INTRODUCTION:

“Investing in adolescents’ health and rights will yield large benefits for the generations to come”

-Anant Kumar

Adolescence is generally understood as the period of transition from childhood to adulthood and describes both development and sexual maturity. The term ‘adolescent’ is derived from the Latin word ‘adolescere’ which means to grow into maturity. It also means to emerge or achieve identity and is the most challenging and critical time of one’s life.

Adolescents’ health is influenced by the strengths and vulnerabilities of individual adolescents and the character of the settings in which they lead their lives. Adolescents change their environments, as happens when they go away to school or college or to a new place to live or work. Environmental changes may bring about personality changes (Sreevani R, 2005)

Gupta R (2006) conducted an epidemiological study to determine the prevalence of smoking and tobacco use among 13 to 18 years of school children in Jaipur. A total of 3,805 samples participated. Results revealed that 1.5% of the boys and 0.4% of the girls agreed to current tobacco use. Smoking cigarettes or beedis was present in 1.5% of the boys and 0.8% of the girls. Smoking or tobacco use was present in immediate family of 42.1% of the boys and 30% of the girls, but was significantly more in families of children who used tobacco.

NEED FOR THE STUDY:

Tobacco use in children and adolescents is reaching pandemic levels. The World Bank has reported that nearly 82,000–99,000 children and adolescents all over the world begin smoking every day (World Bank report, 1999.)

Kit S., Nanette M., Laura L(2012) a larger age range of initiation (eg, 18-30yrs, 18-36yrs). Disparities in young adult smoking initiation existed according to sex, race, and educational attainment.

STATEMENT OF THE PROBLEM:

“A Comparative Study To Assess The Level Of Knowledge On Ill Effects Of Tobacco Use Among Adolescents Residing In Urban And Rural Areas At Kanyakumari District With A View To Develop An Information Booklets”.

OBJECTIVES:

1. To assess the knowledge on ill effects of tobacco among adolescents residing in urban and rural areas.

2. To compare the level of knowledge on ill effects of tobacco among urban and rural adolescents.

3. To find out the association between a selected socio demographic factors and knowledge on ill effects of tobacco among adolescents.

HYPOTHESIS:

H₀: There is no significant difference between the level of knowledge on ill effects of tobacco use among adolescents residing in urban and rural area.

OPERATIONAL DEFINITIONS:

1. Ill-effects: In this study ‘ill-effects’ refers to the harmful adverse effects resulting in various health problems like oral cancer, respiratory diseases, bladder cancer, poor appetite, etc

2. Tobacco use: In this study ‘tobacco use’ refers to use of tobacco in different forms such as tobacco chewing, gutka, pan, beedi, cigarette and snuff.

3. Adolescents: In this study ‘adolescents’ refers to children in the age group of 12-16 years residing in rural and urban areas.

4. Comparative: In This study it refers to differences the knowledge between urban and rural adolescents, towards tobacco.

5. Assess: A systematic way of collecting the information on ill effects of tobacco.

6. Information Booklet: In this study the brochures contains information on tobacco use and ill effects among adolescence.

ASSUMPTIONS:

The study is based on following assumptions:

1. Urban adolescent’s boys have enough knowledge on ill effects of tobacco use.

2. Rural adolescent’s boys have poor knowledge on ill effect of tobacco use.

3. There is difference in level of knowledge on ill effects of tobacco use among urban and rural adolescents.

4. Information booklet helps the rural and urban adolescents to improve their knowledge on ill effects of tobacco use.

DELIMITATION OF THE STUDY:

The study is delimited to:

1. Who is not willing to participate in this study

2. Who cannot speak and understand Tamil.

3. Who cannot available at the time of study.

4. Adolescents’ age group between 12 and 16 years of age.

CONCEPTUAL FRAMEWORK:

A framework is an abstract of logical structure of meaning that guides the development of the study and the body of knowledge. If the framework is derived from a theory, it is a theoretical framework. A theoretical framework guides the investigator to know what idea needs to be collected and gives direction during the entire research process.

REVIEW OF LITERATURE:

The primary purpose of reviewing relevant literature is to gain a broad background or understanding of the information that is available related to a problem.

Kit S., Nanette M., Laura L (2012) systematically reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults. Review done on 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) living in the United States or Canada. The following data were selected from each study the measure of initiation used, age range of initiation, age range of study population, data source, target population, sampling method, and sample size. Summarized the primary findings of each study according to 3 research questions and categories of data (eg, socio-emographic) that emerged during the data extraction process. In the result of 1,072 identified studies, 27 articles that met our search criteria, but several included a larger age range of initiation (eg, 18-30, 18-36) than we initially intended to include.

Bonilha AG., et al (2014) analyzed social characteristics and stress as correlates of cigarette smoking in adolescence. The main intent was to identify elements that distinguish adolescents who had experimented with smoking and did not progress to regular smoking from those who became current smokers. The Students at 10 high schools in the city of Ribeirão Preto, Brazil, completed a questionnaire based on an instrument employed in a similar large-scale study. The students were classified as never-smokers or experimenters. The experimenters were subcategorized as having become current smokers or nonprogressors. Analyses were performed using adjusted logistic models. The result revealed that total of 2,014 students (mean age, 16.2 ± 1.1 years; females, 53%) completed the questionnaire. We categorized 1,283 students (63.7%) as never-smokers, 244 (12.1%) as current smokers, and 487 (24.2%) as nonprogressors.

Al-Zalabani A, Kasim K. (2015) determined the prevalence and predictors of adolescent cigarette smoking in Madinah, Saudi Arabia. A school-based cross-sectional study was carried out in the Madinah region during 2013. A multistage stratified cluster sample was taken and included 3400 students (11-19 years) from 34 intermediate and secondary schools. Data concerning socio-demographic and smoking-related factors were collected using a valid and reliable self-administered questionnaire. The prevalence of smoking was estimated, and appropriate statistical analyses were performed, including univariate, predictive and multivariate regression analyses. The findings were the overall response rate was 97.7%. The prevalence of cigarette smoking in the respondents 3322 adolescents was 15.17% (95% CI=13.95-16.39) with significant differences in socio-demographic factors. The most important predictors were most or all friends smoking (OR=12.5; 95% CI=9.40-16.8). Other significant less important factors were parental smoking, belief in the harmful effects of smoking, cigarette advertisement in mass media, and pocket money. Cigarette smoking prevalence is a relatively low among adolescents in Madinah region. However, friends and parents smoking play an important role in the increased risk of smoking in the studied adolescents.

Dhavan P., et al (2009) aimed to assess whether this unique differential patterns of tobacco use was sustained over time, as students moved into higher grades. Self-reported data from a sample of youth (n=3,404) present at three annual surveys (2004, 2005, 2006) were analyzed. Mixed-effects regression models were used to compare prevalence of lifetime tobacco use and nine psychosocial risk factor scales between two student cohorts, 6th grade (or younger) cohort and 8th grade (or older) cohort. Stratified analyses were also conducted by gender, age, city and school type. The results show that from 2004 to 2006, the 6th grade (or younger) cohort of students reported higher rates of lifetime tobacco use, and these differences were maintained over two years, even when the study sample was stratified by gender, age, city and school type. Similarly, students in the 6th grade (or younger) cohort scored greater risk for tobacco use on all psychosocial risk factors analyzed here.

METHODOLOGY:

It includes the research design, variables, setting, population, sample size, sampling technique, sample criteria, description of tool, content validity, pilot study, data collection procedure and plan for data analysis .

RESEARCH APPROACH:

Research approach indicates the basic procedure for conducting the study. The selection of approach depends upon the purpose of the study. The present study aimed at compare the level of knowledge on ill effects of tobacco use among rural and urban adolescents in kanyakumari district, Tamil Nadu. In a view to develop an Information Booklet hence a Descriptive approach was found appropriate.

RESEARCH DESIGN:

A research design is essentially a plan or strategy aimed at enabling answer to be obtained to research questions. In this present study Comparative descriptive design has been adopted.

In view of the nature of the problem and to accomplish the objectives of the study, assessing the pre-existing level of knowledge on ill effects of tobacco use among adolescents residing in urban and rural area using a structured questionnaire, and to compare the level of knowledge on ill effects of tobacco between urban and rural adolescents residing in urban and rural area

The study design is schematically represented as follows –

SETTING OF THE STUDY:

It is essential for the researcher to consider the setting in which the study is conducted. The location for conducting the research is referred to as the setting. The present study was conducted in Therur and Athalavilai, Kanyakumari district, Tamil Nadu..

VARIABLES:

The categories of variables discussed in this study were

Independent variable:

The variable which can be changed by the researcher. Here information Booklet is the independent variable.

Dependent variable:

The Dependent variable is the present knowledge on ill effects of tobacco use.

POPULATION:

The target population refers to the population that researcher wishes to make a generalization. In this study the target populations were Adolescents between the age group of 12-18 years.

In this study the accessible populations were Adolescents between the age group of 12-18 years residing in urban and rural areas of Kanyakumari district, Tamil Nadu.

SAMPLING TECHNIQUE:

It is the process of selecting subjects from a population in order to obtain information regarding a phenomenon in a way that represents the entire population. In this study the investigator selected Adolescents between the age group of 12-18 years by convenience sampling.

The present study was conducted among 30 Adolescents residing in urban area and 30 Adolescents residing in rural area between the age group of 12-16 years who met the sampling criteria.

CRITERIA FOR SAMPLE SELECTION:

INCLUSION CRITERIA:

Inclusion criteria are characteristic that each sample element must possess to be included in the sample. Adolescent both male and female adolescents who were:

1. Residing in Urban and rural areas

2. Participants available at the time of study.

3. Those who were willing to participate

4. Participants who can understand Tamil and English.

EXCLUSION CRITERIA:

Exclusion criteria are characteristics that could confound or contaminate the results of the study therefore such participants are excluded from the study.

1. Who were not willing to participate in the study.

2. Adolescents who cannot available at the time of data collection.

SAMPLE SIZE:

Sample is subset of population that has been selected to represent the population of interest. The sample for the study was between the age group of 12-18 years. The sample size for this study was arbitrarily decided to be 60, thirty from urban and thirty from rural areas were included in the study.

DEVELOPMENT OF TOOL:

The investigator prepared and developed an closed ended Multiple choice questionnaire on knowledge on ill effects of tobacco use as tool for present study after exploring all sources of information like extensive library search, internet sources and consultation with experts.

DESCRIPTION OF THE TOOL:

The study tool consisted of three sections

Section I: Socio-demographic factors

Section II: A closed ended structured questionnaire- Multiple choice questionnaires (MCQs)

Section III : Information Booklets

VALIDITY OF THE TOOL

The tool developed by the investigator was sent along with the request for validation to six experts including 3 nursing experts and two physicians.. The experts were requested to check for the relevance, sequence, adequacy of language of the tool. The tool was modified according to experts’ opinion. The items with 100% agreement were included in the tool. A few items were modified and retained in the tool.

PILOT STUDY:

Pilot study was conducted in Therur (urban) and Athalavelai(rural) settings at Kanyakumari District to find the feasibility of the study. Five adolescents residing in urban and five adolescents residing rural area who possessed the same characteristic of the sample for the final study but other than the samples selected for the final study were selected by convenience sampling technique.

Prior to the data collection, permission was obtained from the concerned authority. The selected samples were informed of the purpose of the study and the consents were taken.

To assess the level of knowledge, a closed ended questionnaires-MCQs on ill-effects of tobacco use were distributed to five adolescents residing in urban and five adolescents in rural area of Kanyakumari District, Tamil Nadu with an instruction to complete and return them Information Booklets on ill- effects of tobacco use was administered on the same day after assessing the level of knowledge. The collected data were analyzed by using descriptive and inferential statistics.

After conducting the pilot study, it was found that the study was feasible, the concerned authority and the samples were found to be co-operative, the questionnaire and information booklets were relevant and the time and cost of the study was within the limit. It helped the researcher to ascertain the feasibility of the designed methodology.

INFORMATION BOOKLET:

Information Booklet is a learning material that helps the adolescents to gain knowledge on ill effects of tobacco use it helps to cover the topics comprehensively with proper sequence of points and without missing anything.

The information booklet was developed under the following headings, concept of tobacco, harmful chemical substances in the tobacco, types and forms of tobacco consumption, Ill effects of tobacco use and measures to quit tobacco use. Which will be distributed to the adolescents after assessing the level of knowledge on ill effects of tobacco use.

DATA COLLECTION:

Before collecting the data prior permission was obtained from the concerned authority of the urban and rural area of Kanyakumari district. Keeping in mind the ethical aspect of research data collected after obtaining informed consent of the sample. The respondents were assured the anonymity and confidentiality of the information provided by them. The researcher herself collected the data from the subjects.

DISCUSSION:

The results of the study were discussed based on the finding of the study. The findings of the study are discussed under the following sections;

Section I: Descriptions of the socio-demographic factors of the adolescents

Gender wise, distribution of adolescents revealed that greater percentage (70%) was males residing in urban areas and (60%) were females residing in rural areas. Rao S., et al (2014), Atari DO. (2014) Reddy KS, Perry CL, Stigler MH, Arora M. (2006) identified the prevalence of smoking was high with males. In relation to the distribution of adolescents according to the age showed that 40% of respondents belong to age group of 12-14 years residing in urban areas and while 43% in the age group 16-18 years in rural areas. The studies conducted by Atari DO. (2014), Eaton DK, et al (2010) involved the high school students smoked cigarettes. Similarly in the following studies Cheryl L., et al (2009), Bate SL, et al (2009) was conducted among urban areas, Students from 6-8^th grade. And Perry CL., et al (2008), Madan kumar PD., (2006) reported Current users of tobacco by 41.1% of the students. Prevalence was more among boy students (46.3%) when compared to that of girl students (31.6%).

Majority of them belongs to joint family 63% in urban areas and 47% of subjects belong to Nuclear and Joint family in rural areas. Both the subjects residing in urban and rural areas were Hindu 80% and 70%. The Occupation of parents wise, the majority of parents residing in urban areas were having private jobs 33% and the parents in rural areas 30% having agriculture jobs..

Regarding the Monthly income of the family, 40% in urban areas and 67% in rural areas were having the monthly family income as <Rs.5000. in relation to the marital status of the parents, mostly the subjects from urban 80% and rural 90% the parents were living together.

The analyzed data regarding the Status of living, majority 40% of the subjects form urban areas were living in hostel and the 53% subjects from rural areas living with their parents. Regarding the history of smoking or tobacco use in family, majority 67% has no history of smoking or tobacco use in the family in subjects from urban areas and in rural areas 53% of them have family history of smoking or tobacco use.

In relation to the distribution of subjects according to the previous knowledge about the ill effects of tobacco use, 63% of the subjects residing in urban areas were having previous knowledge about ill effects of tobacco use and 43% of subjects residing in rural areas were have no previous knowledge about ill effects of tobacco use.

Regarding the Recreational facility at home, the subjects from urban areas have TV (23%), Radio (30%), Magazines and Newspaper (20%) and internet (27%) and in rural areas the subjects have TV (24%), Radio (33%), Magazines and News paper (33%) and internet (10%). Similar findings were found in another study Shinha D.N.(2005) conducted in Sikkim among13- 15years of students and the result revealed that Current smokeless tobacco users were likely to watch actors chewing tobacco on TV, video, or movies (90.4%); to watch gutkha brand names on TV sporting events or TV programmes (63.1% Vs 36.2%); to watch gutkha advertisement on hording at bus stops etc (63.8% Vs 33.9%); and gutkha advertisements in the community events (65%Vs 38.7%) . In a study conducted by Monika A., et al (2012) Watching tobacco use in Bollywood movies and receptivity to tobacco promotional activities were both independently associated with ever tobacco use among adolescents in India. Similar study by Madan kumar PD., (2006) explains that purchasing tobacco products in a store was reported by 82.5% and almost no one was refused because of age. Almost everyone reported watching a lot of cigarette advertisements on TV, whereas about half reported watching advertisements on other Medias like outdoor hoardings (45.7%), newspapers (65.3%) and social events (67.4%).

Regarding the Educational level of parents, parents from urban areas studied up to primary (33%) and secondary education (33%) and parents from rural areas studied up to HSC (30%) and (24%) were illiterate. Educational level of adolescents’ wise, majority of the subjects from urban areas studying HSC (50%) and subjects from rural areas studying HSC (40%).

Regarding the media through which the knowledge on ill effects of tobacco use, both the subjects from urban and rural areas 40% gained knowledge regarding ill effects of tobacco use through Magazine and Newspaper. In a study conducted by Rao s., et al (2014) identified participants who were deprived of family discussion regarding smoking hazards (girls: odds ratio (OR) 1.56, 95% confidence interval (CI) 0.84-2.89, p value 0.152; boys: OR 1.37, 95% CI 1.04-1.80, p value 0.025), those who had not seen media messages (girls: OR 2.89, 95% CI 1.58-5.28, p value <0.001; boys: OR 1.32, 95% CI 0.91-1.88, p value 0.134), and those who were not taught the harmful effects of smoking at school (girls: OR 2.00, 95% CI 0.95-4.21, p value 0.066; boys: OR 1.89, 95% CI 1.44-2.48, p value <0.001) have higher incidence of tobacco use. And Mathur C. et al (2008) recognized that there is a difference in prevalence of tobacco use among Indian urban youth and the role of socioeconomic status. Government school students scored the lowest for refusal skills, self-efficacy, and reasons not to use tobacco. Social susceptibility to chewing tobacco and social susceptibility to smoking were strong correlates of current tobacco use among government school students. Students attending government schools are using many forms of tobacco at higher rates than private school students.

Section II: Analysis of the Scores on level of Knowledge on ill effects of tobacco use between adolescents residing in Urban and Rural areas

Assessment of overall level of knowledge on ill effects of tobacco use between the subjects from urban areas 70% were having inadequate knowledge on ill effects of tobacco use and 30% were having moderate knowledge on ill effects of tobacco use and no subjects have adequate knowledge on ill effects of tobacco use. Similarly the subjects from rural areas 80% were having inadequate knowledge on ill effects of tobacco use and 20% were having moderate knowledge on ill effects of tobacco use and no subjects have adequate knowledge on ill effects of tobacco use. The findings of the study are consistent with the study conducted in India. The data indicated that highest consumption appeared to be in schools and colleges located in rural and semi-urban areas of Nagaland (63%) and Maharashtra (13%). But the awareness level regarding the harmful effects of tobacco consumption were substantially low among children and youth (Global Youth Tobacco Survey Collaborative Group, 2003). The findings of the study were inconsistent with a study (Gupta R, Singh V, 2006) conducted in Bhavanagar city, Jaipur. All students (100%) knew that smoking is injurious to health and cancer was caused by tobacco consumption. Thomas RE, McLellan J, Perera R (2013) proved that the combined social competence and social influences curricula showed a statistically significant effect in preventing the onset of smoking (OR 0.49, 95% CI 0.28 to 0.87).

Domains-wise analysis of Knowledge on ill effects of tobacco use with Residential status. The Mean 2.40 (SD =1.22) in the concepts of tobacco use, for subjects from Urban areas was slightly higher than Mean 2.10 (SD=1.21) of subjects from Rural areas. This shows that both the subjects have knowledge about the concepts of tobacco us.

The Mean 2.37 (SD =1.79) in the harmful chemical substances in the tobacco, for subjects from Urban areas was slightly higher than Mean 1.93 (SD=1.57) of subjects from Rural areas. The mean shows that rural subjects have lesser knowledge about the harmful substances in the tobacco. The Mean 1.07 (SD =1.05) in the types and forms of tobacco consumption, for subjects from Urban areas was slightly lower the Mean 1.87 (SD=1.04) of subjects from Rural areas.

The Mean 2.90 (SD =1.16) in the ill effects of tobacco use for subjects from Urban areas was slightly higher than Mean 1.73 (SD=1.05) of subjects from Rural areas. The subjects from rural areas have lesser knowledge about the ill effects of tobacco use while comparing with the subjects from urban areas. The findings of the study are consistent with the study conducted by Rao s., et al (2014) identified that those who were not taught about the harmful effects of smoking at school (girls: OR 2.00, 95% CI 0.95-4.21, p value 0.066; boys: OR 1.89, 95% CI 1.44-2.48, p value <0.001) were having high risk. And in another study Cheryl L., et al (2009) on the effects of school based intervention among the students, the intervention group was significantly less likely than were students in the control group to exhibit increases in cigarette smoking or bidi smoking over the 2-year study period.

Section II: Comparison of level of Knowledge on ill effects of tobacco use between adolescents residing in Urban and Rural areas

Analysis shows that there slight difference in Knowledge level between adolescents residing in Urban and Rural areas. The Mean 10.60 (SD =2.69) of subjects from Urban areas was slightly higher than Mean 10.47 (SD=2.87) of subjects from Rural areas. The obtained “t” value, t = .19 (P > 0.05) was not significant. The mean scores of subjects from Urban was not significantly higher than the Mean of subjects from Rural areas. It was inferred that there is no significant difference between the levels of knowledge on ill effects of tobacco use among adolescents residing in urban and rural areas.

Section III: Association between the socio- demographic factors of adolescents residing in Urban and Rural areas and their levels of Knowledge on ill effects of tobacco use.

The association between the socio- demographic factors of adolescents residing in urban areas and levels of Knowledge on ill effects of tobacco use shows that the obtained “Chi Square” values regarding selected socio-demographic such as Gender 1.978 (p=0.16), Age 1.416 (p=0.493), Type of family 0.271 (p=0.603), Religion 1.154 (p=0.662), Occupation of parents 7.5 (p=0.06), Monthly Income of the Family 3.701 (p=0.157), Marital status of the parents 0.072 (p=0.788), Status of Living 2.957 (p=0.398), History of smoking or tobacco use in the family 2.308 (p=0.129), Previous Knowledge on ill effects of tobacco use 2.672 (p=0.102), Recreational facility at home 1.909 (p=0.591), Educational Level of Parents 6.346 (p=0.096), Educational Level of adolescent 5.697 (p=0.127), Media thorough which they get Knowledge regarding ill effects of tobacco use 2.596 (p=0.458) were not significantly (P > 0.05) associated with the levels of Knowledge on ill effects of tobacco use among adolescents residing in urban areas. There was no significant association between the socio- demographic factors of adolescents residing in urban areas and levels of Knowledge on ill effects of tobacco use.

The association between the socio- demographic factors of adolescents residing in rural areas and levels of Knowledge on ill effects of tobacco use shows that the obtained “Chi Square” values regarding selected socio-demographic such as Gender .429 (p=.232); Age .308 (p=.315); Type of family .041* (p=.03); Religion .918 (p=.632); Occupation of parents .857 (p=.722); Monthly Income of the Family .071 (p=.585); Marital status of the parents .238 (p=.626); Status of Living .449 (p=.118); History of smoking or tobacco use in the family .449 (p=.118); Previous Knowledge on ill effects of tobacco use .802 (p=.094); Recreational facility at home .071 (p=.784); Educational Level of Parents .832 (p=.586); Educational Level of adolescent .657 (p=.72); Through which Media through which they get Knowledge regarding ill effects of tobacco use .657 (p=.072). There was no significant association between the socio- demographic factors of adolescents residing in rural areas and levels of Knowledge on ill effects of tobacco use except the type of family. Contrary finding were reported in the following studies conducted by Al-Zalabani A, Kasim K. (2015) the prevalence of cigarette smoking in the respondents 3322 adolescents was 15.17% (95% CI=13.95-16.39) with significant differences in socio-demographic factors.

SUMMARY, FINDINGS, IMPLICATIONS, LIMITATIONS, RECOMMENDATIONS AND CONCLUSION:

SUMMARY:

The prime aim of the study was to compare the level of knowledge on ill effects of tobacco use between adolescents residing in urban and rural areas of Kanyakumari district, Tamil Nadu

The objectives of the study were,

1. To assess the knowledge on ill effects of tobacco among adolescents residing in urban and rural areas.

2. To compare the level of knowledge on ill effects of tobacco among urban and rural adolescents.

3. To find out association between the selected socio demographic factors and knowledge on ill effects of tobacco among adolescents

The study attempted to examine the following research hypothesis

H0: There is no significant difference between the level of knowledge on ill effects of tobacco use among adolescents residing in urban and rural area.

The review of literature enabled the investigator to develop conceptual framework, tool and methodology for the study. Literature review was done as follows: studies related to the concept of tobacco use, causes of tobacco use, prevalence of tobacco use and Ill-effects of tobacco use.

The conceptual framework adopted for the present study was based on Pender’s Health Promotion Model (1996). This model helped the investigator to compare the level of knowledge on ill effects of tobacco use between adolescents residing in urban and rural areas

The present study was a Descriptive-Comparative design. Independent variable in this study was information Booklet and Dependent variable is level of knowledge among the adolescents. Associate variable for this study were socio-demographic factors

The reliability of the tool was established by inter-rater reliability computed reliability co efficient r = 0.98 was high. The pilot study was conducted in Therur and Athalavilai, Kanyakumari district Tamil Nadu, and the study was found to be feasible.

The main study was conducted in Therur and Athalavilai, Kanyakumari district Tamil Nadu. Prior permission from the authorities was sought and obtained. Individual informed consent was taken from study sample. The study samples were selected by convenience sampling method based on sample selection criteria.

A total of 60 subjects (30 Urban, 30 Rural areas) were selected. First data were collected on the level of knowledge on ill effects of tobacco use from the adolescent residing in Urban and then adolescents from Rural areas. After collecting the data the information booklet were administered to the adolescents and clarified their doubts. The collected data were analyzed and interpreted based on objectives using Descriptive and statistical at 0.05 level of significance.

FINDINGS:

The major findings of the study presented under following headings based on the objectives of the study.

Objective – 1:

To assess the knowledge on ill effects of tobacco among adolescents residing in urban and rural areas.

The subjects from urban areas 21(70%) were having inadequate knowledge on ill effects of tobacco use and 9 (30%) were having moderate knowledge on ill effects of tobacco use. Similarly the subjects from rural areas 24(80%) were having inadequate knowledge on ill effects of tobacco use and only 6 (20%) were having moderate knowledge on ill effects of tobacco use.

Objective – 2:

To compare the level of knowledge on ill effects of tobacco among urban and rural adolescents.

There is difference in Knowledge level between adolescents residing in Urban and Rural areas. The Mean 10.60 (SD =2.69) of subjects from Urban areas was slightly higher than Mean 10.47 (SD=2.87) of subjects from Rural areas. The obtained “t” value, t = .19 (P > 0.05) P=0.424986, was not significant. The mean score of subjects from Urban was not significantly higher than the Mean of subjects from Rural areas. There is no significant difference between the levels of knowledge on ill effects of tobacco use among adolescents residing in urban and rural areas.

Mean, SD and Range values of the various Domains wise Knowledge on ill effects of tobacco use with Residential status shows that the Mean 2.40 (SD =1.22) in the concepts of tobacco use, for subjects from Urban areas was slightly higher than Mean 2.1 (SD=1.21) of subjects from Rural areas. The Mean 2.37 (SD =1.79) in the harmful chemical substances in the tobacco, for subjects from Urban areas was slightly higher than Mean 1.93 (SD=1.57) of subjects from Rural areas. The Mean 1.07 (SD =1.05) in the types and forms of tobacco consumption, for subjects from Urban areas was slightly lower the Mean 1.87 (SD=1.04) of subjects from Rural areas. The Mean 2.90 (SD =1.16) in the ill effects of tobacco use for subjects from Urban areas was slightly higher than Mean 1.73 (SD=1.05) of subjects from Rural areas. It was inferred that there is no significant difference between the domains of knowledge on ill effects of tobacco use among adolescents residing in urban and rural areas.

Objective –3:

To find out association between the selected socio demographic factors and knowledge on ill effects of tobacco among adolescents.

There is no association between the socio- demographic factors of adolescents residing in urban areas and levels of Knowledge on ill effects of tobacco use.

There is no association between the socio- demographic factors of adolescents residing in rural areas and levels of Knowledge on ill effects of tobacco use except the type of family.

CONCLUSION:

The following conclusion was drawn from the following study.

The adolescent residing in urban and rural areas has inadequate knowledge on ill effects of tobacco use by improving their knowledge, adolescents will involve in reduction in the amount of tobacco consumption and takes steps to quit tobacco use.

So in addition to providing information booklet, group discussion, pamphlets, role of mass media in propagating the various ill effects of tobacco use can be used for generating public awareness.

The future of this field of nursing promises to the society to be one of the rapid significant professions that promotes the health of the society through health promotion activities. The result of which will directly influence public health by practicing evidence based nursing care

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Received on 03.01.2017 Modified on 30.01.2017

Int. J. Adv. Nur. Management. 2017; 5(2):127-136.

DOI: 10.5958/2454-2652.2017.00028.2