Knowledge of Mothers on the effect of Passive Smoking in Children in a selected Hospital at Mangalore

Mrs. Sandra Jyothi Saldanha¹*, Mrs. Priya Janifer Fernandes¹, Eva Maria Antony²,

Bashisha Manar², Jaisha Jai², Elizabeth Johns², Susan Eapen²

¹Lecturer, Father Muller College of Nursing, Mangalore

²Student, Father Muller College of Nursing, Mangalore

*Corresponding Author Email: sanjyothsal28@gmail.com

ABSTRACT:

Parents have the ability, with a little diligence and understanding to ensure optimum health for the children.¹ Cigarette smoking has caused more bodily harm than all the wars of recorded history combined together. Indirect exposure, also referred to as passive smoking, or involuntary smoking, or side stream smoke has been realized as a source of indoor air pollution that can harm non- smokers. There have been several studies confined to the effects of parental smoking on their children’ health. These studies revealed that children of smoking parents have increased incidence of upper respiratory tract infections.²

Strategies to prevent children’ involuntary exposure to tobacco smoke fall into two general groups: a primary focus on eliminating children’ contact with the tobacco smoke of others, and secondary benefits from reducing the prevalence and consumption of tobacco products. Protecting children from tobacco smoke is essential to comprehensive tobacco control, which includes preventing the initiation of smoking, eliminating involuntary exposure to tobacco smoke, and supporting smoking cessation.³

The aim of the present study was to determine the level of knowledge of mothers on the effects of passive smoking in children. ARTICLE IN PRESS

Methods:

A descriptive approach was adopted for this study. The sample consisted of 100 mothers who were selected by purposive sampling technique.

Results:

Majority of the mothers (70%) had good knowledge, 28% had average knowledge, 1% had excellent knowledge and 1% had poor knowledge regarding effects of passive smoking in children.

There was a significant association found between the knowledge and occupation of the mothers at p˂ 0.05 level of significance.

Interpretation and Conclusion:

The findings of the study have shown that the knowledge level of mothers was good (70%). The awareness campaigns and public awareness programs help in building knowledge; although ongoing programs and reinforcement about complications and dangers should be undertaken to sustain the knowledge and awareness among the mothers.

KEYWORDS: Parents, Ill effects, Passive smoking, Children.

INTRODUCTION:

Tobacco smoke contains many chemicals that are harmful to both smokers and non smokers. Breathing even a little tobacco smoke can be harmful. Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide and ammonia. Secondhand smoke is the combination of side stream smoke and mainstream smoke. Secondhand smoke causes diseases and premature death in non smoking adults and children.⁴

Successfully eliminating children’ involuntary exposure to tobacco smoke requires a comprehensive health promotion effort with two main thrusts: legislation and education. Legislation encompasses all regulatory approaches to controlling where and when people can smoke. Education includes public information, debate, and advocacy, all designed to encourage behavior change. ³

According to Indian Journal of Public Health published in 2011, exposure to Second Hand Smoke (SHS) causes an estimated 5% of the global burden of disease (lung cancer), slightly higher than the burden from direct use of tobacco. Studies reveal that a large number of children are exposed to the risk of SHS. A recent survey indicated that 43% of the children in the two months-11 year age group live in homes with at least one smoker. SHS is lethal because it has at least twice the nicotine amount and tar as the smoke inhaled by the smoker; five times the amount of carbon monoxide; higher levels of ammonia and cadmium; contains hydrogen cyanide, a toxic poisonous gas and nitrogen dioxide which are very harmful. Passive smoking increases the risk of death, disease and disability. It may lead to lung cancer, heart disease, miscarriage and birth defects, sudden infant death syndrome, asthma in children and adults, ear infections, coughing and wheezing, sore throat, eye inflammation, runny nose, nausea and vomiting, headache, lung ailments such as bronchitis, lung infections, pneumonia and other diseases of the respiratory system.⁵

A study was conducted regarding the risk of passive smoking in under five childrens from January to May 2005 in Surat, Mumbai. The study areas were selected by the technique of two-stage sampling. Thus, an urban slum (Morarji Vasahat) and Middle-income group (Harinagar-3) areas were selected. The information was collected by house to house survey using interview technique from 400 families with 300 households from urban slum and 300 households from Middle Income Group area were surveyed. In this study, 788 children of under five age group were assessed to find out the risk of passive smoking. The result of the study was almost equal U 5 boys 21.6 % in urban slum area and 20.8% in MIG area were found at risk of passive smoking (2nd hand smoke). In the same way 24.8% U 5 girls in urban slum and 26.7 % in MIG area were at risk of passive smoking .One-third (37.4) U 5 children were exposed to the risk of passive smoking in urban slum area and (28.6%) in MIG area where mother were illiterate. Decrease in proportion of risk to passive smoking to U 5 children was observed in both study areas with risk in the educational status of mother. Near about one fourth children were found at risk of passive smoking in urban slum area belonged to socio-economic class I, III and IV where as I and II in MIG area. And it is concluded that the impact of educational status of father was variable over the risk of passive smoking among under five children in urban slum area. ⁶

OBJECTIVES:

1. To assess the level of knowledge among mothers on the effect of passive smoking in children.

2. To find association between the knowledge of mothers on the effects of passive smoking in children with selected baseline variables.

MATERIAL AND METHODS:

Research approach:

The research approach used for the study is descriptive survey approach.

Research design:

The study design used for this study was descriptive research design.

Sample:

The sample for the present study comprised of 100 mothers who have children between the age group of 0-15 years attending Father Muller Medical College Hospital in Mangalore.

Sampling technique used was purposive sampling.

Description of the tool:

Section 1: Baseline proforma:

Baseline data consists of 12 items seeking information about age, education, occupation, family, monthly income, number of children and their education, history of smoking in the family and their relation to the child and previous knowledge about passive smoking, age of the child and sources of previous information.

Section 2: Structured questionnaire:

Tool B consists of 15 questions related to general information of passive smoking and active smoking, its side effects and prevention of passive smoking.

Criteria for knowledge scores:

Poor - 0-32% (0-4)

Average– 33-59% (5-8)

Good- 60-85% (9-12)

Excellent- 86-100% (13-15)

Validity and Reliability of the tool:

Validity of the tool was assessed by obtaining opinion from 7 experts which include 1 doctor and 6 nurse educators.

The reliability of the tool was established by using split half method and the correlation coefficient value was r=+0.7.

Data collection procedure:

A prior written permission was obtained from the administrator of the hospital for study. Data collection was done from 24/06/2015 to 30/6/2015. After self-introduction and explaining the purpose and objectives of the study, informed written consent from the mothers was obtained for the study. Structured questionnaire was administered and approximately 10-15 minutes were taken by them to answer the questions and complete it.

RESULTS:

Section A: Distribution of subjects according to baseline proforma.

Table 1: Frequency and percentage distribution of subjects according to baseline proforma N=100

S. No.

Variable

Frequency

Percentage

Age

≤25

26-35

>35

Occupation

Beedi rolling

Coolie

Fisherwoman

Housewife

Laborer

Salesgirl

Teacher

Family

Extended

Joint

Nuclear

No of children

No. of smoker

Present

Absent

Previous Knowledge

Present

Absent

Sources of information

Club

Education

Health care providers

Media

Newspaper

Nil

Others

School

Television

S. No.

Variable

Frequency

Percentage

Income

<5000

5000-10000

>10000

Mother’s education

Degree

High school

Higher secondary school

Lower primary

Nil

Post graduate

Upper primary

Child’s age

0-5 yrs

11-15 yrs

6-10 yrs

Child’s education

High school

Kinder garden

Lower primary

Upper primary

Nil

Relationship with the smokers

Father

Grandfather

Nil

Uncle

Section B: Distribution of mothers according to the level of knowledge regarding the effects of passive smoking in children.

Figure 1: Bar diagram showing the distribution of subjects according to their knowledge level.

Figure 1 depicts that most of the subjects, 70% had good knowledge,28% had average, 1% had excellent and remaining 1% had poor knowledge on effects of passive smoking in children.

Section C : Association between the knowledge of mothers with selected baseline variables.

Table 2: Association between the knowledge of mothers with selected baseline variables using chi square test. N=100

S. No

Variable

Knowledge Score

Χ²Value

value

Median ˂10

Median ˃10

Age

<=25

26-35

>35

5.633

0.06

Smokers In Family

Present

Absent

1.200

0.273

Previous Knowledge

present

Absent

3.319

0.068

Age of Child

0-5 years

6-10 years

11-15 years

3.62

0.164

Table 4: Association between the knowledge of mothers with selected baseline variables using Fisher’s exact test N=100

Variable

Knowledge Score

Fisher’s ExactValue

P value

Median ˂10

Median ˃10

Mother’s education

Degree

High school

HSS

Lower Primary

Nil

Post Graduate

Upper Primary

6.819

0.288

Occupation

Beedi rolling

Coolie

Fisherwomen

Housewife

Laborer

Labourer

Salesgirl

Teacher

11.274

0.011*

Type of family

Extended

Joint

Nuclear

3.509

0.173

No. of children

1.2

0.273

Sources of information

Clubs

Education

Heath Education

Media

Newspaper

Nil

Others

School

Television

12.051

0.283

Childs Education

High School

Kinder garden

Lower primary

Nil

Upper primary

6.2

0.182

Variable

Knowledge Score

Fisher’s ExactValue

P value

Median ˂10

Median ˃10

Relationship With The Smokers

Father

Grand Father

Nil

Uncle

3.435

0.294

Monthly Income

<5000

5000-10000

>10000

0.421

0.900

*significant p <0.05

The data presented in above table shows that there is significant association between knowledge and occupation of mothers ( p=0.01) which shows mothers being housewife have good knowledge.