Category: Tobacco

Tobacco is increasingly becoming the major cause of death in india, which has risen to six million people per annum globally. The number of premature deaths in 20th century globally were 100 million and according to world health organization (WHO) estimates it is supposed to reach 1 billion in 21st century.

Smoking cigarette is not the only leading cause of death in countries like india and Bangladesh , in fact around one third of people in india use smokeless form of tobacco (Gupta and Ray, 2003). In Accordance to the 2010 report of Global Adult Tobacco Survey (GATS), 60% of tobacco consumers in India at present use only smokeless tobacco and in addition 15% of consumers are mixed users, that is, they use both smokeless tobacco and smoked tobacco (GATS INDIA, 2010). In india , we have a varied range smokeless tobacco which differ across country. These include forms like chewing, holding in mouth or applying over teeth and gums. It is not uncommon of females and youth to use tobacco in country. Numerous diseases, both, fatal and non fatal are caused by the use of tobacco. Type of tobacco use may vary from rural to urban areas.

In a large city like Mumbai, Maharashtra, use of bidi (traditional form of cigarette) and cigarette smoking was found to be equal.a relatively higher risk of disease was exhibited by bidi smoking. Mortality rates of women that used smokeless tobacco were age specific in this location. A study showed highest risk of death in extremely thin people who smoked bidi.

One of the studies conducted in Delhi aimed at examining the westernization of use of tobacco and its products among youth. It also stated that influences of western culture are rising high enough and normalizing the use tobacco in city. In Bihar, highest prevalence of tobacco use was seen among students. One of the contributing factors of this issue was the lowest literacy rate in the country. Also it showed that the initiation of the habit started before 10 years of age. In a country like India where smoking tobacco by adolescent girls is not culturally acceptable, still over 8% of girl students presented with the habit. Chewing Gutka was the most common form of tobacco in the state. With either one or both parent addicted to tobacco in the house makes tobacco easily available for the children. Also kids are exposed to the smoke from cigarettes or bidis at a very early age. Thus, increasing the incidence of oral cancer among younger population.

In Bhavnagar , Gujarat , prevalence of chewing tobacco (especially mawa) went from 4.7% in 1969 to 19% in 1994-95 among younger generations. (Gupta PC & Ray CS, Smokeless Tobacco Health in India and Southeast Asia, Respirology (2003)8, 419-31)

In Chennai , Tamil Nadu , studies showed stasticically significant relation between tobacco use and age. Use of tobacco was found more in males than females. Also most tobacco consumers were from the slum areas when compared to non-slum areas.A significantly higher proportion of males resorted to tobacco smoking (28.4%) and smokeless tobacco (11.1%) when compared to the same (0.1%) and (4.9%) respectively among females (P value ,0.001. seventy seven percent of smokers in the city used cigarettes over bidi. (http://repository.ias.ac.in/110617/1/journal.pone.0076005.PDF)

Other than cigarettes , smokeless tobacco forms like gutka , khaini and gul manjan that are locally available are the prevalent in Lucknow, Uttar Pradesh. Bidi also was the coomon modality of smoking in states like Karnataka and uttar Pradesh. There was significant evidence that showed use of tobacco by men first was before 10 years of age. Family income in collaboration with education had association with ever-use of tobacco. In both sexes people with lesser level of education were more prone to use tobacco. Prevalence of tobacco use was less among persons with a higher family income.

The prevalence of tobacco use was reported to be much higher in the North-eastern states compared to other parts of India according to the second National Family Health Survey (NFHS-2) (International Institute for Population Sciences (IIPS) and ORC Macro, 2000. National Family Health Survey (NHFS-2), Mumbai, India 1998-99.) The highest percentage of young people currently using any tobacco product in the North-eastern states of India was in Nagaland (63%) and the lowest (which is very high by any standard) in Assam (36%). The need of tobacco after getting up in the morning is one of the major criteria for tobacco dependence. This criteria was fulfilled by almost three fourths of cigarette smokers and around half of the smokeless tobacco in almost all north-eastern states of india.

Tuibur and hidakphu are watery tobacco products made by passing tobacco smoke through water. This tradition is commonly seen in Mizoram and Manipur with high integration of misconceptions regarding the tobacco water. Even in less concentration , tobacco water does contain nicotine making it equally addictive as to the amount of it being consumed is more.

In Goa tobacco is smoked mainly in the form of cigarettes or bidis (tobacco rolled in a tendu leaf). Seven out every eight people in goa are non smokers.

The most advanced Indian state in terms of social development measured by the health indicators and literacy levels is kerala. Apart for its well known higher literacy rate , use of tobacco was also found to be much higher in the state showing a negative correlation. Much use of tobacco was seen in students for which peer pressure attributed as a contributing factor.

Smoked tobacco or smokeless tobacco , both equally contribute to the mortality rate in the country. The key to tobacco control efforts is the awareness of the health risks of tobacco. These studies and evidences from around the country show an increasing risk of tobacco on one’s life. Advocation of tobacco control program and tobacco ceasation council (TCC) must be implanted in all the states in country.

Summary / Abstract

This proposal is about identifying the causes of tobacco addiction among the youths of Maldives. Since the youth holds the key to the future of any society, it is a really big concern that the number of youths addicted to tobacco use is as great as it is in our society today. Therefore, it is important to identify the root causes of this issue if we are to do find a solution. This report highlights how the research is going to be carried out along with the objectives and purposes of the research. Data will be collected through different research methods and then analysed with the use of SPSS before making any judgements or conclusions. This research will play a vital role in identifying the main causes of tobacco addiction among youths of the Maldives.

1. Introduction

Addiction can be defined as the physical and psychological inability to stop consuming a chemical, drug, activity, or substance, even though it is causing psychological and physical harm. (Felman, n.d.) Tobacco addiction, like any other form of addiction is very hard to overcome once a person becomes addicted to it. Tobacco addiction is also considered one of the most common forms of substance addiction worldwide. The main ingredient that causes the addiction in tobacco is nicotine which is harmful to human body as well as health. Once someone is addicted to tobacco, he cannot stop using it even if he knows that it is harmful. This is because of the physical and mood altering effects produced in the brain by nicotine. According to various studies, the majority of tobacco addicts are most likely to have started using during their teenage years. There are various causes for people to start using tobacco during their youth years.

2. Problem Statement and Justification of the Research Project

2.1. Problem Statement:

Without any doubt, the teenage years are the years that will lay the foundation for what a person will become for the rest of their lives. Similarly, people who start using tobacco and get addicted to it during their youth years are more than likely to be addicted to it for the rest of their lives. Since the tobacco addiction is started at a young age in most cases, it is important to identify the causes for the youth to get addicted in the first place if we want to overcome this growing problem of tobacco addiction in the society. Therefore the topic of this research is identifying the causes of tobacco addiction among the youth in Maldives.

2.2. Justification of the Research Project:

Growing rates of tobacco addicts among the youth in the Maldives has become a major concern for us as society since it has various negative impacts on the overall health of the society. Such negative impacts include decreased life expectancy and increased number of disabled children born to smoking parents. As a result i is vital for us to identify the main causes of tobacco addiction among the youth in Maldives in order to find a suitable solution for this growing problem in our society. y.

The causes of tobacco addiction among the youth of our society

This can of course be identified after also considering several factors such as the society and the lifestyle of the society. Therefore, the outcomes of this research is going to be very helpfulhelpful in identifying the causes of tobacco addiction among the youth in the Maldives and hence finding a solution for the problem.

3. Objectives of the Research

3.1. Research Objectives:

Like any other research, this research also has certain objectives and purposes which will also help to guide the activities throughout the course of the research.

The main objectives of this research study are:

• Identifying the root causes for starting the use of tobacco.
• Identifying the average age at which most people start the use of tobacco.
• Finding the average number of tobacco addicts between different age groups.
• Identifying the point at which a person is considered to be addicted.

3.2. Research Questions:

1. What is tobacco addiction?
2. When is a person considered to be a tobacco addict?
3. What are the factors that lead to starting of tobacco use?
4. What is the average age at which people start the use of tobacco?
5. How does the numbers of tobacco addicts differ from one age group to another?
6. What are the age groups at which the number of tobacco addicts are highest?
7. What are the reasons for people to continue using tobacco?
8. What is the average age at which the tobacco users find themselves addicted to it?
9. How much does an average tobacco addict use it per day/week/month?

4. Hypothesis

The views of the people on the problem statement differs from person to person. In order to achieve the Research Objectives, hypothesis has to be tested by using the data collected using both qualitative and quantitative research methods.

• H0: Tobacco addiction among youth in Maldives is driven by a few common causes.
• H1: There are no specific causes that lead to tobacco addiction among youth in Maldives.

5. Literature Review

There are several reasons why someone starts the use of tobacco and why they continue using it to the point of addiction in any society. When putting the society of Maldives into perspective, it is important to discover the causes of tobacco addiction among the youth of our society. Nevertheless, it is no secret that the use of tobacco use on a regular basis poses some very serious health hazards to human beings. If we take a look into United States, one of the highest tobacco using countries, each year more than 480,000 people die from illness relating to tobacco use. Moreover, smoking tobacco increases the risk of different forms of cancer while also severely increasing the risk of damaging the lungs. In addition to that, it also has various negative effects on human heart and the blood vessels. (The American Cancer Society medical and editorial content team, 2018)

When talking about the harmfulness of tobacco, it is important to understand that it contains various harmful chemicals which makes it harmful to breathing even a little tobacco smoke. 250 chemicals out of all 7000 chemicals found in tobacco smoke is known to be harmful to human body. Out of which at least 69 chemicals causes cancer. Smoking tobacco can cause cancer of lung, mouth, kidney, liver, bladder etc.. while also increasing the risk of heart attacks, strokes, asthma etc. Smoking has some negative effects on the reproductive systems of both genders ehich makes it hard for women to get pregnant. Smoking during pregnancy also increases the chances of a miscarriage while also increasing the risk of baby being born too early or with different disabilities. (National Cancer Institute, n.d.)

Now moving to the most important question of whether tobacco really is addictive or not, it is important to understand that tobacco on its own is not necessarily considered to be addictive. However, nicotine which is one of the main ingredients of tobacco is heavily addictive and is considered to be the reason why tobacco is so addictive among its users. When the human body intakes nicotine it activates the parts of the brain that controls the feelings of pleasure. Since this feeling and the effects disappear after a few minutes, in order to keep feeling the pleasures activated by the brain, the tobacco user chooses to use another round. (The Deadly Effects of Tobacco Addiction, 2006) In addition to this, nicotine causes the bloodstream to have a rush of adrenaline while also triggering an increase in the levels of dopamine, hence causing a physical and psychological addiction to it overtime. The symptoms of being addicted to tobacco and nicotine includes not being able to quit despite various attempts to quit, withdrawals symptoms when trying to quit, and also continued use of tobacco despite the health problems. (Tobacco and Nicotine Addiction, n.d.)

Since it is known that tobacco use among the youth of any society is very high, it is very important to know the main reasons why youth is associated with use of tobacco. It is no secret that despite the obvious health hazards, the tobacco industry spends billions each year on marketing in order to reach new customers and increasing their customer base, with the majority of these new customers being youth. The tobacco industry designs their marketing strategies in such a way where the youths are their main targets using advertising, promotions and sponsorships while falsely linking it with glamour and social success. As a result, the acceptability of tobacco among the youth increases while disregarding the fact that it is a harmful addictive product and also underestimating the risks of tobacco and the likelihood of becoming addicted. (World Health Organisation (WHO), n.d.)

There are various reasons why the youths choose to start tobacco use and keep using it to the point of addiction. One of the reasons could be because the youths simply want to fit in with their peers. This could be one of the most common reasons for youths to start using tobacco since it is marketed in a way that it is appealing to the young age group. Tobacco use is considered to be normal among the youths because of its use in movies, video games as well as among role model figures such as parents. Secondly, if a youths family member or friends or social leaders are a tobacco user, the youths might try to imitate them and start using it as well. Another reason for youths to start using tobacco is depression which results them to find something that will get their mind off whatever it is they are depressed about resulting the majority to choose tobacco as the answer since it is easily available and considered to be normal. (Preventing Tobacco Use Among Youth and Young Adults, n.d.)

6. Research Methodology

Research Methodology is the methods the researcher uses in order to obtain the information and data for solving a research problem and making a decision. The Research Methodology could include, interviews, surveys as well as questionnaires. (Research Methodology, n.d.) For this research both research methods of qualitative research and quantitative research will be used while the data will be collected through questionnaires and interviews among the youth who use tobacco on a regular basis.

Questionnaires:

Questionnaires are considered to be one of the most commonly used research instruments which consists of several questions which are designed to gather information from the respondents. This is considered to be a written interview although it could also be carried out face to face or on telephone. This is widely considered to be one of the easiest and cheapest methods to carry out a research. (McLeod, 2018) The questionnaires would be filled by the youths of Maldives who are actively smoking which would easily give their views on the research problem and also collect the data required for the research.

Focus Group Interviews

Focus Group Interview means that a particular group of people are selected and asked about their opinions on a certain topic. This is a part of qualitative market research where the participants will be able to discuss with each other. (Focus Group Interview, n.d.)

6.1. Research Participants

The participants for this research will be the youths of Maldives who are actively engaged in tobacco use.

6.2. Research Design

Before the start of collection of data required for the research through questionnaires and interviews it is very important to get the permission from the participants while also informing them of the objectives and purposes of the research. After that the data collection will be started through questionnaires which will be given to youths who engage in smoking with a target of 50 participants. Focus group Interview will take place among a chosen number of youths and will be 30 to 60 minutes long, which will however will depend on the participants’ willingness.

6.3. Data Collection Process

The Data Collection Process will be undertaken through questionnaires and focus group interviews as mentioned above.

The questionnaires will be designed so that there will not be much writing which will save time for the participants. The questionnaire will be in the form of a google form which will make it easier to reach more participants. This will however be carried out after getting prior permission from each participant. Moreover the questions will be designed in a way which will make it easy for the analysis of the research. This will mainly be carried out through online platforms which will help to minimize the geographical limitations. This will carried out within the first four weeks

The focus group interviews will be started while carrying out the questionnaires. Since this will require prior permission and sufficient number of participants it is estimated to take up to 4 weeks for the interviews.

6.4. Proposed Data Analysis

Once the required data is collected from questionnaires, and the interviews the data will be statistically analysed using SPSS. This will help to carry out different types of analysis of the data easily and conveniently. The results generated from SPSS will further be explained with written explanations along with diagrams and charts.

7. Limitations

There are several limitations which will have to be dealt with throughout the course of the research. One of those limitations is that a research of this magnitude will require a large amount of time since the data collection will be difficult. Moreover, another limitation is the budget constraint. This research requires a relatively big budget since the process of data collection as well as the data analysis and evaluation is estimated to be costly. In addition to this, the sample size of the research data collection is relatively small considering a large number of youths in Maldives are actively using tobacco while majority of them are addicted to it.

There might be certain ethical issues that might arise while carrying out the data collection process. Therefore the participants will be asked for prior permission as well as inform them about the purpose of the research. However, another issue that might arise is that the participants might not be honest when answering the questions in questionnaires as well as interviews. Therefore, the participants will also be signed on a consent form after agreeing upon the ethical issues.

8. Estimated Budget

No

Description

Unit

Quantity

Unit Price (MVR)

Cost (MVR)

1

Internet and Phone Bill

Monthly

2 months

660

1320

2

Pens

No.

50

5

250

3

Pencils

No.

50

3

150

4

Paper A4

Ream

6

50

300

5

Erasers

No.

50

2

100

6

Highlighters

No.

25

5

125

7

Staplers

No.

10

30

300

8

Printing and Copying

Sheets

2000

2

4000

9

Refreshments for Participants

–

–

–

1000

10

Transport Costs

–

–

–

1500

11

Other Expenses

–

–

–

1000

Total

10045

9. Schedule

Activity

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Choosing suitable participants to base the research.

Giving consent forms.

Distribute Questionnaires

Mailing Questionnaires

Observation

Selecting the focus groups

Focus group interviews

Data recording

Data analysis

Interpretation and Report

10. References

1. Felman, A. (n.d.). What is Addiction? Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/323465.php
2. Focus Group Interview. (n.d.). Retrieved from MBA Skool: https://www.mbaskool.com/business-concepts/marketing-and-strategy-terms/12024-focus-group-interview.html
3. McLeod, S. (2018). Questionnaire. Retrieved from Simply Psychology: https://www.simplypsychology.org/questionnaires.html
4. National Cancer Institute. (n.d.). Harms of Cigarette Smoking and Health Benefits of Quitting. Retrieved from National Cancer Institute: https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet
5. Preventing Tobacco Use Among Youth and Young Adults. (n.d.). Retrieved from Surgeon General: https://www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/factsheet.html
6. Research Methodology. (n.d.). Retrieved from Business Dictionary: http://www.businessdictionary.com/definition/research-methodology.html
7. The American Cancer Society medical and editorial content team. (2018, November 15). Health Risks of Smoking Tobacco. Retrieved from American Cancer Society: https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/health-risks-of-smoking-tobacco.html
8. The Deadly Effects of Tobacco Addiction. (2006). Retrieved from Scholastic: http://headsup.scholastic.com/students/deadly-effects-of-tobacco-addiction
9. Tobacco and Nicotine Addiction. (n.d.). Retrieved from Healthline: https://www.healthline.com/health/addiction/tobacco
10. World Health Organisation (WHO). (n.d.). Tobacco and Youth . Retrieved from Tobacco Free Initiative (WHO): https://www.who.int/tobacco/control/populations/youth/en/

11. Appendices

11.1. Appendix 1: Consent Form

I am currently working on a research to identify the causes of tobacco addiction among the youths of Maldives.

I kindly request a few minutes of your valuable time to fill out this questionnaire. This will only take up to 10 to 20 minutes. The purpose of this questionnaire is to help me collect the required data for the aforementioned research. Therefore, I humbly request your full coorporation in filling out the questionnaire with utmost honesty.

The questionnaire will be solely used for academic purposes and your answers will be fully confidential. Although you are in no way forced to take part in this study, I would really appreciate if you could participate in this study and contribute to my studies.

If you wish to participate in this survey, kindly fill out the questionnaire attached with this letter. Thank you for your time and coorporation.

11.2. Appendix 2: Questionnaire

Section A: General Information (Please tick the appropriate box).

1. Age
   1. Below 18 3) 20-23
   2. 18-20 4) 23-25
2. Gender
   1. Male
   2. Female
3. Employment Status
   1. Employed
   2. Studying
   3. None
4. Are you an active tobacco user? Yes No

Section B:

1. At what age did you use tobacco for the first time?
   1. Below 18 3) 20-23
   2. 18-20 4) 23-25
2. How long have you been using tobacco?
   1. 1) Less than a year 3) 3-5 years
   2. 2) 1-3 years 4) More than 5 years
3. Are you aware of the health risks of tobacco use? Yes No
4. How much tobacco do you smoke per day on average?
   1. 1) Less than 5 3) 10-15
   2. 2) 5-10 4) More than 15
5. Have you tried to stop smoking tobacco? Yes No If yes:
   1. 1) Did you succeed? Yes No And
   2. 2) At what age was it?
   3. a) Less than 18 c) 20-23
   4. b) 18-20 d) 23-25
6. What lead you to smoke your first cigarette?
   1. 1) Just wanted to try 3) Pressure from someone close
   2. 2) Depression 4) Other , If so specify: …………………………………………………………………………………….
7. Why did you continue to smoke after the first one?
   1. 1) It is cool 3) Liked it and wanted more
   2. 2) Pressure from someone close 4) Other If so specify: ………………………………………………………………………………….
8. What is your opinion for the following?

Please tick the most appropriate answer

1= Strongly Agree 2= Agree 3= Neutral 4= Disagree 5= Strongly Disagree

Rating Scale

1

2

3

4

5

Smoking is injurious to health?

Tobacco smoking is highly addictive?

I have a clear understanding of what tobacco addiction is?

I am addicted to tobacco use?

I can stop smoking tobacco if and when I want?

Smoking does not have any benefit to me?

I am thinking of stopping the use of tobacco?

Thank you!

Your time and contribution is highly appreciated!

11.3. Appendix 3: Focus Group Interview Questions

1. Give a short introduction of yourself?
2. Do you understand what tobacco addiction is?
3. Do you consider yourself to be addicted to tobacco?
4. What made you start smoking?
5. Why do you continue smoking?
6. How much tobacco do you use per day on average?
7. Do you want to stop smoking?
8. Do you think you can stop smoking if you wanted?