Abstract

Background:  Smoking is the biggest health issue globally. It not only affects the person who is smoking but also the people surrounding her/him. Many people die because of either direct lung diseases or with the complications associated with it. College students are often the victims of this. Students start smoking at a very early age and continue smoking throughout their life. The main reason for smoking is either because of the stress or because it is cool among their peer group. Smoking has also shown long-lasting health effect on the individuals. Objective: The purpose of the study is to assess the knowledge, attitude, and practices on smoking habits among school children of Dawson Creek. Material and Methodology: It is a cross-sectional study conducted using the random stratified sample. Dawson Creek will be divided into four districts and one school will be selected to represent the study. To evaluate the smoking habits, students from age 14-18years will be selected based on eligibility criteria. The data will be collected using a constructed questionnaire and it will be analyzed statistically. Results: The data will be analyzed using appropriate statistical tools and methods.

Knowledge, Attitudes, and Practices on Smoking Habits Among School Children in Dawson Creek

    Cigarette smoking is the most important public health concern in the world. Around 7 million people die per year because of smoking out of which more than 6 million deaths are because of direct or active tobacco use while around 890,000 deaths are due to second-hand smoking. (who.int, 2018). Tobacco smoking is considered as an epidemic which is threatening the world including Canadian population. The Canadian health system is witnessing increasing prevalence of smoking in the teenagers. Approximately 90% smoker start smoking before the age of 18 years. The government authorities have initiated many campaigns to spread awareness of the side effect of tobacco smoking (Harvey & Chadi, 2016). The provincial and territorial legislation has started taking robust actions like increasing the tax on cigarettes, labeling the packets and adding smoke-free spaces to protect the youth from getting exposed to the effect of smoking. Due to which there has been a decline in the smoking percentages among the youth of 15 to 19 years compared to the past couple of years (cps.ca, n.d.). But despite the efforts, the problem continues due to the introduction of new tobacco products like e-cigarettes. The nicotine which is a tobacco tends to addict its user, any youth who starts smoking at an early age becomes tolerant and dependent on it and any efforts to stop smoking leads to withdrawal symptoms. Unfortunately, smoking begins which begins as a one-time thing or used as a coping mechanism becomes a regular habit which continues in adult life as well (Swetha, Duraisamy, & Kumar, 2018)

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 There are many reasons why school going children get exposed to tobacco smoking like the influence of their social environment like family influence, peer pressure, personal factors like stress, anxiety or demographic factors like weather or gender (Best, Thomson, & Santi, 1988). Moreover, many school children believe smoking to be a coolness factor. There is a strong need for spreading awareness amongst school children about the long-lasting effects of smoking and possible chances of getting lung diseases, stroke, cardiac disease, cancer and so on. (Swetha, Duraisamy, & Kumar, 2018). Efforts should be made to stop smoking particularly those who start smoking before the age of 18 years, with the primary focus being families and friends. Overall, tobacco smoking has increased the burden on the Canadian health care system and has decreased the overall life expectancy of an individual. And hence to avoid further damage, the government must implement the programs to reduce smoking habit in the early stage which is mostly in during school years. Hence, the focus of this study is to understand the smoking habits amongst school children in Dawson Creek. Students are the most important part of the Dawson Creek community and are the youth representing the community and hence it is crucial to reduce the prevalence of smoking amongst them. The aim of this study is to analyze the knowledge, attitude, and practices on smoking habits among school children in Dawson Creek.

Literature Review:

According to the results shown in the study conducted by Swetha, Duraisamy, & Kumar (2018), the school children do get addicted to cigarettes (p.2036). The study was conducted in Chennai city where the city was divided into four parts and a total of 80 students of 14-16 years were selected from each part. The data was collected by asking questions designed in form of a questionnaire to each and every participant in order to avoid confusion and bias effect. The study also concludes that making them aware of the long-term effect of smoking will prevent school children from getting addicted to smoking.

In a study conducted by Stojanović et al. (2013), there is a high level of prevalence of smoking among the physicians in Serbia and it is a necessity to bring more aggressive efforts and campaigns which should be specifically focused towards the medical professionals (p.499) The study was conducted amongst 1383 participants with the use of a self-administered questionnaire. The sample was selected using the stratified random cluster. The result of the study showed that out of a total number of samples, 45.60% were smokers, of which 34.13% were physicians and 51.87% were nurses. (p.498)

In another study conducted by Prabhu et al. (2017) on dental students, the students did not have sufficient knowledge to provide tobacco cessation advice to their patients. And there is a need to include few learnings on tobacco cessation in the dental curriculum (p.117). The study was conducted on 262 dental trainees in two dental colleges and the result showed that even if 51% were aware of the Nicotine Replacement Therapy, only 3.4% were aware of available options.

Proposed Method

The purpose of this study is to analyze and identify the sources of smoking behavior among school children and hence it would be an explanatory quantitative research following a deductive approach (Neuman & Robson, 2015). The study has two main variables included in the causal hypothesis. The conceptual hypothesis of this study is the knowledge, attitude and practices affect the smoking habits of school children in Dawson Creek. The conceptualization of the independent variable, the knowledge, attitude, and practices is done by defining social, personal and demographic factors as well awareness factor of the students while the dependent variable, smoking habits are defined as how many cigarettes they smoke per day. The operationalization of the independent variables will be done by asking students about the incidence of smoking in family members, peers, gender, weather influence, stress levels and the operationalization of dependent variable will be done by creating an index.

Participants:

The study will be conducted on the school children which would be the unit of analysis or the sample for the study. There are two types of schools in Dawson Creek, those are a private and public school. The study will be focusing on both the types of schools. The target population will be all school students in the Dawson Creek area. The participant will be chosen based on the eligibility criteria (exclusion and inclusion criteria)

Inclusion Criteria: student in the age group of 14-18 years who are willing to participate in the survey.

Exclusion Criteria: student below the age of 14 years, students with any history of medication for a systemic illness, physically and mentally disabled students.

Study Design:

The study design will be a cross-sectional and will be done by choosing a random stratified sampling. Random sampling process will increase the probability of selecting a sample representing the true population (Neuman & Robson, 2015).

Procedure:

The city of Dawson Creek will be divided into four parts (North, South, East, and West) and from each part, one representative school was selected randomly. To describe the smoking habits, a sample of approximately 90 students who are of 14-18 years old are selected from each school. The sample is stratified to make avoid sampling error. (Neuman & Robson, 2015). The data will be collected through a questionnaire. The first part will focus on demographic details (age, sex), the second part will focus on the socio-environmental factor (family and peer influences), the third part will focus on actual smoking habits of students (first onset, how many cigarettes per day, use of any other methods like e-cigarettes) and fourth part will be focus on students’ knowledge about health-related effects of smoking and its complications. The interview will be conducted face to face to avoid confusion. The interview will be conducted with following appropriate ethical standards like maintaining confidentially and consents of the parents or guardian.

Result

The collected data from the questionnaire will be coded and analyzed using proper statistical tools and by using measures of association using either rho or chi-squared test. Chi-squared will be performed for interferential statistics with the level of statistical significance set at 0.05. The results will be shown in the form of a scattergram or bar diagram and will be expressed in numbers and percentage of respondents for each question and will be analyzed for further calculations.

References

Best, A. J., Thomson, S. J., & Santi, S. M. (1988). annualreviews.org. doi:10.1146/annurev.pu.09.050188.001113

Canadian Paediatric Societ (n.d.). Prevent of Smoking Among Youth.Retrieved from Canadian Paediatric Society. cps.ca. [Online] Retrived from: https://www.cps.ca/en/status-report/prevent-smoking-among-youth

Harvey, J., & Chadi, N. (2016, May 10). cpc.ca. Retrieved from Canadian Paediatric Society: https://www.cps.ca/en/documents/position/preventing-smoking

Prabhu, A., Jain, J., Sakeenabhi, B., Kumar, P. N., Imranulla, M., & Ragher, M. (2017) Smoking cessation advice: Knowledge, attitude, and practice among clinical dental students. Journal of Pharmacy and Bioallied Sciences,9(5), 117. doi: 10.4103/jpbs.jpbs_118_17

Neuman, L. W., & Robson, K. (2015). Basics of Social Research Qualitative and Quantitative Approach (3rd Canadian ed.). Don Mills,ON: Pearson Canada Inc.

Stojanović, M., Mušović, D., Petrović, B., Milošević, Z., Milosavljević, I., Višnjić, A., & Sokolović, D. (2013). Smoking habits, knowledge about and attitudes toward smoking among   employees in health institutions in Serbia. Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journal of Serbia, 70(5), 493–500. https://doi.org/10.2298/VSP1305493S

Swetha, T.V., Duraisamy, R., & Kumar,M. P. S. (2018, October). Knowledge, attitude, and practices regarding smoking habits among school students in Chennai city. Drug Invention Today, 10(10), 2033-2037. Retrieved from https://bdcnl-ezproxy.libraries.coop:3443/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=131602191&site=eds-live

WHO.int (2018, March 9). Tobacco [online]  Retrieved from:http://www.who.int/news-room/fact-sheets/detail/tobacco