A Study to Assess the Knowledge Regarding Ill Effects of Smoking Among Adults in Selected Rural Areas of Mysuru with a View to Conduct Flash Mob on Smoking and its Complications

Introduction

Tobacco use is a leading cause of preventable deaths all over the world, more so in developing countries. The tobacco situation in India is unique because of the vast spectrum of tobacco products available for smoking as well as smokeless use. Smoking cigarettes particularly beedi and chewing tobacco (smokeless use) is an age-old practice in India.¹

“Tobacco is slow but sure killer, Kill it before it kills you”. India is the third largest producer and consumer of tobacco in the world. The country has a long history of tobacco use. Tobacco is used in a variety of ways in India; its use has unfortunately been well-recognized among adolescents. Tobacco addiction in a large number of adults has been initiated during adolescence. Tobacco use usually begins in adolescents; the time of their observation, understanding, struggling, facing challenges, and psychological development. The prevalence of tobacco use in India is continuously increasing but there are considerable changes in the methods of its use.²

Smoking harms nearly every organ of the body and diminishes a person’s overall health. Smoking is a leading cause of cancer and death from cancer. It causes cancers of the lung, esophagus, larynx, mouth, throat, kidney bladder, pancreas stomach, and cervix as well as acute myeloid leukemia. Smoking also causes heart disease, stroke, aortic aneurysm (a balloon–like bulge in an artery in the chest), chronic obstructive pulmonary disease (COPD), asthma, hip fractures, and cataracts. Smokers are at high risk of developing pneumonia and other airway infections.¹

According to the National Cancer Institute, Cigarette has a higher level of carcinogens, toxins, and tar than any other substance. Our body has a stress hormone called corticosterone which lowers the effect of nicotine. If you are under a lot of stress, you need more nicotine to get the same effect. It also causes headaches and sleep problems. During smoking, nicotine enters the lungs and is absorbed quickly into the bloodstream and travels to the brain in a matter of seconds. Nicotine causes addiction to a cigarette.³

According to WHO estimates, about 194 million men and 45 million women use tobacco in smoked or smokeless form in India. In India tobacco is used in smoke and smokeless forms. Tobacco is used for smoking by a variety of methods as beedis and cigarettes or by using devices like hooka, hookli, chhutta, dhumti, or chillum.⁴

Although increasing the awareness of smoking risks is not always sufficient to reduce smoking on their own. While increasing health knowledge is strongly associated with a reduction in smoking and increases cessation behavior and long-term abstinence from smoking. Quitting smoking at any age leads to immediate health benefits, including reduced risks of stroke, cardiovascular disease, and smoking-related cancers.⁵

Hypothesis

H1: There will be differences in the knowledge regarding smoking among adults before and after the flash mob.

H2: There will be a significant difference in the knowledge regarding smoking among adults depending on their selected personal variables.

Assumptions

Rural adults may have some knowledge regarding smoking.

Delimitations

The study was limited to rural adults in selected rural areas of Mysuru.

Materials and Methods

Research Design

A pre-experimental design

Variables

Extraneous variables included age, gender, occupation, education, religion, marital status, and previous information regarding the ill effects of smoking.

Population

Rural adults of Varuna PHC, Mysuru.

Sample

Hundred rural adults

Sampling technique

Non- probability convenience sampling technique

Sampling criteria

Inclusion criteria

Adults willing to participate in the study

Exclusion criteria

Non-smoking adults were not included in the study. Setting of the study: Rural area of Mysuru

Data collection technique

Section 1: Sociodemographic proforma

Section 2: Structured knowledge questionnaire on smoking

Data collection procedure

Prior to data collection, permission was obtained from the concerned authorities of Mysuru. Informed consent was obtained from hundred rural adults to participate in the study. Subjects were selected by using a nonprobability convenience sampling technique according to the selection criteria, and confidentiality was assured. Data were collected by administering the following tools: a personal proforma and a structured knowledge questionnaire regarding smoking. Pre-test was done on day 1 and the post-test was done on day 8 by using the same tools.

Results

Section 1 - Personal variables

Section 2 - Knowledge scores of adults regarding smoking

The levels of knowledge were categorized into three - "Good/High" (Score 71-100%), "Intermediate" (Score 51-70%) and "Poor" (Score 0-50%)⁶

In the present study, during the pretest, 46% of the adults showed poor knowledge, 41% showed average knowledge, and 13% showed good knowledge regarding smoking.

During the post–test, 94% of adults demonstrated good knowledge levels, 2% demonstrated average knowledge, and 4% showed poor knowledge regarding smoking.

Adults’ mean pretest knowledge score regarding smoking was 10.35 ± 3.36, ranging from 18 - 4.

Adults’ mean post-test knowledge score regarding smoking was 17.10±1.491, ranging from 20-13.

The paired t test value was 9.340, which was significant at 0.001 level, indicating the effectiveness of flash mob in enhancing the knowledge of adults on smoking (Table 4). Thus the research hypothesis H1 was accepted.

Section 3- Association

There was a significant association between the knowledge regarding smoking among adults and their selected personal variables, such as age, which was 5.48. Hence research hypothesis H2 was partially supported and can be inferred that knowledge regarding smoking among adults is influenced by selected personal variables.

Discussion

The majority 84% of adults were in the age group of 21-45 years, and 16% were in the age group of 46 – 65 years. 92% of adults were male and 8% were female. The majority of adults were Hindu 64%, Christian 25%, and 11% were Muslims. 7% were illiterate, 22% had completed Primary education 38% had secondary education, 27% are PUC, and 6% were degree and above. 55% of Business/self-employed, 36% were Private employees and 9% were Government employed. 79% were married, 20% were unmarried and 1% was widow/ divorced. 28% had an income of Rs 5000 - 10,000, 70% had Rs 10,000- 20,000, 2% of above Rs 20,000 income. 50% belong to the nuclear family and 50% belong to joint family. 79% were smokers, 21% were non - smokers.96% had knowledge about smoking ill effects, 4% had no knowledge of ill effects of Smoking.

In the pre- test that majority of the samples 46% had poor knowledge, 41% had average knowledge and 13% had adequate knowledge.

In most of the samples 94% had adequate knowledge, 4% had poor knowledge and 2% had average knowledge regarding smoking among adults. Post-test knowledge score of adults regarding smoking is 17.10 with SD ±1.491ranged from 20-13. Hence, flash mob effectively enhanced adults’ knowledge on smoking.

A similar study was done to assess the effectiveness of a structured teaching program on knowledge among the boys regarding the ill effects of smoking. It was found that the mean pre-test knowledge was (15.49) before imparting a structured teaching program and after a structured teaching program the post-test knowledge score was (24.85). This indicated that a structured teaching program was effective.⁷

Limitations

The smaller sample size included in the study and the convenience sampling technique adopted limits the generalizability of the study findings.

Recommendations

1. Comparative studies assessing the knowledge of smoking among rural and urban adults can be conducted.
2. Factors facilitating smoking among adults can be investigated. 
3. Evaluation of smoking sensitization programmes among adults can be conducted.

Conclusion

The flash mob was found to be effective in enhancing knowledge regarding smoking among adults. This study reinforces the need for conducting awareness programs on smoking and its ill effects. Adults are the future human resources. Smoking increases the risk of various diseases, including cancer, cardiovascular and respiratory diseases. Therefore, it is essential to conduct anti-smoking campaigns and awareness programs for the benefit of public.

Conflict of Interest

None

Acknowledgment

This study is conducted by Ms. Deepa P, Ms. Divya G B, Ms. Jayashree Maruti Hirabayi, Ms. Navya K M, and Ms. Preethi B G of the 3rd year of BSc Nursing under the guidance of Dr. Saraswathi KN, Assoc. Professor of JSS College of Nursing, Mysuru.