INTRODUCTION:

“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 the adolescents. Tobacco addiction of a large number of adults has been initiated during the adolescence. Tobacco use usually begins in adolescents; the time of their observation, understanding, struggling, facing challenges and psychological development. Prevalence of tobacco use in India is continuously increasing but there are considerable changes in the methods of its use. 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 variety of methods as like beedis and cigarettes or by using devices like hooka, hookli, chhutta, dhumti, or chillum. Smoking of cigars and pipes are not common in India, as they are in most western countries. Tobacco is used in a number of smokeless forms in India, which include betel quid chewing, mishri, khaini, gutka, snuff, and as an ingredient of pan masala. According to the most recent Government of India's National Sample Survey data, there are 184 million tobacco consumers in India. About 40% of them use smokeless tobacco, 20% consume cigarettes, and another 40% smoke beedis. The World Health Organization (WHO) estimates that tobacco caused 5.4 million deaths in 2004 and 100 million deaths over the course of the 20th century. Male and female smokers lose an average of 13.2 and 14.5 years of life, respectively. Each cigarette that is smoked is estimated to shorten life by an average of 11 minutes. Smokers are three times as likely to die before the age of 60 or 70 unlike non-smokers.¹Tobacco use is one of the leading preventable causes of morbidity and mortality in the world. Worldwide, tragically the tobacco epidemic kills 5.4 million people a year from various tobacco-related diseases. Many studies have shown that many regular smokers start smoking before or during their adolescent period. The individuals who start with the few cigarettes during adolescence are at double the risk to be regular smoker during early adulthood monthly smoking during adolescence raises the risk of young adult smoker, more them 16 times to become regular smoker. Additionally adolescents have higher rates of dependence at the same level of nicotine use as adults at the same quantity smoked daily.²Suraj Multan (2012) conducted a Cross-Sectional study on Assessment of Knowledge, Attitude, Behavior and Interpersonal Factors Related to the Use of Tobacco among Youth of Udaipur City, Rajasthan. Multistage and random sampling was used to select the study population from 1031, 15-25 year old graduate and diploma students from eight different colleges of Udaipur city. The present study indicates that there is a high prevalence of use of tobacco among youth of Udaipur city³. Dechenla Tsering, Ranabir Pal, and Aparajita Dasgupta (2004) conducted a study to estimate the knowledge regarding adverse effects of smoking use among high school students of West Bengal. An anonymous self-administered pre-tested closed ended questionnaire was designed by adopting the questionnaire developed by WHO. The study population comprised of 4.16 students of both urban and rural schools. A majority of urban and rural users were aware of harmful effects of tobacco use⁴. Dr. Bhuvanesh Shukla, Urvinder Kaur(2014) conducted a quasi-experimental study to assess the effectiveness of structured teaching programme on knowledge among the adolescent boys regarding ill effects of smoking in selected Government Schools of Moga, Punjab. It was found that the mean pre-test knowledge was (15.49) before imparting structured teaching programme and after a structured teaching programme the post-test knowledge score was (24.85). This indicated that structured teaching programme was effective. The pretest and post-test mean knowledge score was statistically significant at p< 0.05 level. There was statistically significant effects of age and educational status of adolescent boys on pre-test and post-test knowledge score regarding ill effects of smoking⁵. With the professional and personal experiences, the investigator felt that it is essential to bring awareness among the adolescent boys about controlling the consumption of Tobacco and its hazards.

OBJECTIVES OF THE STUDY:

1. To assess the knowledge of adolescent boys regarding tobacco hazards in Pre and Posttest.

2. To evaluate the effectiveness of Structured Teaching Programme on knowledge regarding Hazards of Tobacco among Adolescent Boys.

3. To associate posttest level of knowledge score among Adolescent Boys on Hazards of Tobacco with selected demographic variables.

HYPOTHESIS:

· H1:

There is a significant difference in knowledge of Adolescent Boys on hazards of Tobacco before and after Structured Teaching Programme.

· H2:

There is a significant association of selected demographic variables with the posttest level of the knowledge regarding Hazards of Tobacco among the Adolescent Boys.

MATERIAL AND METHODS:

Research Approach

A quantitative research approach was used for this study.

Research Design

A pre experimental, one group pre and post test design was adopted for this study.

O1 x O2

Keys

O1 = Pre test

x = Structured Teaching Programme on prevention of Hazards of tobacco Among Adolescent boys

O2 = Post test

Variables:

Dependent Variables:

Knowledge on Hazards of tobacco among Adolescent boys

Independent Variables

Structured Teaching Programme regarding Hazards of tobacco among Adolescent boys.

Setting of The Study

The study was conducted in a Panchayat office area of Tallarevu village of Kakinada Taluka, East Godavari District. The total population of village was around 3,000. Among them 100 Adolescent boys were selected for the study by adapting purposive sampling technique.

Population

Target Population

The target population refers to Adolescent boys.

Accessible Population

In this study the accessible population was Adolescent boys aged 13-20 years, residing at Tallarevu Village, in Kakinada Taluk, East Godavari District.

Sample

It refers to the Adolescent boys who fulfilled the inclusive criteria.

Sample Size

A total of 100 Adolescent boys in the age group of 13- 20 years and who had satisfied the inclusion criteria were selected for this study.

Sampling Technique

The Adolescent boys were selected by purposive sampling technique.

Inclusion criteria:

· Adolescent boys (age between 13 to 20)

· Available at the time of collection

· Boys who gives the verbal consent for the study

· Boys who can read and understand Telugu

Exclusion Criteria:

· Boys who are not willing to participate

· Boys who are not able to read and understand Telugu.

Tools And Techniques

PART – I:

Demographic variables included age ,Educational status, Occupational status of parents, family income per month, Religion.

PART-II:

It consists of Structured Multiple Choice Questionnaires related to the assessment of the level of knowledge regarding Hazards of tobacco among Adolescent boys during pre and posttest. The questions were related to their knowledge regarding the meaning of Hazards of Tobacco, incidence, causes, risk factors, signs and symptoms, complication.

Data Collection Procedure:

The data collection period was 4 weeks. The researcher initially established rapport, with the Boys and the validation of the study was explained to them. Informed consent was obtained from Adolescent Boys. During the data collection period the Adolescent Boys who met the inclusion criteria were selected from 13- 20 age groups by using purposive sampling technique. Totally 60 Boys were selected. These groups were divided in to four groups and each group consisted of 15 Boys. Every group were given Structured Teaching Programme on the separate days. After the brief self-introduction, demographic data was collected and followed by Pre test was conducted for 15 samples per day by using structured multiple choice questionnaire for assessing the level of knowledge among Adolescent Boys from each sample. From the day of intervention the researcher took eight days’ time to conduct post-test which was done by using the same tool for assessing the level of knowledge regarding Hazards of Tobacco among Adolescent Boys.

Data Analysis:

Descriptive statistics like frequency, mean, SD, mean percentage was used for description of demographic characteristics and assessment of knowledge. Inferential statistics like paired t test was used to evaluate the effectiveness of STP and chi-square test was used to find out the association between knowledge with demographic variables.

RESULTS AND DISCUSSION:

Section-A Description of socio demographic variables

Table 1 depicts that 25 (25%), 43 (43%), 26 (26.0%), 6 (6%) study boys were aged between 13-14, 15-16, 17-18, 19-20 years respectively. Regard to educational status of Adolescent Boys out of 100 Boys only seven (7%) Boys were graduate, 25 (25%) Boys had studied in higher secondary school, 43 (43%) boys were studied secondary education, 25 (25%) boys were studied primary level of schooling only. Regarding occupational status of adolescent boy’s mothers, 40 (40%) were Homemakers, 25 (25%) mothers were daily labors, 15 (15%) mothers of adolescent boys were working as a government employees, 20 (20%) mothers were intended in business and other works. In connection to the occupational status of the fathers, 37(37%) were working as a labors, 36 (36%) were doing agriculture works, 14(14%) were working as a government employs, remaining 13(13.%) were doing business and other works. Related to religion of Adolescent boys 46 (46%) were Hindus, 34(34%) were Muslims, 12(12%) were Christians, 8(8%) were related to other religions. Regarding the income of the family it was found that 31(31%) were below Rs. 3000 per month, 23(23%) were 3001-4000, 23(23%) were 4001-5000 and remaining 23(23%) were in above 5001 rupees per month.

Table 1: Frequency and percentage distribution of demographic variables among Adolescent Boys

S.no.	Demographic variable	Frequency	%
1	Age of Adolescent Boys(in years) a. 13-14 b. 15-16 c. 17-18 d. 19-20	25	25
		43	43
		26	26
		6	6
2	Education a. Primary b. Secondary c. Higher secondary d. Graduate	25	25
		43	43
		25	25
		7	7
3	Occupation of Mother a. Home maker b. Labour c. Government Job d. Business	40	40
		25	25
		15	15
		20	20
4	Occupation of Father a. Labour b. Farmer c. Government job d. Business	37	37
		36	36
		14	14
		13	13
5	Religion a. Hindu b. Muslim c. Christian d. Others	46	46
		34	34
		12	12
		8	8
6	Monthly family Income(in rupees) a. Below 3000 b. 3001-4000 c. 4001-5000 d. Above 5000	31	31
		23	23
		23	23
		23	23

Section B Level of knowledge on Hazards of Tobacco among Adolescent Boys, in pre and post test.

Figure: -1-Frequency and percentage distribution of level of knowledge on Hazards of Tobacco among Adolescent Boys, in pre and post test.

Figure 1 shows that 95 (95%) study participants had inadequate knowledge whereas 5 (5%) had moderately adequate knowledge in pre-test. But in post-test 92 (92%) study participants had adequate knowledge, and 8 (8%) had moderately adequate knowledge.

Section C Effectiveness of Structured Teaching Programme on Knowledge Regarding Hazards of Tobacco

Table 2: Effectiveness of Structured Teaching Programme On Knowledge Regarding Hazards Of Tobacco N=100

Observation

Mean

Mean Difference

Paired ‘t’ value

Pre test

Post test

1.88

21.90

1.86

1.28

-20.11

87.595

Df-99, p<0.0001, extremely significant

The above table depicts that there is a statistically extremely significant difference at p<0.0001 between pre and post test knowledge score on prevention of Hazards of Tobacco among the Adolescent Boys. The study findings is supported by the study conducted by Yogeshwar Puri Goswami1, Dr. Jayalakshmi L. S, Dr. D.M.(2015) who found that post test mean value 26.90 is higher than the pre test 12.93. The improvement between pre-test and post-test was 13.97 and obtained paired ‘t’ test value was 18.9425, it is highly significant at 1% level p<0.001 ⁶.

Section D Association between post test level of knowledge on Hazards of Tobacco among the Adolescent Boys with selected demographic variables

Chi square test was used to find out the association between demographic variable and level of knowledge of Adolescent Boys. It reveals that there is no statistically significant association between demographic variables and the level of knowledge on hazards of tobacco among the adolescent boys at the level of p< 0.05.

CONCLUSION:

Tobacco use is one of the leading preventable causes of morbidity and mortality among Adolescents in the world. The present study findings may help the community to identify the problems when they visit in community. It also suggests importance of conducting community health programmes to prevent, treat and create awareness in Hazards of Tobacco and practice. Nurses are playing a vital role to educate the Boys.

REFERENCES:

1. Chadda RK and Sengupta SN. Tobacco use by Indian adolescents. Tob Induc Dis. 2003; 1(1): 8.

2. Jayakrishnan R, Geetha S, Binukumar B, Sreekumar, Lekshmi K. Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State. Indian J Dent Res 2011;22:195-9.

3. Suraj Multani, MDS et al. Assessment of Knowledge, Attitude, Behaviour and Interpersonal Factors Related to the Use of Tobacco among Youth of Udaipur City, Rajasthan, India: A Cross-Sectional Study. Addict Health. 2012 Summer-Autumn; 4(3-4): 142–150.

4. Dechenla Tsering, Ranabir Pal, and Aparajita Dasgupta. Tobacco Use Among High School Students of West Bengal, India. Indian J Community Med. 2008 Jul; 33(3): 207–208.

5. Dr. Bhuvanesh Shukla, Urvinder kaur. Study to assess the effectiveness of structured teaching programme on knowledge among the adolescent boys regarding ill effects of smoking in selected Government Schools of Moga, Punjab. International Research Journal. 2014: (4)1.

6. Yogeshwar Puri Goswami1, Dr. JayalakshmiL. S, Dr. D.M. A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Substance Abuse among Adolescents at Selected Nursing Colleges of Udaipur District, Rajasthan, India. International Research Journal. 2015:(5)2.

Received on 07.09.2016 Modified on 15.09.2016

Int. J. Adv. Nur. Management. 2017; 5(1): 15-19.

DOI: 10.5958/2454-2652.2017.00004.X