Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Print this page Email this page Users Online: 202

  Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 13  |  Issue : 4  |  Page : 394-398  

A community-based cross-sectional study on the knowledge of harmful effects of tobacco consumption and tobacco control laws among male youths in a resettlement colony of Delhi


1 Department of Community Medicine, Atal Bihari Vajpayee Government Medical College, Vidisha, Madhya Pradesh, India
2 Department of Community and Family Medicine, AIIMS, Bhopal, Madhya Pradesh, India

Date of Submission15-Jul-2019
Date of Decision14-Dec-2019
Date of Acceptance11-Mar-2020
Date of Web Publication20-Jul-2020

Correspondence Address:
Vikas Yadav
Department of Community Medicine, Atal Bihari Vajpayee Government Medical College, Vidisha - 464 001, Madhya Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_204_19

Rights and Permissions
  Abstract 


Introduction: In India, like in other developing countries, the most susceptible time for the initiation of tobacco is during youth, i.e., in the age group of 15–24 years. Therefore, the current study was conducted with an objective to assess the knowledge of harmful effects of tobacco consumption and tobacco control laws among male youths in a resettlement colony of Delhi. Materials and Methods: This cross-sectional study was conducted in 2010–2011 in Kalyanpuri, a resettlement colony in Delhi, India. The study included males aged 15–24 years residing in the study area at the time of survey. A semi-structured interview schedule was designed in Hindi to elicit the information on tobacco use, knowledge about its harmful effects, and tobacco control laws. Data were collected from 811 youths using systematic random sampling methods. Results: Current tobacco users were significantly (P < 0.05) more aware about the harmful effects of tobacco, i.e., weakness (30.7% users vs. 18.7% nonusers), addiction (12.9% users vs. 7.5% nonusers), and asthma (16.0% users vs. 39% nonuser) as compared to tobacco nonusers. Current tobacco users were also more aware about all tobacco control laws, i.e., health warning written on packets (97.8 users vs. 93.5% nonusers), tobacco could not be sold to <18 years of age (67.1% users vs. 32.3% nonusers), smoking is banned in public places (57.8% users vs. 19.7% nonusers), tobacco should be sold 100 yards away from schools (9.8% users vs. 1.8% nonusers), and pictorial health warnings on packets as compared to tobacco nonusers (4.9% users vs. 1.6% nonusers). All these results were statistically significant (P < 0.05). Conclusion: Most current users were having more knowledge about most of the harmful effects of tobacco on health as compared to nonusers. Likewise, current tobacco users were more aware about tobacco control laws as compared to nonusers.

Keywords: Cigarettes and other tobacco products act, harmful effects, India, knowledge, tobacco control law, tobacco, youth


How to cite this article:
Yadav V, Dabar D. A community-based cross-sectional study on the knowledge of harmful effects of tobacco consumption and tobacco control laws among male youths in a resettlement colony of Delhi. Med J DY Patil Vidyapeeth 2020;13:394-8

How to cite this URL:
Yadav V, Dabar D. A community-based cross-sectional study on the knowledge of harmful effects of tobacco consumption and tobacco control laws among male youths in a resettlement colony of Delhi. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Aug 6];13:394-8. Available from: http://www.mjdrdypv.org/text.asp?2020/13/4/394/290164




  Introduction Top


Currently, about one-fifth of all worldwide deaths attributed to tobacco occur in India. More than 800,000 people die and 12 million people become ill as a result of tobacco use each year.[1] The deaths attributable to tobacco in India are expected to rise from 1.4% of all deaths in 1990 to 13.3% by 2020.[2] It is estimated that 5500 adolescents start using tobacco every day in India.[3] Thus, the prevention of tobacco use in young Indians appears to be one of the largest opportunities for controlling this ever-growing epidemic. The prevention policies, if successfully executed, would not only prevent the various noncommunicable diseases attributed to tobacco use, but also decrease its social and economic burden on the society.

Studies suggest an increase in the prevalence of regular tobacco use among urban youth in India. A study conducted in the two metropolitan cities (Delhi and Chennai) found that current tobacco use among teenagers was estimated to be 14.7%, of which 7.4% had smoked cigarettes and 10.8% had chewed tobacco.[4] The global youth tobacco survey (GYTS) 2003, a study among 13–15-year-olds, estimated that ever user for tobacco was 10% in Delhi.[5] National Family Health Survey-3 conducted in 2005–2006, has reported a 27% prevalence of tobacco use among males in the age group of 15–24 years in Delhi.[6] In the Global Adult Tobacco Survey: India (2009–2010), the prevalence of tobacco users among males in the age group of 15–24 years was 27.4%.[7] Global Adult Tobacco Survey 2: India (2016–2017) reported the prevalence of tobacco use among 15–24 years' age group was 12.4%.[8] A more recent survey, National Family Health Survey-4, reported that the prevalence of tobacco users in 15–19 years' age group in India is 18.4%.[9]

Many teenagers start and continue using tobacco due to the fact that they are unaware of the harmful effects of tobacco consumption. Most users are male, and they start using tobacco in 15–24 years' age group (youth); therefore, it will be imperative to study their knowledge about the harmful effects of tobacco use and tobacco control laws in this age group.[3]

The present study was carried out to assess the knowledge of harmful effects of tobacco consumption and tobacco control laws among male youths in a resettlement colony of Delhi.


  Materials and Methods Top


This cross-sectional study was conducted in Kalyanpuri, a resettlement colony in Delhi, India. This study included males aged 15–24 years residing in the study area at the time of survey. The ethical approval was obtained in the year 2010 from the Institutional Ethical Board of Lady Hardinge Medical College, New Delhi. Participants' information sheet was provided to all the participants, and written informed consent was obtained from them.

From the previous study,[4] the prevalence of tobacco consumption among males in the age group of 15–24 years was 14.7%, which would require a sample size of at least 762 participants to estimate the prevalence of tobacco consumption with 2.5% absolute precision and with 95% confidence. Therefore, we decided to collect data from at least 800 participants.

The area has 11 blocks (No. 11–21) with a total population of nearly 34,000. The total population of 15–24-year-old males were nearly 4000 (as per population: male ratio in the Delhi Census 2001).[10] There are 4700 houses (180–500 houses in each block). Every fifth house (total 940 houses) was selected by the systematic random sampling method in each of the 11 blocks of the area to cover sample size of 800 participants. From each of the selected houses, all males of 15–24 years were selected. Those who did not give consent or not available at three visits were excluded from the study [Figure 1].
Figure 1: Selection of participants through systematic random sampling

Click here to view


Following a brief introduction, the purpose of the study was explained to the male youth, confidentiality was ensured, and written consent was sought. If the study participant was not at home or could not spare time, more visits were planned. Those who did not give consent or not available at three visits were excluded from the study. Because of the personal nature of some enquiries, special efforts were made to establish rapport with the respondents, and confidentiality of the information was assured. An attempt was made to conduct the interview in privacy to have an opportunity for responses on all issues.

A semi-structured interview schedule was designed in Hindi to elicit the information on tobacco use, knowledge of its harmful effects, and tobacco control laws. Data collection was done in the years 2010–2011. Participants were classified into tobacco ever users/never (or non) users/current users as per the definitions used in GYTS.[5] “Ever users” were defined as anyone who had used tobacco even once in any form at any point in a lifetime. “Never users” were those who had never used tobacco. “Current users” were those who had used tobacco in any form during the 30 days preceding the survey, and “past users” were defined as ever users who were not current users.

All the analyses have been done using SPSS 18 software (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago, IL, USA: SPSS Inc.). The prevalence and other categorical data have been described as frequency tables, and numerical data have been presented as their mean with standard deviation. For hypothesis testing, Chi-square test has been applied for the categorical data.


  Results Top


A total of 940 (20%) houses among 4700 were surveyed, and 860 individuals were listed. The proportion of study participants (15–24 years male) in population in studied houses was found to be 12.34%. Out of these 860 participants, only 811 (94.3%) participants who consented were interviewed. The prevalence of tobacco use (ever user) was found to be 31.3% (254 out of 811 participants), who had consumed tobacco even once in any form. Among these 254 tobacco users, 225 (27.7%) were current users, who had consumed tobacco in any form during last 30 days and 9 (3.6%) were past users, who consumed tobacco in the past but had not consumed it in last 30 days.

In the current study, we found that current tobacco users were having more knowledge as compared to tobacco nonusers about lung diseases (46.7% vs. 45.1%), lung cancers (37.8% vs. 34.3%), oral diseases (31.6% vs. 33.2%), dental diseases (24.0% vs. 19.9%), weakness (30.7% vs. 18.7%), addiction (12.9% vs. 7.5%), and asthma (16.0% vs. 39%). Among them results for weakness, addiction and asthma were statistically significant (P < 0.05).

Tobacco nonusers were having more information regarding oral cancers (32.3% vs. 25.8%), tuberculosis (13.8% vs. 13.3%), and heart diseases (7.4% vs. 4.0%) as compared to current tobacco users. All these results were statistically nonsignificant (P > 0.05). In other words, participants' knowledge about these diseases is not different in these two groups [Table 1].
Table 1: Knowledge of health hazards of tobacco products among study participants

Click here to view


In the present study, we also found that about 97.8% of tobacco users reported that they are aware about the health warning that is written on tobacco packets, as compared to 93.5% tobacco nonusers. Likewise, awareness of tobacco users for laws, namely tobacco could not be sold to <18 years age (67.1% users vs. 32.3% nonusers), smoking is banned in public places (57.8% users vs. 19.7% nonusers), tobacco should only be sold 100 yards away from schools (9.8% users vs. 1.8% nonusers), and pictorial health warnings on packets (4.9% users vs. 1.6% nonusers) is more as compared to tobacco nonusers. All these differences were statistically significant (P < 0.05) [Table 2].
Table 2: Awareness about tobacco control regulation among study participants

Click here to view



  Discussion Top


The study was conducted at Kalyanpuri resettlement colony among males in the age group of 15–24 years. A total of 940 houses were surveyed and 860 individuals were listed. The proportion of 15–24-year-old males in the study population in sampled houses was 12.34%, which is similar to Delhi census 2001 (11.77%). Finally, 811 male youths who were available and consented for participation in the study were interviewed.

Awareness of health hazards of tobacco use

Health problems associated with tobacco use are widely known. Nonusers and current users were both aware that tobacco is harmful to health. No significant difference was seen in awareness about lung diseases, lung cancer, dental diseases, and acidity. Current users were more aware about tobacco-induced weakness, addiction, and asthma as compared to nonusers for tobacco; however, their awareness about oral diseases, oral cancers, tuberculosis, and heart diseases was somewhat less than the nonusers, probably because of personal experience, and differences were statistically significant. These results were similar to other studies. Bhojani et al.,[11] in Bangalore in preuniversity students, found that awareness about the ill effects of tobacco use among past users and current users was 83.4% and 81.3%, respectively, with 85.8% of never users reporting that tobacco use is injurious to health. The awareness regarding the ill effects of tobacco use on health was mainly in terms of cancer (67%) and respiratory illness (38%). Dongre et al.[12] in Wardha also found that more number of nonusers knew that tobacco use causes cancer than users of tobacco. Dhadwal and Kaushal. conducted a study among adult males and found that their awareness about tobacco-induced heart diseases, lung diseases, brain diseases, and kidney diseases were 54%, 90%, 47%, and 21%, respectively.[13] In another survey, Ibrahim et al. conducted a series of surveys in school children of Mangalore city and found that 78.23% were aware about the harmful effects of tobacco. Among them, 39.8% and 14.7% were aware about the harmful effects of tobacco on lung and heart disease, respectively.[14]

Awareness about tobacco control regulations

Current users were more aware about “health warning written on packets”, “tobacco could not be sold to people below 18 years age,” “ban on smoking on public places,” “should be sold 100 yards away from schools,” and “pictorial health warnings on packets” than nonusers. The differences were found to be statistically significant. Current users were much more aware for various regulations for tobacco control may be because they have seen and bought these products. Jayakrishnan et al. conducted a study on school children in rural area near Thiruvananthapuram city and found that in 15–17 years age group, 66% and 14% were aware about the ban on smoking in public places and ban on selling tobacco products to minors, respectively.[15] In another study, Rao et al. found that in Khammam district, awareness of adults about the ban on selling tobacco products near educational institutes, ban on sale of tobacco products to minors, and written health warning on tobacco products were 16.8%, 18.9%, and 23%, respectively.[16]


  Conclusion Top


Most current users were having more knowledge about the harmful effects of tobacco on health. Moreover, all results were statistically significant except awareness about lung diseases, lung cancer, dental diseases, and acidity. Likewise, more tobacco users were more aware about tobacco control laws as compared to nonusers.

Limitations

This study was conducted in males in the age group of 15–24 years, residing in a resettlement colony of East Delhi. The population residing in resettlement colonies have different characteristics as compared to the general population, so the findings of this survey cannot be extrapolated to the general population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Tobacco: Key Facts. Geneva: World Health Organization; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco. [Last accessed on 2019 Jul 01].  Back to cited text no. 1
    
2.
Verma R, Khanna P, Rajput M, Kalhan M, Prinja S. Why say no to tobacco: Indian perspective. Australas Med J 2011;4:139-42.  Back to cited text no. 2
    
3.
Reddy KS, Arora M. Tobacco use among children in India: A burgeoning epidemic. Indian Pediatr 2005;42:757-61.  Back to cited text no. 3
    
4.
Reddy KS, Perry CL, Stigler MH, Arora M. Differences in tobacco use among young people in urban India by sex, socioeconomic status, age, and school grade: Assessment of baseline survey data. Lancet 2006;367:589-94.  Back to cited text no. 4
    
5.
Arora M, Reddy KS. Global youth tobacco survey (GYTS)-Delhi. Indian Pediatr 2005;42:850-1.  Back to cited text no. 5
    
6.
International Institute of Population Sciences. National Family Health Survey-3. Mumbai: International Institute of Population Sciences; 2005.  Back to cited text no. 6
    
7.
International Institute of Population Sciences. Global adult tobacco survey (GATS) Fact Sheet, India 2009-2010. In: Ministry of Health and Family Welfare, editor. IIPS. Mumbai: Government of India; 2011.  Back to cited text no. 7
    
8.
Government of India. Global adult tobacco survey 2 India 2016-2017. In: Ministry of Health and Family Welfare, editor. GOI. New Delhi: Government of India,; 2017.  Back to cited text no. 8
    
9.
International Institute for Population Sciences. National Family Health Survey-4: 2015-2016. In: Ministry of Health and Family Welfare, editor. IIPS. Mumbai: IIPS; 2017.  Back to cited text no. 9
    
10.
Government of India. Census 2001 Tables. In: Implementation Ministry of Statistics and Programme Implementation, editor. GOI. New Delhi: Government of India; 2001.  Back to cited text no. 10
    
11.
Bhojani UM, Chander SJ, Devadasan N. Tobacco use and related factors among preuniversity students in a college in Bangalore, India. Natl Med J India 2009;22:294-7.  Back to cited text no. 11
    
12.
Dongre A, Deshmukh P, Murali N, Garg B. Tobacco consumption among adolescents in rural Wardha: Where and how tobacco control should focus its attention? Indian J Cancer 2008;45:100-6.  Back to cited text no. 12
[PUBMED]  [Full text]  
13.
Dhadwal D, Kaushal K. Knowledge about the ill effects of tobacco use and cigarettes and other tobacco products (Prohibition of advertisement and regulation of trade and commerce, production, supply and distribution) act among adult male population of Shimla City. CHRISMED J Health Res 2016;3:279-83.  Back to cited text no. 13
  [Full text]  
14.
Ibrahim A, Mathew SB, Arekal SS, Swathi SS, Santosh SS, Kundapur R. A Study to assess the awareness of ill effects of tobacco among adolescents and young adults of Mangalore. Nitte Univ J Health Sci 2016;6:21-3.  Back to cited text no. 14
    
15.
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.  Back to cited text no. 15
[PUBMED]  [Full text]  
16.
Rao AR, Dudala SR, Bolla CR, Kumar BP. Knowledge attitude and practices regarding the cigarettes and other tobacco products act (COTPA) in Khammam, Andhra Pradesh. Int J Res Health Sci 2013;1:96-102.  Back to cited text no. 16
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

Top
   
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
   Abstract
  Introduction
   Materials and Me...
  Results
  Discussion
  Conclusion
   References
   Article Figures
   Article Tables

 Article Access Statistics
    Viewed58    
    Printed2    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal