Indian Journal of Medical Sciences Medknow Publications on behalf of Indian Journal of Medical Sciences Trust ISSN: 0019-5359 EISSN: 1998-3654 Vol. 57, Num. 10, 2003, pp. 457-458

Indian Journal of Medical Sciences, Volume 57, Number 10, October 2003, pp. 457-458

Letter to editor

Smoking behavior and initiation of smoking among adolescent - A threat to public health

Urban J.A.D'Souza

Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.

E-mail: dsouza@kb.usm.my

Code Number: ms03031

Sir,

Initiation of smoking and behavior among school and college students is a major concern to the society. A recent article on smoking behavior among college students in India has indicated that information on tobacco related health hazards, anti-smoking campaigns and a change in attitude towards smoking are the major ingredients for effective control of smoking.¹ Tobacco marketing, advertisements in association with celebrities, like film stars and sports personalities, have increased the chances of smoking among the adolescents. Similarly, exposure of this group to movies in which smoking is associated with toughness, sexiness and rebelliousness² influence the behavior of these adolescents.

In the United States, 61% of the 12^th -grade students have been found to indulge in smoking. Out of this percentage, 19% have become established smokers. Indicating a decline for a previous high of 65% and 25% respectively.³ In another cross sectional survey conducted in Nairobi, Kenya among 5311 secondary school students with a mean age of 16.7 years, 32.2% of the student population were found to be smokers with a gender distribution of 38.6 % males and 17.9% females.⁴ Similarly, the prevalence and dynamics of smoking habit among University and college students in Japan as well as high school students in USA showed a high percentage of incidence in smoking as the students advance to their senior years.^5,6

A survey of attitudes towards smoking and knowledge among Malaysian college students also showed that the lack of educational intervention regarding the health risk factors of smoking and benefits⁷ have contributed to the increased incidence of smoking. In contrast to this view, a recent study in India has shown that knowledge about the hazards of smoking is not the only deterrent factor but rather anti-smoking campaigns that is focused on changing the attitude of adolescents to smoking. This it is believed will be for an effective control of smoking among this group.¹

Despite knowledge based intervention, global trends seem to indicate an increasing smoking habit among the students. Culminating from the above reasons, can adolescent smoking behavior be blamed on parents, society, peers, advertising agencies, the film industries or government bodies? The answer to this seems to be a redesigning of intervention studies that will take into consideration all these factors that contribute towards smoking behavior. This is more so since a WHO estimated record of tobacco related deaths is about 3 million per year and expected to reach to about 10 million within the next 2 to 3 decades.⁸ It is therefore suggested that banning of cigarette sales, anti-smoking campaigns, inclusion of students in national smoking prevention and cessation programs,⁶ training teachers and parents to build up confidence in children at an early age and curtailing of smoking within families will go a long way to curtail the smoking behavior of the youth especially in the developing countries.

Urban J.A.D'Souza

Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.

E-mail: dsouza@kb.usm.my

REFERENCES

1. Sajjan BS, Chacko J, Asha K. Smoking behavior among arts students of a college in Mangalore, Dakshina Kannada. Indian J Med Sci 2003;57:290-3
2. Dalton MA, Tickle JJ, Sargent JD, Beach ML, Ahrens MB, Heatherton TF. The incidence and context of tobacco use in popular movies from 1988-1997. Prev Med 2002;34:516-23.
3. Johnston LD, O'Malley PM, Bachman JG. Cigarette smoking among American teens declines sharply in 2001. Ann Arbor MI: University of Michigan News and information Services. Available at: www.monitoringthefuture.org. Accessed May 15, 2002.
4. Kwamanga DH, Odhiambo JA, Amukoye EI. Prevalence and risk factors of smoking among secondary school students in Nairobi. East Afr Med J 2003:4:207-12.
5. Kitamura T, Kawamura T, Aono M, Takemoto K, Ando M, Okado T, Takahashi Y. Multiphasic epidemiological analyses on smoking habits among undergraduate students in Japan. Asian Pac J Cancer Prev 2003;4:141-5.
6. Choi WS, Harris KJ, Okuyemi K, Ahluwalia JS. Predictors of smoking initiation among college-bound high school students. Ann Behav Med 2003;26:69-74.
7. Kurtz ME, Johnson SM, Ross-Lee B, Narayanan S. Knowledge and attitudes regarding smoking: a health education experiment with Malay college students. Med J Malaysia 1990;45:319-24.
8. World Health Organization: The World Health Report 2002. Reducing risks promoting healthy life. Geneva, WHO, 2002 (WA 540 WO3).

Copyright 2003 - Indian Journal of Medical Sciences.