CHAPTER ONE

INTRODUCTION

1.1 Background

Tobacco is the most important preventable cause of disease burden and death all over the world. Apart from being the single most important determinant of cancer and cardiovascular diseases,  Tobacco smoking remains a serious threat to global health, killing nearly 6 million people each year and causing excessive health-care costs and lost productivity World Health Organization (WHO,  2015)  About 80 % of the more than one billion smokers world widesssss live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest (WHO,2015), A recent study on projection of tobacco use predicted a worsening of tobacco epidemics in countries of Africa and eastern Mediterranean where health system are fragile (Bilano et al., 2015) Children in schools are in a period of transition between adolescence and adulthood, where behavior is influenced by accelerated changes affecting biological, emotional, cognitive, and social functions. Students are vulnerable to tobacco addiction.( Sreeramareddy et al., 2008) The risk factors for initiation of smoking in young adults or adolescents are as follows, low socioeconomic status, Smoking by parents or guardians and/or lack of parental Pppport or involvement, Use and approval of tobacco by peers and siblings, A perception that tobacco use is the norm, Low academic achievement, Low self-esteem or self-image, Lack of skills to resist influences promoting tobacco use, Exposure to smoking in movies, Accessibility, availability  and cost, Aggressive behavior. Smoking leads to disease and disability and harms nearly every organ of the body. (Atlanta et al.,  2012)

More than 16 million Americans are living with a disease caused by smoking. For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis. Secondhand smoke exposure contributes to approximately 41,000 deaths among nonsmoking adults and 400 deaths in infants each year. Secondhand smoke causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.

World Health Organization estimates that nearly 5.4 million deaths can be attributed to   tobacco usage every year. This figure is likely to increase to 20 million deaths by 2030. Furthermore, nearly three-fourths of these deaths will be occurring in low- and middle-income countries of the world. Thus, tobacco use has become one of the major challenges to public health today. (Gururaj et al., 2007).

Cigar: During the fermentation process for cigar tobacco, high concentrations of cancer-causing nitrosamines are produced. These compounds are released when a cigar is smoked. Nitrosamines are found at higher levels in cigar smoke than in cigarette smoke. Cocaine contains a chemical substance called a benzoylmethylecgonine. It is found in the leaves of the Erythroxylum coca plant, which grows at high altitudes in the Andes Mountains of Peru, Bolivia, and Colombia, The stimulant cocaine hydrochloride crystal is the main psychoactive ingredient in cocaine and it is responsible for producing the cocaine high. Cigarette, In general, e-cigarettes often contain ingredients such as propylene glycol (PG) and glycerol, mixed with concentrated flavors and, optionally, a variable percentage of nicotine. Pipe The main ingredient in these cleaners is sodium hydroxide, commonly known as lye. This substance can decompose most organic matter including grease and hair. Hookah the main ingredient in these cleaners is sodium hydroxide, commonly known as lye. This substance can decompose most organic matter including grease and hair.

1.2 Problem statement

Cigarette smoking remains a major preventable public health problem associated with premature deaths worldwide. Tobacco smoke is incredibly harmful to health. There’s no safe way to smoke. Replacing  cigarette with a cigar, pipe, or hookah won’t help  avoid the health risks .Cigarettes contain about 600 ingredients, many of which can also be found in cigars and hookahs. When these ingredients burn, they generate more than 7,000 chemicals, according to the American Lung Association. Many of those chemicals are poisonous and at least 69 of them are linked to cancer. There are no safe substances in any tobacco products, from acetone and tar to nicotine and carbon monoxide. The substances inhale don’t just affect your lungs. They also affect entire body. Replacing your cigarette with a cigar, pipe, or hookah won’t help avoid the health risks.

I have seen many adolescents in the Molyko community; a student residential area smoking in the open. Is it that they are not aware of the consequences of smoking, thus the need for this study to assess the knowledge and factors influencing the initiation of smoking among adolescents of the Molyko community?

1.3. Rationale

Cigarette smoking constitutes a significant health hazard in college students in Molyko community, youth population and especially male students should be continuously targeted by preventive measures and sensitization campaigns against tobacco use. Parents should be aware on the influence of their smoking behavior on initiation of smoking in their children and should be encouraged to quit smoking.

1.4. Research question

1) What knowledge do adolescent of the Molyko community have on the consequences of smoking?

2) What is the level of smoking among adolescent of the Molyko community?

3) What are the factors that influence initiation of smoking among adolescents of Molyko community?

 1.5. Objectives

 1.5.1. General objectives

To assess the knowledge and factors influencing smoking among adolescents in Molyko community.

 1.5.2. Specific objectives

1) To assess the knowledge of adolescent in the Molyko community on the consequences of smoking.

2) To assess the level of smoking among adolescent in the Molyko community.

3) To identify the factors that influencing smoking among adolescents in Molyko community.