) in the control group were current smokers. Up to 14% of ever-smokers smoked daily. Forty-seven percent of current smokers desired to quit smoking and 32.4% had attempted to quit in the previous three months. A relatively high number of never-smokers, 83(18.7%) in the intervention group and 75(16.4%) in the control group reported that they were likely to initiate cigarette smoking within the next year. Post intervention, the number of respondents in the intervention group with a good level of knowledge of cigarette smoking increased significantly from 89(18.6%) at baseline to 304(65.1%) post intervention. The number of respondents with a good anti-smoking attitude also increased from 194(40.6%) to 241(51.6%) post intervention. There was however no statistically significant change in the smoking status of the respondents in either the intervention or control groups post intervention. The number of never-smokers who reported that they were likely to initiate cigarette smoking within the next year reduced from 83(18.7%) to 55(12.7%). There was also a significant increase in the proportion of current smokers who desired to quit smoking from 9(47.4%) to 12(85.7%).
Conclusion: The anti-smoking awareness programme was effective at improving the knowledge and modifying the attitude of the respondents but failed to improve their smoking related behaviour. It however motivated current smokers to desire to quit and reduced the proportion of never-smokers who were likely to start smoking.
Recommendations: Health education sessions on cigarette smoking should be introduced into the secondary school curriculum and periodic anti-smoking awareness programmes should be organised for the students.
