Effectiveness of a Planned Teaching Program on Knowledge of the Negative effects of Nicotine Addiction among Nursing Students –
A Quasi-Experimental Study
K. Gopalakrishnan1, S. Vijayalaskhmi2, Kovi. Poojitha3
*Corresponding Author Email: goldgopal_k@yahoo.com
ABSTRACT:
Background: The tobacco plant and some e-cigarette liquids naturally contain nicotine, a highly addictive substance. Tobacco usage is the second most lethal drug worldwide, with an estimated 5 million deaths from it, and it poses a serious health risk. Objectives: To evaluate the student’s knowledge of the negative effects of nicotine addiction among nursing students and find the association between the pre-test knowledge score of the negative effects of nicotine addiction and the selected demographic variables of Nursing students. Material and Methods: This quasi-experimental study used a one-group pretest and post-test design. Simple random sampling (lottery method) was used to select 50 nursing college students. A structured knowledge questionnaire was used to assess the students' knowledge of the negative effects of nicotine addiction. Results: Study results showed that the pretest poor knowledge score was 30% (n=15) which was reduced to zero in the post-test. The average knowledge score in the pretest was 64% (n=32) which was reduced to 4% (n=2) in the post-test. Most participants scored good knowledge scores in the post-test from 6% (n=3) to 96% (n=48). The average mean knowledge score in the pretest was 13.02±4.70 increasing to 30.40±3.23 in the post-test. The calculated ‘t’ value (t = 58.34) shows a significant difference at p < 0.05 from pre- to post which showed that planned teaching program effectively improved the knowledge score on the negative effects of nicotine addiction among nursing students. Conclusion: Planned teaching program have a considerable impact on students' knowledge level, as demonstrated by the statistical data provided by the study findings.
KEYWORDS: Nicotine addiction, Knowledge, Negative effects, planned teaching programme, Nursing students.
INTRODUCTION:
Tobacco is made from the leaves of various species of nicotine plants. When combined with nicotine, tobacco becomes one of the most abused recreational drugs.1 Nicotine, a naturally occurring stimulant in tobacco, can be poisonous if taken in sufficiently high doses, which is not the amount of nicotine absorbed by tobacco use.2 Nicotine is an addictive substance that makes the user feel alert at first, then relaxed with continued use.1 Products that can be chewed, sucked, smoked, or snuffled are classified as tobacco products if they contain tobacco leaf as a raw material, either fully or partially. Nicotine is the highly addictive psychoactive component found in all of them.2
The tobacco epidemic is one of the worst public health problems the world has ever seen, killing some 6 million people annually. Of the six million deaths, five million are directly related to tobacco usage, while over six hundred thousand are the result of second-hand smoke exposure for non-smokers.3 The WHO defines students, from ages 10 to 19, as the era of human growth and development that occurs after childhood and before maturity. Approximately 80% of smokers reside in low- and middle-income countries where the burden of tobacco use is highest. It is marked by an incredible rate of growth and change that is only surpassed by infancy and marks one of the most significant transitional stages in a man's life.4 Because of their curiosity, media exposure, and peer pressure, they often experiment with various products and harmful behaviors. Today's tobacco users were mostly students when they first developed their habit. It is essential to forbid the sale of tobacco goods to individuals, raise the price of tobacco products through taxation, outlaw tobacco product ads, and keep the surrounding area smoke-free5. Globally, at least 10% of teenagers between the ages of 17 and 20 smoke, however, certain regions have substantially higher rates. There appears to be a decline in certain high-income countries.6
One of the primary risk factors for several chronic illnesses, including cancer, cardiovascular disease, and lung disorders, is tobacco use. Many nations have laws that limit the advertising of tobacco and tobacco products, control who can purchase and use them, and specify where individuals are allowed to smoke7. Tobacco usage is the second most lethal substance worldwide, with an estimated 5 million deaths from it, and it poses a serious risk to one's health. Student cigarette smoking is still a major public health concern because many of them carry on this habit into adulthood 8.
MATERIAL AND METHODS:
A quasi-experimental study with one group pre-test post-test design was used in this study. The sample was students studying in the Global College of Nursing, Bangalore. Simple random sampling technique was used with a random table, fifty (n= 50) B.Sc. Nursing students were selected.
Inclusion criteria:
The study includes,
· Students who volunteered to engage in the study are included in the research.
· Students were present when the data was being collected.
Exclusion criteria:
· People who have previously just attended events like conferences and workshops designed to discourage cigarette smoking.
· Not willing to participate
Instrument used:
Section A: The following demographic information was included: age (in years), religion, place of residence, family type, level of education of the father and mother, occupation of the father and mother, the family's monthly income, a source of knowledge about the negative effects of nicotine dependence, and a family history of smoking.
Section B: Structured knowledge questionnaire about the negative consequences of nicotine addiction (37 items). Each right response received a score of one (1), while every wrong response received a score of zero (0). The structured knowledge questionnaire has a maximum score of 37.
The various knowledge levels are divided into the following categories.
Good (26 – 37)
Average (14 – 25)
Poor (0 – 13)
Validity of the tool:
The investigator prepared the instrument based on the literature review, Professionals in Nursing and Medicine then validated the instrument, and changes were made based on their recommendations.
Reliability of the tool:
The split-half approach was used to test the reliability of the tool. The reliability obtained was 0.94.
Data collection procedure:
Formal permission was obtained from the head of the institution and the principal of Global College of Nursing, Bangalore. The investigator built a rapport with the nursing college students by introducing her to them. The study employed one group pre-test and post-test control group design. Fifty students (n=50) were chosen using a simple random sampling technique using random table. The samples were appropriately briefed about the study's purpose, the questionnaire's format, and the steps taken to protect their identity and confidentiality. A structured knowledge questionnaire comprising multiple-choice questions was used to administer the pre-test. Each sample was given a 30-minute time window for the pre-test. Following the conclusion of the pre-test, the investigator used an LCD to conduct a 30- to 45-minute planned teaching program on information about the negative effects of nicotine dependence. This information included broad facts about the components of nicotine, the negative effects of each system on the body, and smoking cessation advice. After a week, post-test was conducted by the investigator using the same knowledge questionnaire.
RESULTS:
Table 1. Distribution of samples based on their demographic variables (N=50)
|
S. No |
Demographic variables |
n (%) |
|
1. |
Age (in years) a)18 b)19 c)20 d)21 and above |
15(20.3) 23(31.1) 10 (13.5) 2 (2.7) |
|
2. |
Religion a) Hindu b) Christian c) Muslim |
23 (31.1) 26 (35.1) 1 (1.4) |
|
3. |
Type of family a) Joint b) Nuclear |
20 (27) 30 (40.5) |
|
4. |
Area of Residence a) Rural b) Urban c)Semi Urban |
16 (21.6) 15 (20.3) 19 (25.7) |
|
5. |
Father’s educational status a) Primary b) Secondary c)Diploma/Graduate |
6 (8.1) 34 (45.1) 10 (13.5) |
|
6. |
Mother’s educational status a) Primary b) Secondary c)Diploma/Graduate |
4(5.4) 33(44.6) 13(17.6) |
|
7. |
Father’s occupation a) Unemployed b) Daily wages c) Self-employed d) Government employee |
2(2.7) 10(27) 22(29.7) 6(8.1) |
|
8. |
Mother’s occupation a) Homemaker b) Daily wages c) Self-employed d) Government employee |
31(41.9) 6 (8.1) 9 (12.2) 4 (5.4) |
|
9. |
Monthly income a) 5000– 10000 b) 10001– 15000 c) 15001– 20000 d) Above 20001 |
9 (12.2) 13 (17.6) 7 (9.5) 21 (28.4) |
|
10. |
Family history of Smoking a) Yes b) No |
11 (14.9) 39 (52.7) |
|
11. |
Source of information a) Health personnel b) Parents/Friends c) Mass media d) No information |
6 (8.1) 17 (23) 25 (33.8) 2 (2.7) |
Note: Data presented is the frequency with the percentage in parenthesis
Table 2. Comparison of pre and post-test knowledge scores on the negative consequences of nicotine addiction among Nursing students (N=50)
|
Knowledge level |
Pre-test n (%) |
Post-test n (%) |
Mean ± SD |
‘t’ Value |
p value |
|
|
Pre-test |
Post-test |
|||||
|
Poor (0 – 13) Average (14– 25) Good (26 – 37) |
15(30) 32 (64) 3 (6) |
0 (0) 2(4) 48 (96) |
13.02±02 |
30.4± 3.23 |
5.34 |
0.001* |
Note: * Significant at p<0.05
Table 3. Association between the pre-test knowledge score of the negative effects of nicotine addiction and the selected demographic variables of nursing students. (N=50)
|
S. No |
Demographic Variables |
Level of knowledge |
Chi-Square (χ2) Value |
Sig |
|
|
Above Mean (13) |
Below Mean (13) |
||||
|
1. |
Age (in years) a) 18 b) 19 c) 20 d)21 and above |
15 23 10 2 |
20.3 31.1 13.5 2.7 |
0.812 |
NS |
|
2. |
Religion a) Hindu b) Christian c) Muslim |
23 26 1 |
31.1 35.5 1.4 |
0.543 |
NS |
|
3. |
Type of family a) Joint b) Nuclear |
20 30 |
27 40.5 |
0.678 |
NS |
|
4. |
Area of Residence a) Rural b) Urban c) Semi Urban |
16 15 19 |
21.6 20.3 25.7 |
0.407 |
NS |
|
5. |
Father’s educational status a) Primary b) Secondary c) Diploma/Graduate |
6 34 10 |
8.1 45.1 13.5 |
0.373 |
NS |
|
6. |
Mother’s educational status a) Primary b) Secondary c) Diploma/Graduate |
4 33 13 |
5.4 44.6 17.6 |
0.941 |
NS |
|
7. |
Father’s occupation a) Unemployed b) Daily wages c) Self-employed d)Government employee |
2 10 22 6 |
2.7 27 29.7 8.1 |
0.815 |
NS |
|
8. |
Mother’s occupation a) Homemaker b) Daily wages c) Self-employed d)Government employee |
31 6 9 4 |
41.9 8.1 12.2 5.4 |
0.031 |
NS |
|
9. |
Monthly income a) 5000– 10000 b) 10001– 15000 c) 15001– 20000 d) Above 20001 |
9 13 7 21 |
12.2 1.6 9.5 28.4 |
0.606 |
NS |
|
10. |
Family history of Smoking a) a) Yes b) b) No |
11 39 |
14.9 52.7 |
0.313 |
NS |
|
11. |
Source of information c) a) Health personnel d) b) Parents/Friends e) c) Mass media d)No information |
6 17 25 2 |
8.1 23 33.8 2 |
0.395 |
NS |
Note: NS- Not significant, Chi-square (χ)2 test is used to assess the association between knowledge scores and the selected demographic variables.
DISCUSSION:
The study attempted to investigate the effectiveness of planned teaching program on knowledge of the negative effects of nicotine addiction among nursing students. The average mean knowledge score in the pretest was 13.02±4.70 increasing to 30.40±3.23 in the post-test. It shows that the knowledge level of students was less before the teaching program. The findings from Dr. Prabhat et al., (2010), supported the study findings that more than 30 percent of men and five percent of women aged 30-69 smoke either regular cigarettes or "bidis," small, cheaply made versions containing about one-fourth the amount of tobacco. Substantial hazards were found among both educated and illiterate adults in both urban and rural areas. However, smoking-related deaths are mainly caused by TB in rural areas, while in urban areas deaths are often linked to heart attacks. The study also found smokers in India have twice the cancer rate of non-smokers.9,10 The calculated ‘t’ value (t = 58.34) shows a significant difference at p < 0.05 from pre- to post which showed the planned teaching program effectively improved the knowledge score on the negative effects of nicotine addiction among nursing students. As a result, the study hypothesis (H1) was accepted. A similar study results by David (2014) found that relationship between the initial smoking characteristics of participants, acceptance, retention, and result of a school-based smoking cessation program, and individual differences in impulsivity and emotional disorders in adolescent smokers. A pre-post test design with one group was implemented. The information came from a youth-specific, cognitive-behavioural, and motivation-boosting program that was tested in 22 schools in Germany with 139 adolescent smokers who participated. Regarding impulsive and emotional issues, acceptance and retention were similar, but initial smoking status was not. Intervention rates for less impulsive smokers showed varying cessation rates. Despite receiving a generally high review, impulsive students appear to derive less benefit from smoking cessation programs compared to their non-impulsive peers.11,12
The present study findings showed no significant association between the knowledge score and the selected demographic variables of nursing students. Thus, the knowledge of the negative effects of nicotine addiction among nursing students was not related to their socio-demographic variables. So, schools and colleges insisted on conducting smoking cessation programs for students. The support for these four junior high schools in Taiwan chose 469 seventh- to ninth-grade students, dividing them into three groups based on class units using a pre-test-post-test approach. A six-session smoking prevention education and a school-wide no-smoking policy were implemented for the experimental group A. The only policy that Experimental Group B encountered was the school-wide ban on smoking. There was no intervention in the control group. A week before the intervention started and a week after it concluded, the pupils took tests. Compared to experimental group B and the control group, experimental group A showed a superior comprehension of the risks associated with smoking and strategies for quitting. Group A showed less intention to below smoke than experimental group B. Compared to the control group, experimental group A also exhibited a more positive attitude toward quitting smoking. The study concluded that to lower the smoking rates among junior high school students, diverse school-wide no-smoking policies and standardized, varied measures should be implemented. This will allow for a more effective and objective evaluation of the results of smoking prevention efforts13-17.
CONCLUSION:
Planned teaching programs have a considerable impact on students' knowledge levels, as demonstrated by the statistical data provided by the study findings.
REFERENCES:
1. Alexander C. Peers, Schools, and adolescent cigarette smoking. Journal of Adolescent Health. 2001; 29 (1): 22-30. Retrieved from: http://www.jahonline.org/article
2. Basavanthappa BT. Nursing Research. Jaypee Brothers Medical Publish (P) Ltd. 2007.
3. Backinger CL. Improving the future of youth smoking cessation, American Journal of Health Behaviour, 2003; 27 (2): S 170 – 84.
4. Bhanji S. Factors related to knowledge and perception of women about smoking: a cross-sectional study from a developing country. BMC Women’s Health. 2011; 16. Retrieved from www.biomedcentral.com/1472-6874/11/16
5. Bjartveit K. Health consequences of smoking1-4 cigarettes/day. Tobacco Control. 2005: 315- 20 www.ncbi.nlm.nih.gov/pubmed/16183982
6. Butterfield RM, Emmons KM, Puleo E, Park ER, Mertens A, Gritz ER, et al., Smoking among participants in the childhood cancer survivors cohort: the Partnership for Health Study. J Clin Oncol. 2003; Jan 15; 21(2): 189-96. doi: 10.1200/JCO.2003.06.130. PMID: 12525509.
7. Campaign for tobacco-free kids web site. The path to smoking addiction starts at very young ages Washigton. 2009. http://www.rwjf.org/files/research/72051.tobaccocampaigns.050311.pdf12
8. Cogliano VJ, Baan R, Straif K, Grosse Y, Lauby-Secretan B, El Ghissassi F, et al., Preventable exposures associated with human cancers. J Natl Cancer Inst. 2011 Dec 21;103(24):1827-39. doi: 10.1093/jnci/djr483. Epub 2011 Dec 12. PMID: 22158127; PMCID: PMC3243677.
9. Crisis in India. Smoking expected to kill one million people annually by 2010, Retrieved from: URL: http://environment.about.com
10. Elakuvana D and Bhaskhara Raj. DEBR’S Psychiatric Nursing. 2014; 1stedition, Bangalore: EMMESS Publishers.
11. David J, Lang IA, Langa KM, Naughton F, Matthews FE. Exposure to second hand smoke and cognitive impairment in non-smokers: A national cross sectional study with cotinine measurement. BMJ. 2009 Feb 12; 338: b462. doi: 10.1136/bmj.b462. PMID: 19213767; PMCID: PMC2643443.
12. Dockrell M. E-cigarettes: Prevalence and attitudes in Great Britain. Nicotine and Tobacco Research. 2013. Retrieved from: http://www.cesar.umd.edu/tobacco.asp
13. Doull J. List of ingredients added to tobacco in the manufacture of cigarettes by 6 major American Cigarette Companies. Retrieved from: http://www.the freedictionary.com/ill
14. Edward A, Wenten M, Berhane K, Rappaport EB, Avol E, Tsai WW, et al., TNF-308 modifies the effect of second-hand smoke on respiratory illness-related school absences. Am J Respir Crit Care Med. 2005 Dec 15;172(12):1563-8. doi: 10.1164/rccm.200503-490OC.
15. Forastiere F, Lo Presti E, Agabiti N, Rapiti E, Perucci CA. Health impact of exposure to environmental tobacco smoke in Italy: 2009. Jan-Feb; 26(1): 18-29. PMID: 11942141.
16. Gandini S. Tobacco smoking and cancer: meta-analysis International Journal of Cancer: 2008. Retrieved from http ://www.cancer.gov/cancer
17. Gaviermallol. Effects of active tobacco smoking on the prevalence of asthma-like symptoms in students. International Journal of Chronic Obstructive Pulmonary Disease. 2007; Mar; 2(1): 65-69.
|
Received on 15.10.2024 Revised on 25.11.2024 Accepted on 27.12.2024 Published on 24.02.2025 Available online from March 17, 2025 Asian J. Nursing Education and Research. 2025;15(1):58-62. DOI: 10.52711/2349-2996.2025.00013 ©A and V Publications All right reserved
|
|
|
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License. |
|