TOBACCO USE KNOWLEDGE, ATTITUDE, AND PRACTICE AMONG STUDENTS IN TERTIARY INSTITUTIONS IN DELTA

TOBACCO USE KNOWLEDGE, ATTITUDE, AND PRACTICE AMONG STUDENTS IN TERTIARY INSTITUTIONS IN DELTA

ABSTRACT

This research examines “Tobacco use knowledge, Attitude and Practice Among Students in Tertiary Instructions in Delta State”. Four specific objectives were formulated with two research questions. Two null hypotheses were also postulated to guide the study. A descriptive survey research design was used for the study. The population of the study consisted of 31600 undergraduates in the selected tertiary institutions in Delta State. The sample size consisted of 395 undergraduate students. Structured questionnaire was the instrument used for data collection. Face validity of the instrument was established by three experts from the Department of Human Kinetics and Health Education. The reliability of the instrument was established. Cronbach-alpha statistics was used to determine the reliability of section B on attitude while the split-half reliability test (Spearman-Brown correlation formula) was used to establish the reliability index of section C on practice. After computation, a reliability coefficient of .079 was obtained for the instrument and adjudged reliable for use. Statistical package for social sciences version 22 was used for data analysis. Percentage and standard deviation were used in answering the research questions. The t-test and chi-square statistics were used in testing the hypotheses. Results of the study indicate that students in tertiary institutions had a negative attitude towards tobacco use (mean score of 2.37); a good proportion (61.3%) of the students in tertiary institutions had practiced tobacco use. Furthermore, no significant difference was found to exist between students of various ages in their attitude (t-cal = .0174, df =393, p-value = .0596) and practice (χ² =.0981, df =1, p-value =.539) of tobacco use. Based on the findings, recommendations such as education regarding smoking, emphasizing its negative consequences, should begin early in primary schools and should be part of the primary school curriculum.

 

CHAPTER ONE

GENERAL INTRODUCTION

1.1     Background of the Study

Smoking has become a complex global public health problem and a major health risk factor linked with the development of cancer, heart disease, chronic respiratory diseases and diabetes (World Bank, 1999). It is responsible for the largest preventable cause of death in the world. Each day more than 13,000 people die prematurely because of tobacco use (CDC, 2000). This figure is expected to almost double by the year 2020. Countries at all levels of development are victims of the tobacco epidemic (WHO, 2003a).

According to the World Bank Reports in 2003 there were about 1.3 billion people smoking cigarettes or other products, and out of them, almost one billion were men and 250 million were women. About 80 percent of these people lived in low and middle-income countries (Guindon & Boisclair, 2003). Cigarette smoking has become not only a national social problem but a global one also. Smoking is expected to kill 4 million people in the next 12 months, and by 2030, it will kill 10 million people a year, which is more than any other single cause of death. Seven million of these deaths will occur in low-income and middle-income countries (World Bank, 1999; CDC, 2000). Numerous studies reveal that smoking prevalence has remained stable in the United States of America (USA) at 23% since 1993 (Etter, 2004; Fiore, 2003; Giovino, 1994).

Tobacco use has been a global public health issue but appears to be a more challenging issue in developing countries especially among the younger population. The World Health Organization (WHO, 2011) attributes approximately four million deaths annually to tobacco consumption, and this estimate is expected to increase to eight million by the year 2030. It accounts for more than 7 million deaths annually with about 10% of these resulting from second-hand smoke; there are around 1.1 billion smokers worldwide and about 80% of these live in low- and middle-income countries (LMICs), where more than two-thirds of smoking-related deaths occur (WHO, 2019). The smoking rate appears to be increasing in the Middle East and Africa (Scoll, and Winstanley, 2018). For example, in sub-Saharan Africa, the consumption of tobacco increased by 57% between 1990 and 2009 (Eriksen, Nyman, and Whitney, 2014). In Nigeria, there are about 13 million smokers in 2012 (WHO, 2015), with over 16,000 deaths attributable to smoking (The Tobacco Atlas, 2018). Though global current smoking rates among adults decreased from 23.5 to 20.7% between 2007 and 2015 (Scollo, and Winstanley, 2018), however, among young people it has been an increasing public health concern. Globally an estimated 82,000 to 99,000 young people start smoking every day of which many are under the age of 10 and most reside in low- or middle-income countries (Shafey, Eriksen, Ross & Mackay, 2009). The United States Department of Health and Human Services (USDHHS, 2014) reported that tobacco product use is started and established primarily during adolescence. Nearly 9 out of 10 daily cigarette smokers first try cigarettes by age 18, and 99% first try smoking by age 26 (USDHHS, 2012). Specifically, Adeniji, Bamgboye, and van Walbeek (2012) noted a growing use of tobacco products among Nigerian youths. Kale, Olarewaju, Usoro, Ilori, Ogbonna, Ramanandraibe, and Musa (2012) in their nationwide survey noted that about two-thirds of the Nigerian population started smoking before attaining 20 years. The continued use of tobacco products can predispose young people to prolonged nicotine exposure and subsequently nicotine addiction (USDHHS, 2014) and other risk factors for several chronic diseases associated with smoking.

Smoking is recognized as an important risk factor for several diseases and disorders and is the main modifiable factor for many oral conditions, including periodontal disease, potentially malignant disorders, and oral cancer (Musskopf, Fiorini, Haddad, Susin, 2014). Mackay and Ericksen (2002) opined that tobacco kills half of all lifetime users, and half die in middle age between 35 and 69 years old. According to them, no other consumer product is as dangerous as tobacco. They further stated that tobacco is the only legally available consumer product that kills people when it is entirely used as intended. Furthermore, they maintained that while the most serious effects of tobacco use normally occur after decades of smoking, there are also immediate negative health effects for younger smokers. The authors added that most smokers especially teenagers are already addicted during adolescence and that the younger a person is when he or she begins to smoke, the greater the risk of eventually contracting smoking-related diseases such as cancer, or other heart diseases.

WHO (2002) stated that tobacco affects adolescents in several ways; and that active smoking by young people is associated with significant health problems. The report further stated that as with alcohol, adolescents‘ cigarette smoking is strongly associated with illicit drug use. Youths who consistently smoke throughout adolescence are at significantly greater risk of marijuana and drug abuse and dependency. Several factors could be linked to tobacco use among young people. Factors associated with youth tobacco product use include the social and physical environment, biological and genetic factors, mental health, and personal views (USDHHS, 2012; 2014 and Centres for Disease Control and Prevention, CDCP, 2016) among other associated factors. Oyewole, Animasahun and Chapman (2018) outlined the most common risk factors for tobacco use to include: peer influence, family conditions, psychosocial factors, and male gender; also, concomitant substance abuse, media advertisements and increasing age

1.2 Statement of the Problem

The World Health Organization (WHO) has estimated that five million deaths occur annually due to tobacco use and this number of deaths is expected to reach more than eight million by the year 2030 (Gajalakshmi et al., 2004; WHO, 2009). About 80% of this number will be in developing countries (WHO, 2009). However, the exact magnitude of the problem of smoking in developing countries is not well defined. There is little information to describe the characteristics of smoking patterns in these countries (Gajalakshmi et al., 2004). Smoking has a great economic burden by causing a decrease in economic productivity and high healthcare expenditures in addition to the cost of tobacco (Ruff et al., 2000).

Smoking also has an environmental impact due to secondhand (passive) smoking (El-Ansari, 2002). The impact of smoking is not limited to smokers, it can spread to affect non-smokers as well. Secondhand smoke has an impact on birth outcomes represented in low birth weight (Abu-Baker et al., 2010), and contributes significantly to respiratory tract infections in infants (Jones et al., 2011).

It is well known that cessation of smoking is extremely difficult. This statement is supported by research that has proved beyond doubt that nicotine is highly addictive (Rugkasa et al., 2001). Smoking prevalence rises sharply during adulthood. This means that there is an induction of smoking even after high school (Torabi et al., 2002). Between 1991 and 1997, the rate of smoking increased by 32% among 18 to 24-year-old adults in the USA (Torabi et al., 2002). Studying smoking behavior and attitudes among this sector of the population will add valuable information about the patterns of smoking among this age group (Vakeflliu et al., 2002). In addition, knowledge about previously identified socio-environmental factors associated with smoking among college students in developing countries is limited (Pickett et al., 2000; Moore, 2001).

1.3 Purpose of the Study

The purpose of this study was to determine tobacco use knowledge, attitude, and practice Among Students in Tertiary instructions at Delta State

. Specifically, the study determined:

1. attitude of students in tertiary institutions towards tobacco use;
2. practice of tobacco use by students in tertiary institutions;
3. attitude of students in tertiary institutions towards tobacco use according to age;
4. practice of tobacco use by students in tertiary institutions according to age;

1.4 Research Questions

The following research questions have been posed to guide the study.

1. What is the attitude of the students in tertiary institutions towards tobacco use?
2. What is the practice of tobacco use by students in tertiary institutions?
3. What is the attitude of students in tertiary institutions towards tobacco use according to age?
4. What is the practice of tobacco use by students in tertiary institutions according to age?

1.5 Hypotheses

The following null hypotheses were postulated and tested. 05 level of significance:

1. There is no significant difference in the tobacco use attitude of the students according to age.
2. There is no significant difference in tobacco use practice of the student according to age.

1.6 Scope of the study

The study focuses specifically on tertiary institutions located within Delta State, Nigeria. This includes universities, polytechnics, colleges of education, and other higher education institutions across the state. The study targets students enrolled in these tertiary institutions, regardless of their age, gender, field of study, or residential status

1.7 Significance of the study

The significance of the study on tobacco use among students in tertiary institutions in Delta State extends to various stakeholders, including teachers, parents, students, policymakers, and the existing literature in this field.

Firstly, teachers play a crucial role in shaping students’ attitudes and behaviors. By understanding the prevalence and attitudes towards tobacco use among students, teachers can implement targeted educational programs and interventions to raise awareness about the dangers of tobacco and promote healthy lifestyle choices.

Secondly, parents are integral in influencing their children’s behaviors, including tobacco use. This study can provide parents with insights into the extent of tobacco use among students and equip them with the knowledge to engage in open discussions with their children about the risks associated with tobacco use, thereby fostering a supportive environment for tobacco prevention and cessation.

Thirdly, for students themselves, this study can serve as a wake-up call regarding the prevalence and misconceptions surrounding tobacco use. By understanding their peers’ attitudes and behaviors towards tobacco, students can make informed decisions regarding their health and well-being, potentially leading to a reduction in tobacco initiation and use among this demographic.

Fourthly, policymakers can use the findings of this study to inform the development and implementation of evidence-based tobacco control policies and programs targeted at tertiary institutions. By addressing the factors contributing to tobacco use among students, policymakers can work towards creating environments that promote and support tobacco-free campuses, thereby protecting the health of students and the broader community.

Finally, this research contributes to the existing literature on tobacco use by providing valuable insights into the attitudes, practices, and demographic factors associated with tobacco use among students in tertiary institutions in Delta State.

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