INTRODUCTION:

India is the second largest consumer of tobacco followed by China as first in developing countries. India is a home to 12% of world smokers. More than 1 million people die every year due to tobacco usage. 26% of younger people aged 30-44 years premature death is due to CVD. CVD are the number one cause of death, causing 27,51,972 each year that is almost 28.1% of all deaths (Factsheet 2018, WHO, India). Top 5 causes of overall death are ischemic heart disease, chronic obstructive pulmonary disease, Diarrheal disease, cerbrovascular disease, lower respiratory infection.

There are about 266 million current tobacco users and substantial number of people exposed to secondhand smoke are at increased risk of CVDs. Most people start early increasing the risk of heart disease in younger people. Despite strong evidence that quitting both smoked and smokeless tobacco helps to immediately reduce the risk of CVDs.

Tobacco products are made entirely or partly of leaf tobacco as raw material which is grown widely all over the world and are intended to be smoked, sucked, chewed or snuffed. All contain the highly addictive psychoactive ingredient called nicotine⁵.

Tobacco use is one of the main risk factors for a number of chronic diseases such as cancer, lung diseases, and cardiovascular diseases throughout the world. A number of countries including India have legislation restricting tobacco advertising, and regulating who can buy and use tobacco products, and where people can smoke².

Nicotine is a chemical that contains nitrogen, which is made by several types of plants, including tobacco plant. It is also produced synthetically in Laboratory. Nicotine is not cancer-causing or excessively harmful on its own, nicotine is heavily addictive and exposes people to the extremely harmful effects of tobacco dependency. Smoking is the most common preventable cause of death all over the world. Chewing or snorting tobacco products usually releases more nicotine into the body than smoking products. The side effects of nicotine can affect the heart, hormones, and gastrointestinal system. when the nicotine is induced in the body a person may have “kick”, a pleasurable feeling. This is due to stimulation of adrenal glands to secrete adrenaline⁵. Tolerance to nicotine increases with the amount of nicotine consumed and people require higher doses to enjoy the same initial effects. With all these above mentioned facts, statistics, and review of literature, researcher found to survey the nicotine dependence among tobacco users in selected rural area in part of Rajasthan.

OBJECTIVES:

· To assess the Nicotine dependence among tobacco users

· To find out association between Nicotine dependence and socio demographic factors.

METHODOLOGY:

Research Approach:

The research approach adopted for this study was Quantitative approach as the study aimed to assess the Nicotine dependence among tobacco users in selected rural area of Udaipur.

Research Design:

An community based, observational study which belongs to non experimental descriptive design was adapted to assess the nicotine dependence among tobacco users.

Research Setting:

The present study had been conducted in Sisarma village under Nai CHC (community health centre) which is been adapted by Geetanjali university Udaipur.

Sample and Sample Size:

The study population comprises of community people who were identified as tobacco users in any form.200 Samples was selected for data collection by using Purposive sampling technique.

Inclusion criteria:

Community people who were identified as tobacco users in any form, and not less then 18 years of age group and willing to participate in the study, available during the period of data collection.

Exclusion criteria:

Substance abuse non other then tobacco and age limit less then 18 years was excluded. Who are not able to speak, understand Hindi and not willing to participate or expose data.

Procedure for Data Collection:

Data collection is a systematic gathering of information (data) relevant to the research purpose¹. Formal intimation was given to the medical officer CHC and consent taken from each clients before interviewing for Nicotine dependence.

study was done in the month of Feb 2019 using the non probability purposive sampling method 200 respondents are selected for the study. The purpose of study was explained to the respondents and confidentiality of their response was assured. After obtaining the permission and consent, modified fagerstrom test for Nicotine Dependence was used to conduct an interview. Initially demographical data was collected including form of tobacco usage and later modified questions from fagerstrom test was asked for Nicotine dependence. The time taken from respondents for answering questions was 15-20 min.

RESULT:

The study revealed that 68.2 % of respondents have moderate Nicotine Dependence followed by 14.40% as low and 17.40% as high nicotine dependence. Majority of the respondents were male and belongs to age group of 19-29 years. 89% of respondents were married with 74% of schooling completed. almost 68% of respondents belong to joint family. Most of the clients reported as tobacco chewing, and habitual from more then 3years.television and mass media is the source of information for awareness of dangerous of tobacco usage.

Fig: 1 Showing form of tobacco usage

Diagram showing 84% of respondents are tobacco chewers followed by 13% who use in the form of smoking and only 3 % belongs to mixed method.

Socio demographical factors such as age, sex, family status, income and form of tobacco usage were found to be associated with nicotine dependence (P<0.05). where as factors such as religious, marital status, education status, habitual to tobacco and aware of dangerous of tobacco were found to be not significant.

Fig 2: Showing that level of nicotine dependence among respondents

DISCUSSION:

The study shown that maximum respondents come in the category of moderate dependence followed by high and low dependence.

A similar study was conducted by M. Janu., S. Bonu., “ Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey”. The findings of the study highlight that an agenda to improve health outcomes among the poor in India and also to include effective interventions to control tobacco use. Failure to do so would most likely result in doubling the burden of diseases in rural and urban community.

Other similar study coincides with the finding where the study was conducted in Burdwan town, West Bengal. The study revealed that, maximum tobacco users from joint family, and belonged to lower socioeconomic status and sex, income are significant with tobacco usage³.

CONCLUSION:

The over all conclusion of the study shows that tobacco usage is one of the addictive substance which leads to chronic disease. And the chemical substance called nicotine is responsible for dependence. Maximum respondents were from moderate dependence but if not controlled and educated they may reach to high dependence. Hence forth efforts to be taken to solve this social problem for promoting health in the community.

RECOMMENDATION:

A similar study can be conducted in wider population for generalization. It can also be applied for rural and urban population as comparative study. similar study can be conducted for evaluative approach with intervention to prevent nicotine dependence.

REFERENCES:

1. Suresh K Sharma. Nursing Research and statistics. Second edition; Elsevier publication: page no: [71-83].

2. K Park. Preventive & social medicine. 21^st edition: Banarasidas Publication: page no: [868-875].

3. Islam K, Datta AK et.al “A study on the prevalence and correlates of nicotine dependence among adolescents of Burdwan Town, West Bengal”; Indian J Psychiatry.2019 jan-feb:61(1) 89-93.

4. Tobacco use in India: available from: https://www.who.int/topics/tobacco/en/

5. Fast facts on Nicotine: available from: https://www.medicalnewstoday.com/articles/240820.php

Received on 02.04.2019 Modified on 30.04.2019

Int. J. of Advances in Nur. Management. 2019; 7(3):194-196.

DOI: 10.5958/2454-2652.2019.00045.3