|Year : 2016 | Volume
| Issue : 1 | Page : 10-13
Change in attitude of smokeless tobacco users after educational intervention”
P Linda1, Sandhya Gupta2, Sonali Jhanjee3, Vijay Prakash Mathur4
1 Faculty, College of Nursing-Santosh Medical College, GZBD, New Delhi, India
2 Faculty-College of Nursing, AIIMS, New Delhi, India
3 Faculty-Department of Psychiatry & NDDTC, AIIMS, New Delhi, India
4 Faculty- Centre for Dental Education & Research, AIIMS, New Delhi, India
|Date of Web Publication||17-Jun-2019|
Faculty-College of Nursing, AIIMS, New Delhi
Source of Support: None, Conflict of Interest: None
Tobacco exposure is the single greatest preventable cause of morbidity, disability and mortality for chronic and debilitating diseases. In public health education, an important aspect is treatment of tobacco use dependence. This experimental study is intended to deter use of smokeless tobacco for users who seeks treatment and who doesn’t seek treatment as well. The study was conducted using a pre test post test design on smokeless tobacco users (taking dental treatment= 40, not taking-dental treatment= 40) in a tertiary care setting. The Educational video was received by subjects in two groups, dental group and non-dental group. Educational video is a video film of 14 minutes was developed by researcher that included contents related to chemical properties of tobacco, its harmful health effects, the diseases caused by tobacco use and the facilities available for treatment. Subject data sheet and attitude questionnaire where used as tool for the study. The mean age of subjects in dental group was 39 years and in non-dental group was 34 years. Most of the subjects in dental group and non-dental group were using gutka. Attitude scores of subjects significantly increase from pre-test (55.32±7.0 ) to post-test (62.74 ±4.2). There was statistically significant difference between attitude scores of subjects in dental group (60.3±13.23) and non-dental group(62.6±4.19) at one month follow up (p=<0.05). The Educational video film regarding ill effects of tobacco use and its treatment was effective in enhancing positive attitude. Hence video film regarding ill effects of tobacco use and its treatment is found equally useful for both potential and current smokeless tobacco users, those having dental/oral cavity complications as well as those who are not yet seeking for dental/oral cavity treatment.
Keywords: Smokeless tobacco, Smokeless tobacco users, Educational video, attitude regarding smokeless tobacco use, dental group, non- dental group
|How to cite this article:|
Linda P, Gupta S, Jhanjee S, Mathur VP. Change in attitude of smokeless tobacco users after educational intervention”. Indian J Psy Nsg 2016;12:10-3
|How to cite this URL:|
Linda P, Gupta S, Jhanjee S, Mathur VP. Change in attitude of smokeless tobacco users after educational intervention”. Indian J Psy Nsg [serial online] 2016 [cited 2021 Dec 2];12:10-3. Available from: https://www.ijpn.in/text.asp?2016/12/1/10/260544
| Introduction|| |
Tobacco is a highly addictive substance. Tobacco use is among the most preventable causes of disease and premature death worldwide. Global Adult Tobacco Survey India 2009-2010 revealed that more than one-third (35%) of adults in India use tobacco in some form, 21% use smokeless tobacco, 9% smoke, and 5% are mixed users. The World Health Organization predicts that tobacco deaths in India may exceed 1.5 million annually by 2020.Smokeless tobacco use is a significant part of the overall world tobacco problem. The prevalence of use is relatively high in many countries especially in South Asia, there is strong evidence that smokeless tobacco use leads to oral mucosal lesions, including oral pre-cancerous lesions, and gingival recession. Substantial evidence indicates that tobacco cessation not only reduces the prevalence of a range of diseases, but also limits their progression and improves treatment outcomes. Patients who visit dental clinic routinely have little interaction with healthcare professionals about tobacco use and related hazardous effects in a casual manner. To minimize gap between actual practice in the direction of tobacco cessation activities of health professionals , improvement of education of tobacco users should be considered as it will result in high self motivation of the users. As a first step, data have been collected from patients who seeks dental treatment and who doesn’t seek dental treatment about attitude of tobacco use and cessation.
| Materials and Methods|| |
The objective of the study to determine the effectiveness of Educational video regarding ill effects of tobacco use and its treatment on attitude of smokeless tobacco users taking dental treatment and not seeking dental treatment.
Research hypothesis: H1-Smokeless tobacco users who receive educational video will show enhanced attitude scores as measured by attitude scale significant at p<0.05.
A Quantitative, Experimental approach, Pre experimental design, one group pre-test post-test, time series design was used for this study.
A - Attitude towards smokelesstobacco use
EV - Educational video regarding ill effects of tobacco use and its treatment
Treatment : Educational video regarding ill effects of tobacco use and its treatment.
Outcome was tested on knowledge, attitude and practice of smokeless tobacco users.
The study sample involved persons currently using smokeless tobacco were chosen from AIIMS, New Delhi. Subjects using smoking tobacco along with smokeless tobacco were excluded from the study. Total 80 tobacco users were enrolled for the study, 40 in each group. 17 subjects did not come for follow up on post test 1. A total of 62 subjects, 32 in subgroup 1 and 30 in subgroup 2 completed the study, by convenient sampling method. To achieve the objective of the study following tools were used
Subject Data Sheet: Demographic data form: It has 13 items eliciting the demographic details. Demographic data includes age, sex, marital status, educational status, occupation, monthly family income and area of residence.Tobacco related characteristics includes type of tobacco, use per day, age of initiation, age started chewing regularly and interest in quitting. Tool 1: Attitude questionnaire was developed for assessing the attitude of smokeless tobacco users regarding tobacco use. It has 15 items. Minimum score was 15 and maximum score was 75.Content validity was established by giving it to experts. Reliability was established by test retest method ( 0.83).Both tools were used in Hindi.
Intervention (Educational - video film) regarding ill effects of tobacco use and its treatment: Content of Educational video regarding ill effects of tobacco use and its treatment was validated by four experts from AIIMS. Accordingly script was modified and the validity was established.Try out of the video was done for 14 minutes duration before use.
Content of the Educational video: The Educational video includes, description of tobacco and tobacco products, effects and complications of tobacco use, complications of tobacco use on oral cavity, strategies available for cessation of tobacco use, resources available for cessation of tobacco use.
Ethical clearance was obtained from ethics committee of AIIMS, informed written consent was taken from the study participants and their confidentiality and anonymity was maintained.
The pilot study was conducted before actual data collection.
| Results|| |
Description of the subjects
The mean age of subjects in dental group was 39 years (SD±11.2) and in non-dental group was 34 years (SD± 6.23). Most of the subjects were male 95.5% in dental group and 95% in non-dental group. Most of the subjects were married, 72.5% in dental group and 95% in non- dental group. Educational status of 35% of subjects in dental group was of primary level and 52.5% of non-dental group was of secondary level. More than half of the subjects were employed, 60% in dental group and 62.5% in non-dental group. Most of the subjects had monthly income of Rupees 5001-10,000/-, 45% in dental group and 50% in non-dental group. Most of the subjects were from urban area, 57.5% in dental group and 62.5% in non-dental group [Table 2].
|Table 2: Frequency distribution of socio-demographic characteristics of the subjects n=80|
Click here to view
Seventy three percent subjects in dental group and 42.55 % in non-dental group were using gutka. The mean number of smokeless tobacco pouch used per day were five (SD ± 1.08) in subjects of dental group and three (SD± 1.9) in non-dental group. The mean number of smokeless tobacco pouches chewed per day was two (SD± 1.6) in subjects of dental group and three (SD± 2.0) in non-dental group. The mean age of initiation of tobacco was at 23 years (SD ± 6.13) in subjects of dental group and at 22 years (SD± 5.77) in non-dental group. The age of subjects for initiating chewing regularly was 24 years (SD ± 7.08) in subjects of dental group and at 22 years (SD ± 5.61) in non-dental group. Most of the subjects (>50%) were “very interested in quitting of tobacco use” in dental group as compared to non-dental group before intervention [Table 3].
| Discussion|| |
To our knowledge, this study is the first to document the attitude and perceived effectiveness regarding tobacco use and cessation simultaneously among smokeless tobacco users who seeks dental treatment and who doesn’t seek dental treatment.
In our study, mean attitude scores of subjects increase from pre-test (55.32± 7.0) to post-test (62.74 ±4.2) which was statistically significant p value <0.05(Mean difference = 6.42). Hence there was significantly increased attitude scores of smokeless tobacco users for leaving smokeless tobacco use after one month follow up of the intervention.
In present study, the baseline attitude mean score was 55.32± 7.0 which is in contradictory to the findings of Horn K A et al(2000) (West Virginia) where it was reported that the baseline attitude scorewas25.86 ±5.38.
We found that, there was statistically significant difference between attitude scores of subjects in dental group (60.3±13.23) and non-dental group(62.6±4.19) at one month follow up p value <0.05. Hence subjects in non-dental group have more positive attitude as compared to dental group after one month follow up of the intervention.[Table 4]. This may be because non dental group have a higher qualifications as compared to dental group though the difference was not statistically significant.
|Table 4: Comparison ofpre test and post testattitude scores between dental group and non-dental group|
Click here to view
| Conclusion|| |
The Educational video film regarding ill effects of tobacco use and its treatment was effective in enhancing the positive attitude towards cessation of smokeless tobacco use.Hence video film regarding ill effects of tobacco use and its treatment is found equally useful for both potential and current smokeless tobacco users, those having dental/oral cavity complications as well as those who are not yet seeking for dental/oral cavity treatment.
| References|| |
USDHHS. Healthy People 2010, ed. US Department of Health & Human Services, National Centre for Chronic Diseases Prevention & Health Promotion. Office of Smoking and Health. Atlanta, GA: USDHHS 2004.
Dhumal G G, Pednekar M S, Gupta P C, Sansone G C, Quah A, Bansal-Travers M, Quit history, intentions to quit, and reasons for considering quitting among tobacco users in India. Indian J Cancer. 2014 Dec; 51:S39-S45.
Murray C J, Lopez A D. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Massachussets: Harvard School of Public Health, 1996.
Recommendation on Smokeless Tobacco Products - Scientific Advisory Committee on Tobacco Products Regulation.
Preshaw P.M, Heasman L, Stacey F, Steen N, McCracken G.Is, Heasman P.A. The effect of quitting smoking on chronic periodontitis. J. Clin. Periodontol. 2005;32(8):869-879.
Horn K A, Gao X, Dino G A, Bahl S K. Determinants of Youth Tobacco Use in West Virginia: A Comparison of Smoking and Smokeless Tobacco Use. Am j Drug Alcohol Abuse 2000; 26(1):125-13
[Table 1], [Table 2], [Table 3], [Table 4]