PATTERNS OF SMOKING AND HEALTH RISK PERCEPTION OF OUT-OF-SCHOOL YOUTHS

1.1 Introduction

Smoking can be defined as burning of tobacco substance via cigarette and then the smoke of tobacco is inhaled, tested and taking puff through mouth. Cigarette smoking will be accountable for many of the heart, brain and lungs related disease due to which multiple morbidity and mortality of the smokers occurs (Akram et al., 2014). Smoking is one of the most treatable health hazards for the smokers and for passive smokers also which can be preventable .smoking behavior is developing day by day in young generation and the attitude of students towards smoking is changed, most of the students believed that smoking may add a positive attributes in their personality instead of having enough knowledge that smoking cause serious diseases (Oort, 2006).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

1.2 Background of Study

The impact of smoking and tobacco use on health cannot be over emphasized. Cigarette smoking remains a gigantic public health problem and is still regarded as one of the leading preventable causes of morbidity and mortality worldwide (Can et al., 2009; Mpabulungi & Muula, 2004; Salawu et al., 2009; World health Organisation, 2015). It is well-known that many smokers start before the age of 18 years, however, it is of great interest to know that the increasing trend in smoking prevalence amongst youths and the likelihood that many of these young people who begin to smoke at an early age, will continue to do so throughout adulthood (Adebiyi et al., 2010).

According to Sharif (2012), smoking is the leading health hazards and causes of deaths in all over the world which can be preventable if sufficient steps were taken for the prevention and ban smoking in universities and colleges. Smoking is the single most preventable reason for death worldwide, tobacco utilization result in the death of millions of people every year. And if current patterns continue, the deaths from tobacco will be increase to more than 8 Million if current situation continue by the 2030 with the majority of the tobacco-related morbidity and mortality happening disproportionately in low and middle income countries.

Although tobacco use has declined in many high income countries such as the United States and United Kingdom, it is increasing in many low and middle income countries (Boutayeb & Boutayeb, 2005; Warren, Jones, Eriksen & Asma, 2006) and in current situation, tobacco smoking is by far the most popular form of smoking and is practiced by over one billion people in the majority of all human societies (Akinpelu, 2015). Tobacco is the most common hazardous substance and this is aided by its legally availability, heavy promotion and wide consumption and has been revealed to be problematic including other forms of use other than cigarettes, which is on the rise among adolescents in many countries, and is likely to jeopardize progress in reducing chronic diseases and tobacco-related mortality (CDC, 2010; Warren et al., 2006).

The constant increase in the consumption of tobacco among adolescents is emerging as a complex and multidimensional problem (Soni & Raut, 2012). Melgosa (2006) rightly considers tobacco as a drug with the lowest risk, in the short term but one which takes away health and life from the greatest number of people in the long term.

Cigarette smoking is said to be responsible for over 25 diseases in humans some of which include: ischemic heart disease, chronic bronchitis and cancers of the lung, oral cavity, urinary bladder, pancreas, and larynx (Desalu et al., 2008). Over the past four decades, tobacco use has caused an estimated 12 million deaths in the world, including 4.1 million deaths from cancer, 5.5 million deaths from cardiovascular diseases, 2.1 million deaths from respiratory diseases and 94,000 infant deaths related to mothers smoking during pregnancy (WHO, 2009; Centers for Disease Control and Prevention, 2002; Ekrakene & Igeleke, 2010) and on average cigarette smokers lose about 15 years of their life (The global tobacco survey collaborative group, 2002; Raji et al., 2013).

It is estimated that number of deaths due to tobacco will increase from 3 million per year worldwide to 70 million per year by 2025 (Reddy & Arora, 2005; US Department of Health and Human Services, 2012). It has been said that adolescents are especially vulnerable to these effects and may be more likely than adults to develop an addiction to tobacco (Chakraborty, 2009). In addition, it has been predicted that if the pattern currently seen among youth continues, a lifetime of tobacco use would result in the deaths of 250 million children and young people alive today, most of them in developing countries (WHO, 2012).

Like other developing countries, the most susceptible age for initiating tobacco has been found between the ages of 15-24 years as evident in the study by Gboyega, Adesegun and Chikezie (2013) identifying youths as a major group involved in smoking over the last two decades, an age group where most are expected to be in school. For the past 30 years, smoking prevention programmes have been focused almost exclusively upon youth, mainly within the school setting (Backinger, 2003; Ekanem, 2008; Salawu, Danburam & Isa, 2010; Fawibe & Shittu, 2011; Hammond, 2005; Nwafor, Ibe & Aguwa, 2012; Odukoya et al., 2013; Okagua, Opara & Alex-Hart, 2015) despite School dropouts being more likely to smoke heavily than students (Aloise-Young, Cruickshank & Chavez, 2002). In Nigeria, the prevalence of tobacco use among youth tends to be higher than among adults (Odukoya et al., 2013).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Patterns of Smoking and Health Risk Perception of Out-Of-School Youths.

1.3 Statement of Problems

Investigation revealed that smoking among youths has been on an increase worldwide (Pomara et al, 2012) with values ranging from 721 million in 1980 to 967 million in 2012 (Marie, 2013). Studies have revealed that there has been a high increase in the prevalence rate of smoking among youth in sub-Saharan Africa (Shafey, Dolwick & Guindon, 2012) and Nigeria precisely (Drope, 2011; Yahya et al., 2010), with statistics showing that youths form over 40% of the Nigerian population and 18% of the youths smoke, identifying youths as a major group involved in smoking over the last two decades (Gboyega et al., 2013).

Smokers' low perception of the negative effects of their smoking behavior on their health also results in many of them being unwilling to quit smoking with most of them expressing a sense of invincibility to the hazards of smoking (Fawibe & Shittu, 2011). Studies have shown that individuals who perceive fewer risks and greater benefits of smoking are more susceptible to initiation (Song et al., 2009). Literatures have shown that perceptions about health risks influence cigarette smoking among youths (Aryal et al., 2013; Mantler, 2013). Further studies have also shown that each day, more than 3,200 people under 18 smoke their first cigarette, and approximately 2,100 youth and young adults become daily smokers.

Furthermore, studies have indicated that as at 2012 it was noted that death as a result of non-communicable diseases (respiratory tract infection inclusive), accounted for 2.7 million deaths in sub-Saharan Africa with the inclusion of Nigeria as a result of smoking (WHO, 2000-2012). Also literature has shown that nearly 9 out of 10 lung cancers are caused by smoking and smokers today are much more likely to develop lung cancer than smokers were in 1964 (Siegel, Miller, Jemal, 2016).

In Nigeria and worldwide smoking causes many types of cancer, including cancers of the throat, mouth, nasal cavity, esophagus, stomach, pancreas, kidney, bladder, and cervix, as well as acute myeloid leukemia (Jha, Ramasundarahettige & Landsman, 2013). Also studies still shows that 8 out of 10 COPD (Chronic Obstructive Pulmonary Disease) deaths are a result of smoking and currently, there is no cure for COPD (Madu, Matla, 2014).

In spite of the passage of the National Tobacco Control Bill by the National Assembly in Nigeria, a bill aimed at domesticating WHO Framework Convention on Tobacco Control (FCTC) to avert the unimaginable disaster associated with smoking many youth are still caught in the web of the act, thereby endangering their lives. It will therefore be of immense benefit to investigate Patterns of Smoking and Health Risk Perception of Out-Of-School Youths in selected motor parks in Oshodi local government area of Lagos state, Nigeria.

1.4 Aim and Objectives of Study

The aim of the study is to assess the Patterns of Smoking and Health Risk Perception of Out-Of-School Youths. In achieving this aim, the following specific objectives were laid out as follows:

1. To measure the level of smoking prevalence among respondents;
2. To assess the pattern of smoking among respondents; and
3. To determine if respondents have a good health risk perception of smoking.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Do respondents have a good health risk perception of smoking?
• What is the pattern of smoking among respondents?
• At what level is the prevalence of smoking among respondents?

1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant difference in level of smoking prevalence across the demographic characteristics of respondents.
• H1: There is a significant difference in level of smoking prevalence across the demographic characteristics of respondents.

Hypothesis Two

• H0: There is no significant association between prevalence of smoking and health risk perception of respondents.
• H1: There is a significant association between prevalence of smoking and health risk perception of respondents.

Hypothesis Three

• H0: There is no significant association between prevalence of smoking and health risk knowledge of respondents.
• H1: There is a significant association between prevalence of smoking and health risk knowledge of respondents.

1.7 Significance of Study

This study intends to describe the pattern of smoking and health risk perception amongst a set of youths who are more likely to be overlooked by program planners. The findings will give an insight to the current situation of out of school youth smoking habit with the result aimed at giving recommendations towards health program interventions that will reduce to the simplest minimum the smoking habits among out-of-school youths in Lagos, Nigeria.

Also the results emanating from it would provide adequate guidance and a benchmark for program planners to include these set of youths in smoking prevention intervention programs in Nigeria. This will go a long way to improve the health of youths in Nigeria and by extension people in Sub-Sahara Africa.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

1.8 Scope of Study

The scope of the research is focused on the Patterns of Smoking and Health Risk Perception of Out-Of-School Youths Oshodi local government area of Lagos state, Nigeria.

1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.10 Operational Definition of Terms

Smoking: This is one of the most common forms of recreational drug use.

Out-of-School Youths: They are described as several groups of young people, those who have dropped out of school, those who never attended school, or those who participate in non-formal school programs. These youths are a diverse group who may have completed elementary school (but lack basic skills to progress to high school or vocational training), dropped out or never started school. Those who drop out of school may fail to acquire fundamentals of basic education and life skills (Fatoye, 2013).