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研究生:謝朗明
研究生(外文):Lamin M. Ceesay
論文名稱:The Prevalence And Determinants Of Smoking Among Secondary School Students in Kombo North, The Gambia
論文名稱(外文):The Prevalence And Determinants Of Smoking Among Secondary School Students in Kombo North, The Gambia
指導教授:楊振昌楊振昌引用關係
指導教授(外文):Chen-Chang Yang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:86
中文關鍵詞:adolescentssmokingtobaccotobacco controlThe Gambia
外文關鍵詞:adolescentssmokingtobaccotobacco controlThe Gambia
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Introduction: Cigarette smoking which is the most common form of tobacco use is a global public health challenge. Data on smoking and its determinants among school-going adolescents however are scarce in many developing countries, especially the sub-Saharan countries.

Objective: To estimate the prevalence of those who have ever smoked cigarettes and current cigarette smokers and to attempt to identify the socio-demographic factors that tend to facilitate smoking initiation among the secondary school students in Kombo North, the Gambia.

Methods: This study used a modified Global Youth Tobacco Survey (GYTS) questionnaire. A cross-sectional survey using a two-stage sampling strategy was carried out among 540 students in 15 secondary schools in Kombo North District, the Gambia in 2008. In each participating school, we first randomly selected one class from each grade. Fifteen students were then randomly chosen from each preselected class. The relation between baseline characteristics and smoking status (ever smoker, current smoker and non-smoker) was analyzed.

Results: Out of the 540 students, 168 (31.1%) reported having ever smoked cigarettes, while 82 (15.2%) were current smokers. In terms of gender, 52% (143/275) males and 9.4% (25/265) females were ever smokers; 79 males (28.7%) and 3 females (1.1%) were current smokers. Males were significantly more likely to be current smokers, use other tobacco products and perceive themselves to initiate smoking in the future. While the current smoking rate was 13.7% among junior secondary schools students, it was 16.7% among the senior secondary school students. This difference was not statistically significant. The pattern of smoking intensity across the types of school showed that the percentage of current smokers who were experimenters (51.4%) was higher in junior secondary school and the percentage of smokers who were regular or established smokers (46.7%) was higher in senior secondary schools.
The general knowledge about the adverse effects of smoking was very high in this study. However, participants’ knowledge on specific health problems associated with smoking was very limited. Over 80% of the students knew that smoking is harmful to health. More than 60% of the students reported that they were taught about the dangers of smoking during the last academic year. There was no statistically significant difference between current smokers’ and non-smokers’ knowledge. Current smokers had more favourable attitude toward smoking than the non-smokers. Males tended to have a more favourable attitude toward smoking than females.
Three hundred and nineteen (59.1%), 312 (57.8%) and 384 (71.1%) of the students reported being exposed to environmental tobacco smoke at home, school and other public places respectively. Moreover, viewing smoking in movies was very common in the Gambia. About 96% of the student saw actors smoke in movies.

Conclusion: Many male adolescents in Kombo North, The Gambia were current smokers. Although most of them had learned about the adverse health impacts of smoking, the prevalence of smoking remains high in this region. Our findings stress the need for an early and integrated national tobacco control programme in the Gambia.
Introduction: Cigarette smoking which is the most common form of tobacco use is a global public health challenge. Data on smoking and its determinants among school-going adolescents however are scarce in many developing countries, especially the sub-Saharan countries.

Objective: To estimate the prevalence of those who have ever smoked cigarettes and current cigarette smokers and to attempt to identify the socio-demographic factors that tend to facilitate smoking initiation among the secondary school students in Kombo North, the Gambia.

Methods: This study used a modified Global Youth Tobacco Survey (GYTS) questionnaire. A cross-sectional survey using a two-stage sampling strategy was carried out among 540 students in 15 secondary schools in Kombo North District, the Gambia in 2008. In each participating school, we first randomly selected one class from each grade. Fifteen students were then randomly chosen from each preselected class. The relation between baseline characteristics and smoking status (ever smoker, current smoker and non-smoker) was analyzed.

Results: Out of the 540 students, 168 (31.1%) reported having ever smoked cigarettes, while 82 (15.2%) were current smokers. In terms of gender, 52% (143/275) males and 9.4% (25/265) females were ever smokers; 79 males (28.7%) and 3 females (1.1%) were current smokers. Males were significantly more likely to be current smokers, use other tobacco products and perceive themselves to initiate smoking in the future. While the current smoking rate was 13.7% among junior secondary schools students, it was 16.7% among the senior secondary school students. This difference was not statistically significant. The pattern of smoking intensity across the types of school showed that the percentage of current smokers who were experimenters (51.4%) was higher in junior secondary school and the percentage of smokers who were regular or established smokers (46.7%) was higher in senior secondary schools.
The general knowledge about the adverse effects of smoking was very high in this study. However, participants’ knowledge on specific health problems associated with smoking was very limited. Over 80% of the students knew that smoking is harmful to health. More than 60% of the students reported that they were taught about the dangers of smoking during the last academic year. There was no statistically significant difference between current smokers’ and non-smokers’ knowledge. Current smokers had more favourable attitude toward smoking than the non-smokers. Males tended to have a more favourable attitude toward smoking than females.
Three hundred and nineteen (59.1%), 312 (57.8%) and 384 (71.1%) of the students reported being exposed to environmental tobacco smoke at home, school and other public places respectively. Moreover, viewing smoking in movies was very common in the Gambia. About 96% of the student saw actors smoke in movies.

Conclusion: Many male adolescents in Kombo North, The Gambia were current smokers. Although most of them had learned about the adverse health impacts of smoking, the prevalence of smoking remains high in this region. Our findings stress the need for an early and integrated national tobacco control programme in the Gambia.
Acknowledgements I
Abstract III
1 INTRODUCTION 1
1.1 Background 1
1.2 STUDY SIGNIFICANCE AND SPECIFIC AIMS 4
1.3 Situational Analysis, The Gambia 5
1.3.1 Health Care System 5
1.3.2 Tobacco Control In The Gambia 6
2 LITERATURE REVIEW 8
2.1 Trends of Tobacco Consumption 8
2.2 The Impacts of smoking on Health 9
2.3 The Economic Consequences of smoking 11
2.4 Worldwide Adolescent smoking 1312
3 THE STUDY 16
3.1 Research Questions 16
3.2 Research Hypothesis 16
3.3 Relevance/Policy Implications 16
4 METHODOLOGY 18
4.1 STUDY POPULATION AND SETTING 18
4.1.1 ETHICAL CONSIDERATIONS 19
4.2 STUDY DESIGN AND DATA COLLECTION 20
4.2.1 Data analysis 2221
5 RESULTS 2322
5.1 Descriptive Findings 2322
5.1.1 Personal characteristics of study participants 2322
5.1.2 The prevalence of smoking 2322
5.1.3 Personal characteristics of current smokers 2524
5.1.4 Knowledge and attitudes toward tobacco 2625
5.1.5 Perception and attitude toward cigarette smoking 2827
5.1.6 Exposure to Environmental Tobacco Smoke 3332
5.1.7 Media messages about smoking 3433
5.1.8 Tobacco-related school curriculum 3534
5.2 Factor Associated with Current Smoking 3534
5.2.1 Demographic characteristics associated with smoking 3635
5.2.2 Knowledge and Perceptions associated with smoking 3735
5.2.3 Attitudes associated with smoking 3836
6 DISCUSSION 3938
6.1 Prevalence of tobacco use 3938
6.2 Initiation of Smoking and daily consumption 4140
6.3 Knowledge, Attitude and Perceptions 4241
6.4 Exposure to Second- Hand Smoke 4544
6.5 Media and Advertising Exposure 4645
6.6 Access and Availability 4846
7 CONCLUSION AND RECOMMENDATION 5048
7.1 Strengths and Limitations 5249
8 REFERENCES 5351
9 APPENDICES 5755
9.1 Questionnaire 5755
9.2 TABLES 6867
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