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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 32  |  Issue : 1  |  Page : 4-8

A study to evaluate the knowledge and belief regarding tobacco consumption among the non-teaching staff members working in four heath institutes in Hingna


Department of Oral Medicine and Radiology, Vspm's Dental College, Hingna, Nagpur, Maharashtra, India

Date of Submission25-Jan-2020
Date of Decision17-Mar-2020
Date of Acceptance17-Mar-2020
Date of Web Publication17-Apr-2020

Correspondence Address:
Dr. Apurva M Khator
25, Daga Layout, Shilpak Apartments, Nagpur 22, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaomr.jiaomr_14_20

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   Abstract 


Background: In a developing country like India, where illiteracy is high, tobacco is the leading cause of mortality estimated to have killed hundreds of people. The emergence of tobacco-related diseases is a growing public health problem. The increased risks for diseases like cardiac diseases, lung cancer, oral and pharyngeal cancers, and tuberculosis are shared by both men and women who consume tobacco. One in two males and one in ten females in India use tobacco in some or the other form. A large number of awareness programs are conducted especially in the health institutes regarding ill effects of tobacco, despite which it is observed that the non-teaching staff members working in the same institutes are regularly consuming tobacco. Therefore, this study is being carried out to assess the level of knowledge regarding the same in these people (non-teaching staff members) who mainly belong to the lower socioeconomic group. Aim: To evaluate the level of awareness regarding tobacco consumption among the non-teaching staff members of four health institutes in Hingna. Materials and Methods: The study was interview based using a validated questionnaire consisting of closed-ended questions to evaluate the knowledge regarding tobacco consumption among the non-teaching staff members of four health institutes (medical, dental, physiotherapy, and nursing colleges in Hingna). A trained interviewer interviewed one subject at a time in person and the questions were asked in Marathi or Hindi depending on subjects' choice. The study population included 600 non-teaching staff members (300 males and 300 females) irrespective of their age. Results: Out of the total 600 subjects, the number of people who consumed tobacco was 387 of which 175 were females and 212 were males. It was evident from the results of the questionnaire study that even though moderate amount of awareness was present among the non-teaching staff members, they still did not refrain from the use of tobacco. Conclusion: Awareness programs must be undertaken to educate the non-teaching population about the ill effects of tobacco consumption and further studies should be undertaken to evaluate a larger number of people.

Keywords: Knowledge, non-teaching staff members, tobacco


How to cite this article:
Khator AM, Motwani M, Sharma A, Singh J, Sayyed F, Solanki M. A study to evaluate the knowledge and belief regarding tobacco consumption among the non-teaching staff members working in four heath institutes in Hingna. J Indian Acad Oral Med Radiol 2020;32:4-8

How to cite this URL:
Khator AM, Motwani M, Sharma A, Singh J, Sayyed F, Solanki M. A study to evaluate the knowledge and belief regarding tobacco consumption among the non-teaching staff members working in four heath institutes in Hingna. J Indian Acad Oral Med Radiol [serial online] 2020 [cited 2020 Jun 1];32:4-8. Available from: http://www.jiaomr.in/text.asp?2020/32/1/4/282604




   Introduction Top


Around 10 million people globally are diagnosed with cancer every year. It is estimated that by 2020, there will be 15 million new cases per year.[1] Tobacco is the leading preventable cause of death which kills hundreds of people in a developing country like India. It affects all people from the young to the old; the rich to the poor; men, women, and children. Of the several causes investigated for cancer, the use of tobacco has shown strong and consistent associations with cancer at several sites of the body.[1]

The number of tobacco-related diseases is increasing at an alarming rate. Tobacco can be consumed in smoking or smokeless form which may lead to cancer of lungs, oral cavity, and different parts of the body as well as cardiovascular diseases.[2]

The increased risks for diseases like cardiac diseases, lung cancer, oral and pharyngeal cancers, and tuberculosis are shared by both men and women who consume tobacco. One in two males and one in ten females in India use tobacco in some or the other form.[2]

Tobacco smoking has been suspected to be a risk factor for breast cancer, as there has been evidence that carcinogens present in smoke from tobacco could be transported to the breasts through lipoproteins and albumin of plasma.[2]

About two-thirds of the tobacco consumed is in the alternative form such as bidis, chewable tobacco, powdered tobacco, guthka, khaini, cigars, chillum mawa, and misri which are largely consumed by the people belonging to lower socioeconomic group.[3]

The health threats have three main facets:

  • Tobacco use by men and women
  • Exposure to second-hand smoke
  • Diversion of family resources from food, shelter, healthcare, and education to purchase tobacco products.[4]


Therefore, in this study, the people belonging to the lower socioeconomic have been targeted who show a lack of awareness and education that leads to increased tobacco consumption.

A large number of awareness programs are conducted especially in the health institutes regarding the ill effects of tobacco, despite which it is observed that the non-teaching staff members working in the same institutes are regularly consuming tobacco. Therefore, this study was carried out to assess the level of knowledge regarding the same among the non-teaching staff members who are majorly working in four health institutes.

This study was aimed to evaluate the level of awareness regarding tobacco consumption among the non-teaching staff members of four health institutes in Hingna, also to assess the tobacco use among the non-teaching staff members of four health institutes, to assess the discrepancy in knowledge and belief toward tobacco consumption, and to counsel the tobacco users about the hazards of tobacco consumption. To our knowledge, this is the first study carried out exclusively on the non-teaching staff members regarding tobacco use which included Class 3 and 4 workers (clerks, attendants, and sweepers).


   Material and Methods Top


This study was started after getting the institutional ethics committee approval (letter number- VSPM/IEC/2019/14). This was a descriptive prospective type of a study which was interview based using a validated set of questions consisting of closed-ended questions to evaluate the knowledge regarding tobacco consumption among the non-teaching staff members of four health institutes (Medical, Dental, Physiotherapy, and Nursing college in Hingna). A trained interviewer interviewed one participant at a time in person and the questions were asked in Marathi or Hindi depending on their choice. The study population included 600 non-teaching staff members (300 males and 300 females) irrespective of their age. The duration of the study was 3 months.

Statistical analysis

The sample size of 600 subjects was calculated by simple random sampling method. Data analysis was done by SPSS software version 16.0. Randomization and blinding were not required as all the non-teaching staff members were included in the study. P value and confidence interval were not calculated as there is only one group in the study and no control group was present.

Inclusion criteria

All the subjects who were willing to participate were included in the study.


   Results Top


Out of the total 600 participants, the number of people who consumed tobacco was 387 of which 175 were females and 212 were males. 66.7% of the participants believed that smoking should be banned in public places. 64% of the participants agreed that chewing tobacco can cause oral cancer. 41.5% of the participants in the study were exposed to secondhand smoke. According to 56.3% of the participants, tobacco-related advertisements influenced tobacco consumption. 33.4% used products containing tobacco to clean their teeth. Only 18.3% were given free cigarettes by somebody else. As many as 61.2% of the participants believed occasional tobacco use can be injurious to health. Among the total participants included in the study, family members of 35.2% participants consumed tobacco. 60.8% of the participants were explained about the ill-effects of tobacco by some health care specialist. A total of 62.8% believed that they have the courage to admonish someone for smoking cigarettes in their presence.


   Discussion Top


Non-teaching staff members working in medical institutes constitute a formidable workforce and an important sector as they are the first people the patients encounter when they visit these colleges.[5] In the present study, 600 non-teaching staff members irrespective of their age were interviewed, among which 35.3% males and 29.1% females consumed tobacco [Figure 1]. In a study conducted in Chhattisgarh, tobacco was consumed by the women in both smoked (42.16%) and smokeless form (48.7%) and the percentage is higher as compared to the present study.[2]
Figure 1: A pie diagram showing the number of male and female participants consuming tobacco

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400 participants (66.7%) of them believed that smoking must be banned in public places. In a study conducted by Anup et al., 79% of non-teaching staff claimed strong attitudes toward banning tobacco use.[6] This shows that the maximum of them were aware of the ill effects of smoking in public places [Figure 2].
Figure 2: Questionnaire used to interview the non-teaching staff members

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In a study conducted by Kaleta et al., there was a significant difference between the teachers and non-teaching staff in terms of knowledge and the opinion on tobacco control issues; more than 90% of the teachers and 83% of the non-teaching personnel agreed with the statement that active and passive smoking causes serious diseases (P < 0.001). Similarly, significantly more teachers comparing to other school personnel shared the opinion that smoking should be banned in all workplaces and governmental offices (P ≤ 0.006) as well as that tobacco advertising should be completely banned (P < 0.001).[7] This can be attributed to the higher rate of illiteracy and lesser knowledge of the non-teaching staff as compared to the teaching staff.

Out of 600, 384 members of them, i.e. 64%, were aware that chewing tobacco can cause oral cancer, while 216, i.e. 36%, were not much aware about the fatal result of tobacco consumption which showed that most of them were well aware of the hazardous consequences of tobacco use.

A total of 249 members (41.5%) were exposed to second-hand smoke on a general basis which infers that they were passive victims of cigarette smoking, while 351 members (58.5%) were not exposed to second-hand smoke [Figure 3]. As a greater percentage of people lie in the non-exposed category, it can be said that they are in a relatively safe zone in comparison to the other group.
Figure 3: Bar diagram showing the responses to the questions of the interview

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The impact that tobacco-related advertisements have on tobacco consumption can be proven by the fact that a total of 337 out of 600, i.e. 56.3%, believe that tobacco-related advertisements do influence tobacco consumption, while a total of 262, i.e. 43%, still believe that tobacco-related advertisements have no influence on tobacco consumption. The above greater percentage clearly signifies that nearly half of the illiterate population is immensely motivated to consume tobacco in some or the other form after getting tremendously influenced by the popular faces that they come across in advertisements and other sources of media. The fact that despite the intensifying regulations of (COTPA, 2003), people still continue to turn a blind eye and promote cigarette and tobacco products disregarding its harmful consequences on the general population. This percentage might decline if strict authoritative rules are levied on to the manufacturers as well as those buying them.

In this study, it was assessed whether the members used products containing tobacco to clean their teeth to which we found that a total of 200 members, i.e. 33.4%, still used products containing tobacco to clean their teeth. This number can be reduced by making the people aware of the grave effects that various forms of tobacco will have on the body when they are routinely used for cleaning teeth. The use of tobacco for cleaning teeth is more prevalent in the lower socioeconomic classes of society due to lack of knowledge, belief in age-old traditions and customs, and lack of monetary resources to buy tooth cleansing agents.

In a study by Tiwari et al., they found in Chhattisgarh that there was lack of knowledge emphasis and misconceptions about tobacco present in the rural areas.[2]

We are aware that people are easily influenced by the environment created around them which has a deep impact on their mindsets. It was assessed that even today a surprisingly total of 110 people, i.e. 18.3%, were offered cigarettes by somebody, while on a positive pace, around 490, i.e. 81.7%, have either refused to take cigarettes or have never been offered free cigarettes by somebody [Figure 4]. This above result is a clear indication that positive impact would occur onto those who have accepted cigarettes from somebody if they are rightly counseled for leaving this habit.
Figure 4: Bar diagram showing the responses to the questions of the interview

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Though the fact that daily consumption of tobacco is hazardous to health, we found some 367 members (61.2%) considered occasional tobacco use injurious to health, showcasing their awareness regarding severe hazards of occasional tobacco consumption, while a striking 233 members, i.e. 38.8%, still do not consider occasional tobacco consumption injurious to health. This clearly signifies the low level of awareness prevalent among the masses regarding the use of occasional tobacco. This might be because of their inability to stop the habit of consumption of tobacco in various forms even if they are aware of its ill effects or simply because of neglect or ignorance.

Tobacco use by a family member influences and increases the likelihood that somebody else in his/her family will adopt the tobacco consumption habits. Similarly, in our study, a staggering 211 number of people (35.2%) had such members in their family who consumed tobacco [Figure 5]. It is pity to watch youngsters and teenagers getting lured to smoking and chewing tobacco just because they have seen a grown-up getting addicted to it. This is simply because of neglect and lack of knowledge regarding tobacco hazards which necessitates spreading of awareness to curb this malpractice.
Figure 5: Bar diagram showing the responses to the questions of the interview

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As we belong to a Health Care Institute, we know the role a health care professional plays in educating and making the people aware of the ill effects of tobacco and can also help them quit the habit. In our study, a convincing number, i.e. 365 members (60.8%), had been explained about the ill effects of tobacco by any of the health care specialist, whereas 235 members, i.e. 39.2%, still had never been explained about the ill effects of tobacco. This gives us an insight that there are still numerous people who have been spared and have had no access to awareness from any health care professional regarding tobacco use. It is our moral duty to stop this habit among people.

It needs the courage to convince somebody to quit any habit they have been associated with, so in our study we assessed that a total of 37 members, i.e. 62.4%, who were courageous enough to admonish someone for smoking cigarettes in their presence, while a disappointing 223 of them, i.e. 37.2%, were disinterested to do the same, thus, unveiling the lack of interest people have about helping someone to quit the habit.

To the best of our knowledge, this is the first study conducted exclusively on non-teaching class 3 and class 4 workers with such a large sample size. Therefore, we were unable to find recent references for comparison with the present study.

Limitations and future scope of the study:

The study can be carried out on a larger population like a community survey to get more appropriate results. Further studies should be done by professionally trained interviewers and the tobacco addicts should be systematically counseled for deaddiction in the same institute.


   Conclusion Top


The present study indicates that even though the knowledge and awareness among the non-teaching staff are average, still the members of tobacco consumers were fairly high which shows that they are addicted to tobacco. Even though various health awareness programs are conducted especially in health institutes regarding ill effects of tobacco, it is observed that non-teaching staff members are regularly consuming tobacco. It is also evident that the health hazards are not explained properly to the non-teaching group of people. Therefore, seminars and camps must be undertaken to educate the non-teaching population about the ill effects of tobacco consumption. All the health care institutions must have deaddiction centers operated by trained professionals wherein they can explain in detail the deleterious effects of tobacco consumption and also treat the addicts in a systematic manner. Therefore, this study must be carried out on a larger scale with a bigger sample size to create awareness and educate the non-teaching population since they play an important role in health care institutions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Bhonsle RB, Murti PR, Gupta PC. Tobacco habits in India. Control of tobacco related cancers and other diseases: proceedings of an International Symposium, January 15-19, 1990. Mumbai: TIFR, Bombay, New York: Oxford University press; 1992. p. 25-46.  Back to cited text no. 1
    
2.
Tiwari R, Gupta A, Agrawal A, Gandhi A, Gupta M, Das M. Women and tobacco: Discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural women in Chattisgarh, central India. Asian Pac J Cancer Prev 2015;16:6365-73.  Back to cited text no. 2
    
3.
Shimray R. Smokeless tobacco and rural women: Influencing factors towards the usage. Int J Sci Res Publications 2015;5: 1-7  Back to cited text no. 3
    
4.
Amos A, Greaves L, Nichter M, Bloch M. Women and tobacco: A call for including gender in tobacco control, research, policy and practice. Tob Control 2012;21:236-43.  Back to cited text no. 4
    
5.
Shashikanth YK, Priydarshini A. Health education as a tool to quit tobacco use among non-teaching staff in a medical college of North Karnataka: An interventional study. Int J Community Med Public Health 2019;6:2023-7.  Back to cited text no. 5
    
6.
Anup N, Jeph V, Biswas G, Shravani G, Jhajharia A, Jain P. Knowledge and attitude of tobacco use among workers (non -teaching staff) in a dental college in Jaipur, Rajasthan. IOSR J Dent Med Sci 2015;14:68-73.  Back to cited text no. 6
    
7.
Kaleta D, Polańska K, Rzeźnicki A, Stelmach W, Wojtysiak P. Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland. Tob Induc Dis 2017;15:3.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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