Rajiv Gandhi University of Health Sciences s48

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Mr. PAVAN KUMAR.N IST YEAR M.Sc NURSING COMMUNITY HEALTH NURSING YEAR 2010-2012

CAUVERY COLLEGE OF NURSING #42/2B, 2C, THERESIAN COLLEGE SIDDARTHA LAYOUT MYSORE KARNATAKA

1 | P a g e RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA - BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 1 NAME OF THE MR .Pavan kumar.N CANDIDATE AND 1ST YEAR M.Sc., NURSING ADDRESS CAUVERY COLLEGE OF NURSING, MYSORE.

2 NAME OF INSTITUTION CAUVERY COLLEGE OF NURSING, MYSORE.

3 COURSE OF STUDY AND MASTER IN NURSING SUBJECT M.Sc., Community health NURSING.

4 DATE OF ADMISSION TO THE COURSE 01.06.2010

5 TITLE OF THE STUDY Assess the knowledge of high school students regarding ill effects of smoking in selected government high school at Mysore district

6 STATEMENT OF THE “A study to assess the effectiveness of planned PROBLEM teaching program on knowledge regarding ill effects of smoking among high school students in selected government high school at Mysore district”

6.0 BRIEF RESUME 0F THE INTENDED WORK

2 | P a g e 6.1INTRODUCTION

BACKGROUND OF THE PROBLEM

“Kill it before it kills you”

Smoking is a major public health problem around the world; especially in Developing countries.1200people die each day from the effects of tobacco. Smoking is now by far the largest preventable cause of death in the industrialized world. Someone dies from the effects of smoking every 10 seconds. It is estimated that by 2025,75%of early death in developing countries will be due to smoking related illness.1/3of the global population, aged 15 years and over are current smokers.1

“Smoking is a act of drawing in to mouth and puffing out, the smoke of tobacco contained in a cigarette, cigar pipe”. The dried leaves of the plant NICOTINA TABACUM containing the drug nicotine, which may be smoked, chewed or inhaled. Prevalence of smoking is more in the developing countries, especially in males. Smoking popularity was high in 1964when42%of all adults in United States smoked. Each day more than 3500 people under the age of 18 try their first cigarette and another 1100 become smokers.1

Smoking causes ill effects like heart diseases, cancer-lungs, oral, esophageal, leucopenia. Lung disease, such as asthma, bronchitis, emphysema, influenza, pneumonia and sinusitis, peptic ulcer.2 A study was conducted by Bablog College of medicine, Houston, Texas the knowledge of high school students regarding ill effects of smoking. Following this survey through smoking presentation program antismoking measures was delivered to the children through a cartoon movie a comeback involving lovable and depicting the ill effects of smoking.2

Smoking, primarily of tobacco, is an activity that is practiced by some 1.1 billion people, and up to 1/3 of the adult population. The image of the smoker can vary considerably, but

3 | P a g e is very often associated, especially in fiction, with individuality and aloofness. Even so, smoking of both tobacco and cannabis can be a social activity which serves as a reinforcement of social structures and is part of the cultural rituals of many and diverse social and ethnic groups. For adolescents, it can function as a first step out of childhood or as an act of rebellion against the adult world. Also, smoking can be seen as a sort of camaraderie. It has been shown that even opening a packet of cigarettes, or offering a cigarette to other people, can increase the level of dopamine (the "happy feeling") in the brain, and it is doubtless that people who smoke form relationships with fellow smokers, in a way that only proliferates the habit, particularly in countries where smoking inside public places has been made illegal.2.

Male and female smokers lose an average of 13.2 and 14.5 years of life, respectively.

At least half of all lifelong smokers die earlier as a result of smoking.

Smoking one cigarette a day results in a risk of heart disease that is halfway between that of a smoker and a non-smoker. The non-linear dose response relationship is explained by smoking's effect on platelet aggregation. 4

Many governments are trying to deter people from smoking with anti-smoking campaigns in mass media stressing the harmful long-term effects of smoking. Passive smoking, or secondhand smoking, which affects people in the immediate vicinity of smokers, is a major reason for the enforcement of smoking bans. This is a law enforced to stop individuals smoking in indoor public places, such as bars, pubs and restaurants 5.

The effects of addiction on society vary considerably between different substances that can be smoked and the indirect social problems that they cause, in great part because of the differences in legislation and the enforcement of narcotics legislation around the world. Though nicotine is a highly addictive drug, its effects on cognition are not as intense or noticeable as other drugs such as, cocaine, amphetamines or any of the opiates

(including heroin and morphine).2

4 | P a g e Despite the many bans, European countries still hold 18 of the top 20 spots, and according to the ERC, a market research company, the heaviest smokers are from Greece, averaging 3,000 cigarettes per person in 2007. Rates of smoking have leveled off or declined in the developed world but continue to rise in developing countries. Smoking rates in the United

States have dropped by half from 1965 to 2006, falling from 42% to 20.8% in adults. 2

A common concern among legislators is to discourage smoking among minors and many states have passed laws against selling tobacco products to underage customers 3

6.2 NEED FOR THE STUDY

Smoking popularity was its height in 1964 when 42% of all adults in United States smoked. In that year the surgeon general report on smoking and health linked smoking to heart diseases, lung cancer and other lung diseases since this 1964 report the percentage of smokers over 17 years as declined to 33%.3 A study reported between 1882 and 1990 smoking behaviors in 11-14 years of school boys had fallen from 51%-42% in fact many children try their first cigarette while at primary school. Smoking behavior include associating smoking with fun, pleasure smoking as a means of calming nerves and smoking as being sociable and building confidence all of which have been reported by young smokers. Social factors such as parental smoking peer and school influence the believes and behavior of children. 3 Parents who smoke also influence their children’s behavior. Smokers are 3 times more likely than non-smokers to have parents to smoke. Advertising is a powerful social force, it attracts children’s mind for a glamorous image.1 To prevent the students from smoking it is very important that teachers and students should have adequate knowledge and appropriate behavioral attitude related to their habit. Hence researchers felt the need for study for assessing the knowledge of high school students so that an appropriate planned educational program can be prepared . 2

Among female students, a significant quadratic trend was detected, indicating that the prevalence of current smoking peaked during 1997--1999 and then declined significantly by 2001. Similarly, among white female, black male, Hispanic, Hispanic

5 | P a g e female, Hispanic male, and 9th- and 11th-grade students, current smoking prevalence peaked by 1999 and then declined significantly by 2001. A positive linear trend was detected among black female students, indicating that the prevalence of current smoking among this subgroup increased significantly throughout the decade.2

Among male students, significant linear and quadratic trends were detected, indicating that the prevalence of current smoking increased significantly during 1991--1997 and then declined significantly by 2001. A similar pattern was detected among white, white male, black, and 10th- and 12th-grade students; however, among 12th-grade students, the increase lasted until 1999.4

The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female current smoker, in the absence of competing causes of death. The corresponding estimates for lifelong nonsmokers are a 1.1% probability of dying from lung cancer before age 85 for a man of European descent, and a 0.8% probability for a woman Among the diseases and afflictions that can be caused by smoking are vascular stenosis, cancer attacks and chronic obstructive pulmonary disease.12

A study was carried out to ascertain the prevalence of smoking among high school students in Alkhraj. This study was carried out by means of a questionnaire and department of family and community medicine in Alkhraj military hospital, kingdom of Saudi Arabia, conducted it. The participants were students of age 15 years and above in randomly selected Alkhraj high schools. Results: - out of 819, correspondence 166(20%) were current smokers, 134(16%) were ex-smokers. 519(64%) were non-smokers. The average starting age low current smokers was 13.8 years (13-15years). 105 (63%) of current smoked less than 10 cigarettes per day.12 A study was conducted by university of Philippines- Philippine general hospital, Manilai, Philippines to determine the prevalence of smoking among high school students in a tobacco-producing region. A 15 self administered questionnaire were distributed to students from randomly selected public high schools. Survey results included a total of 2714 student response with age range 10-20 years. Overall 31.6% of students in a tobacco-producing region have tried smoking; 22.8% are current smokers.

6 | P a g e Smoking is a major public health problem around the world, especially in developing countries. Each day more than 3500 people under the age of 18 try their first cigarette and another 1100 became smokers.1200 people died each day from the effects of tobacco12.

The Investigator have come across in his own personal experience that many High school Students are smoking in public places , so, it becomes the felt need of the investigator to plan a educational program on ill effect of smoking to high school student

6.3 STATEMENTS OF PROBLEM

“ A study to assess the effectiveness of planned teaching program on knowledge regarding ill effects of smoking among high school students in selected government high school at Mysore district”

6.4 OBJECTIVES OF THE STUDY

1) To assess the existing knowledge of high school students regarding ill effects of smoking. 2) To administer the planned teaching program regarding ill effects of smoking among high school students. 3) To evaluate the effectiveness of planned teaching program on knowledge regarding ill effects of smoking among high school students in turns of post test. 4) To determine association between selected demographic variable with post test knowledge score of high school students regarding ill effects of smoking.

6.5 HYPOTHESIS

7 | P a g e H1 – There will be significant difference between mean pretest knowledge and post test knowledge among high school students regarding ill effects of smoking. H2- There will be significant association between post test knowledge score with selected demographical variable.

6.6 ASSUMPTION

1. High school Students may have knowledge on smoking but unaware of its complication.

2. High school Students in high school are more attracted towards smoking by the influence of celebrities and peer group compulsion.

3. High school Students may have limited knowledge on ill effects of smoking.

6.7 OPERATIONAL DEFINITION

Knowledge: Information, facts or awareness gained through planned teaching program by the high school students that is evaluated by the correct response given by them regarding ill effects of smoking.

Ill effects of smoking: Are the results of smoking which leads to unfavorable condition to the health of the High school Students

High school students: Are the persons studying in 8th, 9th and 10th std in schools to whom the knowledge regarding the ill effects of smoking is administerd through planned teaching program.

Planned teaching program: A formulated and detailed method of information that is arranged and designed on knowledge regarding ill effects of smoking which is administered to the high school students and evaluated to asses its effectiveness.

8 | P a g e 6.8 CONCEPTIONAL/ THEORECTICAL FRAME WORK

Ludwing von bertlandflyl system”s theory is used for this study.

The present study focused on assessing the knowledge of high school students Regarding ill effects of smoking. Conceptual model of the present study is based on Ludwing Von bertlanfly’s system theory. This model consists of three phases input, throughput (process) and output.

6.9 DELIMITATION

 The study is limited only to high school students.  This study will be limited only for 4-6 weeks.  Study is limited to only for 60 samples,.

6.10 REVIEW OF LITERATURE

9 | P a g e INTRODUCTION

Researchers often undertake a literature review to familiarize them with that knowledge base. The review of literature in a research report is a summary of current knowledge about a particular problem and includes what is known and not known about the problem. The literature id reviewed to summarize knowledge for use in practice or to provide a basis for conducting study.

The content of the literature is presented under the following headings.  Knowledge of high school students regarding ill effects of smoking  Incidence and prevalence of smoking habits among high school students  Effectiveness of planned teaching program or guide among high school students regarding ill effects of smoking.

KNOWLEDGE OF HIGH SCHOOL STUDENT’S REGARDING ILL EFFECTS OF SMOKING. . A study was conducted to obtain base line knowledge in early grade school children about the ill effects of smoking by Bayous College of medicine, Houston Texas. A 10-point questionnaire was administered to 4161 children of 1st, 2nd & 3rd grades in corpus Christie Texas. The overall base line knowledge of all grades about ill effects of smoking, its addictive nature, and the effects of passive was good. The current responses for all grades ranged from 81%-97%. There was statistically significant higher knowledge

rd st nd among 3 graders compared to 1 & 2 graders.5

A study was conducted to estimate the knowledge regarding adverse effects of smoking use among high school students of West Bengal, India from June 1st 2003 to May 31st 2004. An anonymous self-administered pre-tested dose ended questionnaire was designed by adopting the questioner developed by WHO. The study population comprised

10 | P a g e of 4.16 students of both urban and rural schools. A majority of urban and rural users were aware of harmful effects of tobacco use.6

A study was conducted to assess the level of knowledge about the health effects of smoking by Asia province of South-western Saudi Arabia among secondary school adolescence. The student’s age ranged from 14-19 years. A modified Arabic version of WHO slandered questionnaire was applied. (11 point true or false question’s.). The overall level of current knowledge among the students after study was 61.9% & 65.5% respectively.5

INCIDENCE AND PREVALENCE OF SMOKING HABITS AMONG HIGH SCHOOL STUDENTS

A study was carried out to ascertain the prevalence of smoking among high school students in Alkhraj. This study was carried out by means of a questionnaire and department of family and community medicine in Alkhraj military hospital, kingdom of Saudi Arabia, conducted it. The participants were students of age 15 years and above in randomly selected Alkhraj high schools. Results: - out of 819, correspondence 166(20%) were current smokers, 134(16%) were ex-smokers. 519(64%) were non-smokers. The average starting age low current smokers was 13.8 years (13-15years). 105 (63%) of current smoked less than 10 cigarettes per day.10 A study was conducted by university of Philippines- Philippine general hospital, Manilai, Philippines to determine the prevalence of smoking among high school students in a tobacco-producing region. A 15 self administered questionnaire were distributed to students from randomly selected public high schools. Survey results included a total of 2714 student response with age range 10-20 years. Overall 31.6% of students in a tobacco- producing region have tried smoking; 22.8% are current smokers.6

A study was conducted to assess second hand smoke exposures (SHS) among middle and high school students in Texas. The Texas department of health (TDH) analyzed data from 2001 Texas youth tobacco survey (TYTS). All the students in the

11 | P a g e selected classes completed an anonymous self-administered questionnaire. A total of 17383 students from 192 schools participated in the 2001 TYTS. During 2001 the prevalence of SHS exposure increases with 50.6% of middle school students compared with 65.8% of high school students.8

EFFECTIVENESS OF PLANNED TEACHING PROGRAMME OR GUIDE AMONG HIGH SCHOOL STUDENT’S REGARDING ILL EFFECTS OF SMOKING.

A study was conducted by Baglog College of medicine, Houston, Texas about the knowledge of high school students regarding ill- effects of smoking. Following this survey through smoking prevention program antismoking measures was delivered to these children through a cartooned movie and come back involving lovable and depicting the ill effects if smoking.8

A study was conducted by Asia provinces of South Western Saudi Arabia to assess the impacts of short term anti smoking education program implemented in selected schools. The program was conducted one whole school day. The educational content was based on the recommendations in the medical literature. Teaching method included lecture group discussion poetry. Roll play, and exhibition in addition to the use of ex-smokers as models9

7.0 MATERIALS AND METHODS OF DATACOLLECTION

7.1 SIGNIFICANCE OF THE STUDY

The study helps to estimate the level of knowledge regarding ill effects of smoking among high school students and become awareness of its complication after the administration of planned teaching program.

7.2 SOURCE OF DATA

The data will be collected from the high school students in selected government high school at Mysore district 12 | P a g e 7.3 RESEARCH DESIGN

Quasi experimental one group pre test and post test design adopted for this study.

7.4 METHOD OF DATA COLLECTION Level-1;- Pre-test knowledge of high school students will be assessed using structured interview schedule .

Level-2;-Planned teaching program is administered to improve the knowledge of high school students.

Level-3;-After a week of planned teaching program post test will be conducted to evaluate the the effectiveness planned teaching program.

TOOLS OF DATA COLLECTION

Tools of data collection consist of 2 parts Part A: Demographic variables- name, age, education, medium studying, language spoken, type of family, education of the parents, and income of family per month, habits and area of residence.

Part B: Contains of questioner related to knowledge on ill effects of smoking.

7.6 SAMPLING PROCEDURE

7.6.1CRITERIA OF SAMPLE The study sample was selected keeping the following pre-determined criteria.

1. INCLUSION CRITERIA  High school students who are present at the time of study.  High school students who can speak Kannada and English  High school students who are studying in 8th, 9th, 10th std.

2 EXCLUSION CRITERIA:- . Students who are not willing to participate in the study, 13 | P a g e . Students who are absent at the time of study.

7.6.2 POPULATION In the present study the population is all government high school students.

7.6.3 SAMPLE The present study comprise of high school students in selected high schools at Mysore district. Who fulfill its inclusion and exclusion criteria.

7.6.4 SAMPLE SIZE 60 high school students of selected government high school students

7.6.5 SAMPLING TECHNIQUE Convenient sampling technique used for the present study.

7.6.6 SETTING OF THE STUDY Selected government high schools at Mysore

7.6.7 PILOT STUDY Pilot study was conducted to assess the feasibility of the tool. A study design at selected high schools at Mysore district.10% of the samples will be selected for pilot study.

7.7 VARIABLES

Independent Variables:- planned teaching program on ill effects of smoking. Dependent Variables:- knowledge of the high school students.

14 | P a g e 7.7 PLANS FOR DATA ANALYSIS

 Frequency, mean, median, standard deviation and range of knowledge of high school students regarding ill effects of smoking.  The chi-square to find out the association between knowledge with their personal variables viz; name, age, education, medium studying, language spoken, type of family, education of the parents, and income of family per month, habits and area of residence.

7.8 PROJECTED OUTCOME

The findings of the study will help to high school students to know about ill effects of smoking and prevent the complication and develop as a good adult.

7.9 ETHICAL CONCENTRATION  Has ethical clearance been obtained from your institution. Yes.

8.0 LIST OF REFERESENCES

1. Ill effect of smoking : a brief history,[online].available from;URL; http;//en.wikipedia.org/wiki/tobacco-smoking.

15 | P a g e 2. Study on knowledge regarding ill effect smoking of high school students,[online] from;URL www.healthypinoy.com/health/articles/

3. Ill effect of smoking .available from;URL. www.cdc.gov/mmwr/preview/mmwrhtml/mm5 4. Park k preventive and Social Medicine.18th edition.Jablpur;M/s Banarsidas publishers:2005 .pg no;430 5. Ill effect of high school students,[online] from;URL http;//www.openlibrary.org/books/OL16743850M/Mer . 6. . Study on knowledge regarding ill effect smoking of high school students,[online] from;URL a. www.cancer.gov/cancertopics/tobacco/s

7. . Ill effect smoking of high school students,[online] from;URL medind.nic.in/iaj/t08/i3/iajt08i3p207

8. Ill effect smoking of high school students,[online] from;URL www.pgh.gov.ph/departments/medicine

9. smoking habits ,[online] from;URL www.globalresearch.ca/index.php%3Fcon

10. ,Teaching program [online] from;URL www.libraryinstruction.com/confusion

11. Loretta e heliogerken ; “Teaching and learning schools of nursing”; 3rd edtion lipincott publishers ,2005 ,page no-258

12. Henry kl,SlaterMD, sp effectof anti smoking programme.journasl of americamn academy of child and adolocent2008sep(9) ,[online] from;URL freehosting.tomaweb.com/quitsmoking/s .

16 | P a g e 9 Signature of the candidate

10 Remarks of the guide

11 Name & Designation of (In Block Letters)

Signature

Co-Guide (If any)

Signature

Head of Department

Signature

12 12.1 Remarks of the Chairman & Principal

12.2 Signature

17 | P a g e 9 Signature of the candidate

10 Remarks of the guide

11 Name & Designation of (In Block Letters)

Signature

Co-Guide (If any)

Signature

Head of Department

Signature

12 12.1 Remarks of the Chairman & Principal

12.2 Signature

18 | P a g e 19 | P a g e