A Study To Access The Knowledge and Attitude of Tobacco Use Among Students of Selected Colleges of Belguam City

“A Study to assess the knowledge and attitude of
tobacco use among the students of selected colleges

of Belgaum city.”
By
Mrs. Omana R. Shinde

Dissertation submitted to the Rajiv Gandhi Uni versity of
Health Sciences,
Karnataka, Bangalore.
In Partial fulfillment
of the requirement for the degree of
Master of Sciences
In
Community Health Nursing
Under the Guidance of
Prof. David A. Kola M .Sc. ( N),

Head of Department, Community Health Nursing .
K.L.E. Society’s Institute of Nursing Scienc es,

Nehru Nagar, Belgau m – 590010. Karn ataka, India.
SEPTEMBER - 2006
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RAJIV GANDH I UNIVERSITY OF H EALTH SCIENCES,
K ARNATAK A
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled – “A Study to
assess the knowledge and attitude of tobacco use among the
students of selected colleges of Belgaum city” is a bonafide and
genuine research work carried out by me under the guidance o f
Prof. David A. Kola M . S c . ( N) , Head of Department, Co mmunity
Health Nursing, K.L.E.S Institute of Nursing Sciences, Nehru
Nagar, Belgaum – 10.

Post Graduate Student
K.L.E.S Institute of Nursing
Sciences, Nehru Nagar,
Belgaum.
Date:
Place: Belgaum
II
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A Study to
students of selected colleges of Belgaum city ”, is a bonafide
research work done by Mrs. Omana R. Shinde in a partia l
fulfillment of the requirement for the degree of Master of Sciences
in Nursing.
Guide: Co-Guide.
Mr. David A. K ola M . S c . ( N ) Ms. Meenaxi R. Devangmath M . S c . ( N )

Professor & H.O.D Assist ant Professor
Depart ment of Co mmunit y Depart ment of Co mmunit y
Healt h Nur sing Healt h Nur sing
K.L.E.S Institute of Nursing Sciences, K.L.E.S Institute of Nursing Sciences,
Belgaum. Belgaum.
Date:
Place: Belgaum
III
ENDORSEMENT BY THE H.O.D., PRINCIPAL,
K.L.E.SOCIETY’S INSTIUT E OF NURSI NG
SCIENCES, NEHRU NAGAR, BELGAUM – 590010
This is to certify that the dissertation entitled “A Study to
students of selected colleges of Belgaum city” is a bonafide
research work done by Mrs. Omana R. Shinde under the guidance
of Prof. David A. Kola M . S c . ( N) , Head of Depart ment, Communit y
Health Nursing.
Seal & Signature: Seal & Signature:
Mr. David A. Kola. M . S c . ( N) Mr. R. S. Hooli M . S c . ( N)

Professor & H.O.D., Pr incipal & Professor
Department of Community Health Nursing Department of Medical Surgical Nursing
K.L.E.S Institute of Nursing Sciences, K.L.E.S Institute of Nursing Sciences,
Belgaum. Belgaum.
Date: Date:
Place: Belgaum Place: Belgaum
IV
COPYRI GHT
Declaration by the Candidate
I hereby declare that Rajiv Gandhi University of Health
Sciences, Karnataka shall have the rights to preserve, use and
disseminate this dissertation in print or electronic format for
academic / research purpose.

Post Graduate Student
K.L.E.S. Institute of Nursing
Sciences, Nehru Nagar,
Belgaum – 10.
Date:
Place: Belgaum
Lovingly Dedicated to
My teacher. . . . My best friend. . . . My husband
Dr . Ravi kan t G. Shi n de M.D.(Med.)

Ex-Prof., H.O.D.(Med.), Govt. Medical College, W.H., Miraj.,
who made me believe in myself . . . . . Is and will

always be, An inspiration to me to go on . . . . .
“ When you have come to the edge

of all light that you know,
And are about to drop off into
the darkness of unknown,
Faith is knowing, One of two
things will happen:
VI
There will be something solid
to stand on
Or you will be taught to fly ”
VII
Acknowledgement
“In the multitude of counselors purposes are
established”
I express my deep sense of gratitude to Almighty God for His blessings, and guiding me to
reach up to this step and complete my study. His Omnipresence has been my anchor through the fluctuating
hard times.
It is my proud privilege to express my deepest sense of gratitude to my teacher and research guide
Prof. David A Kola, H.O.D. community health Nursing Department, his intelligent, unrelieved,
unwavering faith, study guidance valuable suggestions unconditional support and co-operation, his
personal interest, endless patience, have been the foundation of this study.
I extend my whole hearted thanks to Prof. R. S. Hooli, principal K.L.E.S institute of
nursing sciences for his constant motivation, counseling, expert valuable suggestions and his blessing
enabled me to go forward to complete this study.
It is my pleasure to indebt my sincere gratefulness and genuine thanks to my co-guide Miss.
Meenakshi Devangmath, associate professor for her valuable suggestions, guidance, support, love
and co-operation through out the study.
I am indebted to Prof. Usha M. Joshi former principal and senior faculty member for her
concern timely guidance, expert advice encouragement and blessing.
My heartiest special thanks to Mr. Suresh Saler, chief executive, nurse consultant, my teacher.
It has been his blessings, help and continued encouragement, which enabled me to complete my study.
I would like to express my profound sense of gratitude and heartfelt thanks to Prof. Milka
Madhale, Vice principal for her valuable guidance and counseling.
I extend my sincere thanks to Prof. Sheela Williams for her constant help and valuable
suggestions and encouragement throughout the study
I wish to express my heartfelt thanks to all the six polytechnic college principals, staffs and students
for their co-operation and support throughout the entire study.
I am also obliged to all faculty members of the K.L.E’S institute of nursing sciences, Belgaum.
I express my heartfelt gratitude to Prof. Mallapure for guiding me in the statistical analysis
and interpretation of data.
I am thankful to language expert Mrs. Patil for critically editing the manuscript and also wish to
express my sincere thanks to all the experts who validated the tool.
I have special word of appreciation to the librarians Mr. Prakash and Mrs. Shivaleela
who have helped immensely to make use of the reservoir of knowledge.
I wish to express my thanks to Mr. Parvez Sayyad and Asif Kini of Informative
Computers for their excellent and skillful computer services.
VIII
I am extremely thankful to Madam. A. Singh and entire staff of T.G.I.N.E Pune for
their support and all the help rendered.
I pay my grateful salutations to my parents, Sisters and my children
S h a r o n , A n n and D a n who were the reason for all this hard work and study. Their
constant prayer, love, sacrifice, encouragement, and support without which this study would not have been
possible.
No words can express gratitude to my dear friends- Sabinu, Sinoj, James, Binoj,
Shailaja and Deenamma aunty their faith, encouragement, prayer support which has always
given me strength and abundant blessings
I express my thanks to all well-wishers for their help and best wishes at all times.
My hear tfel t than ks to al l
DATE:
PLACE: Si gn atur e of the can di date
IX
TABLE OF CONTENTS
Sl. Page
Particulars
No. Nos.
I. INTRODUCTION 1-13
Need for the study
Statement of the problem
Objectives of the study
Operational Definition of terms.
Assumptions
Conceptual framework
II. REVIEW OF LITERATURE 14-23

Section I
Section II
III. METHODOLOGY 24-33

Research Approach
Research Design
Variables
Research Hypothesis
Setting Of The Study
Population
Sample And Sampling Techniques
Method Of Data Collection
Description Of The Tool
Knowledge Score
Content Validity
Pilot Study
Reliability
Procedure of Data Collection
Plan For Data Analysis
IV ANALYSIS AND INTERPRETATION OF DATA 34-54
Distribution of subjects according to socio-demographic
variables (table1-5)
Distribution of subjects according to knowledge of
tobacco (table 6)
Distribution of subjects knowledge to regarding ill-
effects of tobacco (Table 7)
Distribution of subjects, knowledge regarding de-
addiction (Table 8)
Over all level of knowledge regarding tobacco use. (Table 9)
Positive attitude towards tobacco use (Table 10)
Negative attitude toward tobacco use (Table 11)
Relationship between knowledge and attitude. (Table
12)
Relationship between knowledge and selected
demographic variables (Table 13)
Relationship between attitude and selected
demographic variables (Table 14)
V RESULTS, DISCUSSIONS, SUMMARY, CONCLUSION, MAJOR 55-68

FINDINGS, IMPLICATIONS, LIMITATIONS AND
RECOMMENDATIONS
VI BIBLIOGRAPHY 69-74
APPENDICES
MASTERSHEET
AREA MAP OF BELGAUM CITY
XI
LIST OF TABLES
Table Particulars Page No.
1. Dist r ibut io n of subject s according to socio -demographic 35,36

var iables.
2. Dist r ibut io n of family me mber s according to use of 37

tobacco.
3. Dist r ibut io n of subject s use o f t obacco form 38
4. Dist r ibut io n of subject s according to influent ial fact or in 39

habit fo r mat ion.
5. Dist r ibut io n of subject s according to reasons for for ming 40

tobacco habit .
6. Dist r ibut io n of subject s according to knowledge o f 41

tobacco.
7. Dist r ibut io n of subject s knowledge regarding ill-effect s of 42

tobacco use.
8. Dist r ibut io n of subject s knowledge regard ing de-addict io n 43

of t obacco use.
9. Dist r ibut io n of subject s according to t he over all level o f 44

knowledge regarding t obacco use.
10. Dist r ibut io n of t he subject s according t o posit ive at t it ude 45

towards tobacco use.
11. Dist r ibut io n of subject s according to negat ive at t it ude 47

12. Relat io nship bet ween knowledge at t it ude. 48
13. Relat io nship bet ween knowledge and select ed socio - 49

demographic var iables.
14. Relat io nship bet ween at t it ude and select ed socio - 50

demographic var iables.
XII
LIST OF FIGURES
Figure Particulars Page

No.
Concept ual Framework 10

1.
Research process 33
2.
51
3. Graph showing over all level o f knowledge regarding
tobacco use.
4. Graph showing t he relat io nship bet ween knowledge 52

and at t it ude.
5. Graph showing t he relat io nship bet ween knowledge 53

and select ed socio -demogr aphic var iables
6. Graph showing relat io nship bet ween at t it ude and 54

select ed socio -demographic var iables
XIII
LIST OF APPENDICES
Sl. Particulars
No.
1. Let t er request ing per missio n for research st udy.
2. Let t er request ing for cont ent validat io n of tool.
3. List of expert s for cont ent validit y.
4. Tool and Blue Pr int
5. Mast er Sheet
6. Map o f Belgaum Cit y
7. Abst ract
8. Abbr eviat io ns
XIV
I n t r od u ct i on
Chapter – 1
INTRODUCTION
“Tobacco is slow but sure killer”
“Smoking is a custom loathsome to the eye, hateful

to the nose, harmful to the brain, dangerous to the lungs,
and in the black, stinking fume thereof nearest resembling
the horrible Stygian smoke of the pit that is bottomless.”
King James I of England
History traces that human beings has been using

tobacco since 600 A. D. It was introduced in Europe by
Columbus who came to know about it from Caribeans
during his historical journeys
The Portugues e introduced tobacco in India 400 years

ago and established the tradition of tobacco trade in their
colony of Goa. Two hundred years lat er the Britishers
introduced commercially produced cigarettes to India and
established tobacco production in the country . Today of
the 1.1 billion people who smoke worldwide, 182 million
(16.6) live in India.
Tobacco use in India is more varied than in most of

other countries. Only 20% of total tobacco consumption is
in the form of cigarettes. A common alternative to
tradit ional cigarettes is the bidi, a hand-rolled, filt er-less
tobacco cigarette. Bidis account for the largest proportion
40% of tobacco consumption in India. Tobacco is also used
in the form of hookah (a traditional water pipe), as pan
masala or guthka (a ch ewing tobacco cont aining areca

nut), as chutta (a clump of tobacco smoked with the
lighted end inside the mouth), and mishri (a powdered
tobacco on the gums as dentifrices). In India an estimated
65% of all men and 33% of all women use some form of
tobacco, snuff (inhaled powdered tobacco), khini (mixture
of t obacco and slaked lime) and creamy snuff and mishri
(burnt tobacco for cleaning teeth). While the prevalence of
smoking among men and women differs subst antially. 35%
of men and 3% of women – both use smokeless tobacco
products to approximately the same extent.
Adolescence and young adults are considered t o be

those people who fall in the 15- 24 years old range. They
considered very important by our society because they
represent the future of our natio n. During this period of
life they undergo transition from childhood to adulthood.
They face many changes in life such as hormonal,
emotional, psychological and physical maturation. They
are living in a fast paced ever -changing society where the
demands are still high. During t his period of t ime in one’s
life that many health related beliefs, attitude and
behaviours are adopted and consolidated. This st age of life
young people have increased freedom and assess t o health
compromising behaviour like tobacco u se and cert ain life
style decisions that will have long time influence on health
in latter years of life.
Tobacco kills between 8- 9lakhs people each year in

India, this will multiply many folds in the next 20 years.
Tobacco use in children and adolescent is reaching

pandemic levels. The World Bank has reported that nearly
82,000 to 99,000 children and adolescence all over the
world begin smoking everyday. About half of them would
continue t o smoke t o adulthood and half of the adult
smokers are expected to die prematurely due t o smoking
related diseases like corollary heart diseases, carcinomas,
bronchitis etc and also causes economic and social
deterioration.
The prevention of t obacco use in young people

appears to be the single greatest opportunity for
preventing non-communicable diseases in the world t oday.
If current trends continue tobacco will kill nearly 250
million of today’s children.
NEED FOR STUDY
No one begins to use tobacco with the intention of

becoming addicted (Crowe, Reeve 1994 P. 21) h owever, all
too frequent ly what began as an experience to satisfy
curiosity or peer group pressure leads to a point of no
return where addiction has occurred. Tobacco is identified
as the single most lethal agent known to humanity (united
nations foundation 1999). 9
There are 25 tobacco related diseases known today.

These include cancers of the lung, oral cavity, pharynx,
oesophagus, pancreas, bladder, cervix and leukaemia. In
India tobacco related cancers among men are about one
fifth of the total cancer among women. Besides these,
nicotine increases blood pressure, exacerbates asthma,
causes impotence, infertility, heart attack and stroke. 1 1
The largest number of deaths from tobacco -related

diseases are due t o heart attack and not , as is commonly
believed, lung cancer or any other forms of cancer. 1 3
Healthy people 2000 highlights the significance of

smoking as a major health problem and tobacco use is one
of 22 priorit y areas. 2 0
The f acts from center f or the advancement of health.
 Tobacco use usually begins in early adolescence,

typically by age 16. Among adults in the United
States who have ever smoked daily, 82 percent tried
their first cigarette before age 18, and 53 percent

became daily smokers before age 18.
 At least 4 million adolescents smoke, and more than

3,000 children and adolescents become regular users
of t obacco each day.
 Most young people, including those who say they

have smoked as few as 100 cigarettes in their
lifetime, report that they want to quit but are unable
to do so.
 Seventy-two percent of eighth graders and 88 percent

of tenth graders feel that they could get cigarettes
“fairly easily” or “very easily” if they wanted them,
although these figures have fallen since 1996.
 Among students who were high school seniors during

1976- 86, 44 percent of daily smokers believed that in
five years they would not be smoking. However,
follow-up studies indicated that five to six years
later, 73 percent of these persons remained daily
smokers.
 Nicot ine generally is the first drug used by young

people who use alcohol, marijuana, and harder drugs.
Adolescent tobacco use also is associat ed with being
in fights, carrying weapons, and engaging in high -risk
sexual behavior.
 Data from California and Massachusetts indicate that

increasing cigarette excise tax es is one of the most
cost-effective short-term strategies to reduce
consumption among adults and to reduce initiation
among youth, and that tax increases combined with

anti-smoking campaigns help to sustain lower rates
of t obacco consumption. 2 4
Nurses can intervene at all levels of prevention. The

most important intervention is primary prevention. It is
accomplished through awareness and education that
instills in population, the healt h hazards of tobacco use
and motivates them to avoid using tobacco p roduct s. 1 1
Secondary interventions focus on cessation of t obacco

use and breaking the addiction. Guiding individuals
through smoking cessation groups and educat ing
regarding alternate activities to smoking is helpful.
Tertiary prevention focuses on helpin g persons to remain
smoke free by preventing relapse. 20
As health care providers in primary care, schools

based clinics and diverse care environments, the discipline
of nursing has the professional and ethical obligation to
play pivotal role in t obacco use interventions. 2 2
The alarming statistics and the prediction of death,

diseases and disability investigator strongly felt to carry
out a baseline survey study on tobacco use, underst anding
the initiat ing factors, knowledge of adverse effects and
attitude t owards tobacco use amongst college students,
which will help to plan and arrange various methods of
awareness programs in the colleges to save the young boys
from the clutches of this evil addiction. 1 4
STATEMENT OF PROBLEM
“A study to assess the knowledge and attitude of tobacco

use among the students of selected colleges of Belgaum
city”.
OBJECTIVES OF THE STUDY
1. To assess the knowledge of tobacco use among

students
2. To assess the attitude of students towards t obacco

use
3. To find out the relationship bet ween knowledge and

attitude of the student’s regarding tobacco use.
4. To find out the association bet ween the knowledge

and select ed socio-demographic v ariables.
5. To find out the association between the attitude and

selected socio- demographic variables.
Operational def initions
Knowledge : Refers to the accurate answer to the

knowledge questions about tobacco use received through
filled in questionnaire from the students.
Poor Knowledge : If the score is less than  – 1SD
Average knowledge : In between й – 1 SD t o  + 1 SD,
Good knowledge: I f the score is more than  + 1 SD
Attitude : Refers to opinion expressed by the students

regarding knowledge, ill effects and de -addiction of
tobacco use.
Negative attitude: If the score is less than  – 1 SD.
Neutral attitude: If the score is between –1 SD to +1 SD
Posit ive attitude: If the score is more than  + 1 SD.
Tobacco use : Refers to the habit of using tobacco in the

form of smoking, chewing (Ghut ka), Brushing, souff, etc.
Students: Those who are studying for final year diploma in

selected polytechnic colleges of Belgaum city.
Socio demographic variables : Gender, habitat type of

family etc.
Hypothesis
There is significance association between level of

knowledge and attitude t owards tobacco us e at 0.05 level
of significance.
Assumptions
1. 3 r d year polyt echnic students hav e some knowledge of

tobacco, it s ill effect s on human body and regarding
de-addiction.
2. The knowledge about the tobacco use influence on

the attitude towards it .
Inclusion Criteria:
3 r d year polytechnic students in different colleges of

Belgaum City.
Exclusion Criteria:
First year and 2 n d year student s were not included.
INPUT THROUGHPUT OUTPUT
INTRA-PERSONAL
` FACTORS REACTION TO STRESS PRIMARY
 Age PREVENTION
 Gender S  Awareness
Program
 Habit
T  Health Education
 Anxiety POSITIVE
 Frustration ATTITUDE
BEHAVIOUR
 Poor Copying R MODIFICATION
strategies
E SECONDARY
PREVENTION
INTER-PERSONAL
S  Peer
FACTORS Identification
 Peer pressure  Treatment
 Poor family S
relationships NEGATIVE
 Habit in family O ATTITUDE
NO CHANGE
members
 Role expectations R TERTIARY
PREVENTION
S  Rehabilitation
 Prevent from
EXTRA-PERSONAL Relapse
FACTORS FLEXIBLE LINE OF DEFENCE
 College atmosphere
 Movie/media NORMAL LINE OF DEFENCE
 Groupisms
LINE OF RESISTANCE
 Extra Pocket Money
BETTY NEUMAN’S SYSTEM MODEL. - - - - - - - Not Under preview of the study

10
CONCEPTUAL FRAMEWORK
The conceptual model selected for the study is

based on the general syst em t heory by Bertalanffy
(1969) and Betty Neumans syst em model (1986). A
system is composed of a set of interactive elements
and yet each system is distinct from the environment
in which it exists. In all system activ ity can be
resolved into an aggregation of feed back circuits
such as input, throughput and output. The feed back
circuit helps in maintenance of an intact system. 6
According to Betty Neumans system model each

human is a tot al person and multidimensional, a
composite of physiological, psycological, socio -
cultural, developmental and spiritual variables. The
concentric rings surrounds the basic core structure
of human beings. They represent lines of resistance,
the internal factors defending against stressor s. The
normal line of defence is essentially what the person
becomes over a life time. The flexible line of defence
(broken lines) acts as a buffer t o the normal line of
defence. 5
Input - It is any form of energy, information or

human that enters int o a system through it’s
boundaries. In this study the input is all the
stressors arising variables like physiological,
psychological, socio-cultural, developmental and
spiritual. These can affect the line of defence and
resist ance of an individual – student. Students are
living in an environment where t hey are influenced by
11
different stressors like intra- personal, inter-personal

and extra-personal.
In this study the intra-personal stressors are

forces occurring within the individual like age,
curiousity, poor coping strategically, increased
freedom, etc.
Inter-personal forces occurring between one or

more individual. In this study peer pressure poor
family relationship, role expect ations leads them to
stress.
Extra-personal forces that occur outside the

system such as medias, movies, extra pocket money
influences the syst em permit them to develop health
compromising behaviors
Through put: It is the process that occurs in

between the input and output , the throughput in this
study is the reaction to stressors that is the students
easily gets into type of any high risk health
behaviours such as tobacco chewing, smoking, drugs,
alcohol, etc., which leads to addiction and illness.
Output: It is the energy, material or information

that is transferred to the envir onment. In this study
the output is careful assessment of the impact of
stress which came out from throughput on the
student and appropriate intervention.
12
Primary intervention: Awareness programmes

(awareness and guiding into act ion by motivation) in
the college campus and proper health education to
the students.
Secondary intervention: Ident ification of the

problem and early treatment.
Tertiary intervention: helps the students to

change their attitude towards t obacco use
Positive attitude - behaviour modification and
restitution
Negative attitude - No change in behaviour
added further stressors.
13
R ev i ew O f L i t er a t u r e
Chapter – 2
REVIEW OF LITERATURE
The literature review involves identification and

analysis of relevant publications that contain
information pert aining to the research problem. It
helps to discover what is already known about the
problem.
The literature relevant to this study was

reviewed and arranged in the following sections
1. Literature related to knowledge attitude and

behavior of college student s t owards tobacco
use.
2. Literature related to its ill effect s of tobacco use

among adolescence.
Section - I
Literature related to knowledge attitude and behavior.
1. Attitude and practice regarding tobacco

consumption among the college students of
Bhavnagar city, a study conduct ed by U. N. Shah,
P. B. Verma, C. B. Tripathi (1998) on 585 final
year students of various colleges, the tobacco
consumption seems to be more common in non -
medical (29.4% ) as compared to medical students
but it was not the case (17.6% ) it is expected that
the tobacco consumption should be lower among
medical students because of their knowledge, but it
14
is not the case, the knowledge did not change the

behaviour of the students. Out of 394 male
students, 54 (13.70% ) were smokers, of whic h 23
(5.83% ) were daily smoker and 31 (7.86% ) were
occasional smoker. The highest 27.8% prevalence
rate of smoking was found in life science college
and lowest was in pharamacy college i.e., 4.1% .
2. Charles W. Warren, Leanne Riley, et. al. (1999)

Conducted a project to study for disease control
and prevention to track tobacco use among youth
in 13 countries across the world. The finding of the
study shows that tobacco use in the age group of
18-24 ranged from a high of 33% to a low of 10% .
The majority of the respondents reported being
taught in school about the dangers of smoking.
Environmental tobacco smoke exposure was very
high in all the countries, majority of current
smokers wanted to stop smoking very few were able
to attend a cessation program. These result shows
that GYTS surveillance system is enhancing the
capacity of countries to design, implement and
evaluate tobacco prevention and control programs. 6
3. Prakash C. Gupta and Hemali C. Mehta (2000)

conducted a Cohort study of all -cause mort alit y
among tobacco users in Mumbai. Active follow up
of 52568 individuals in the cohort was undert aken
5-6 years after the baseline st udy, it is report ed
that 97.6% were traced. A tot al of 4358 deaths
were recorded among these individuals. The annual
15
adjusted mortality rates were 18.4/1000 for men

and 12.4/1000 for women. The mortality rates for
smokers were higher than those of non -users of
tobacco across all age groups among men. 7
4. A Study conducted by David Williamson (2001)

Shows that family-direct ed program can reduce
adolescent tobacco use. A family program designed,
implemented and evaluated reduced first use of
tobacco among adolescents by about 25% in white
teens. When all teens in the st udy were included,
the reduction rate was 16.4% . 1 3
5. An observat ional study by P. Mecarron et. al.,

(2001), The study about tobacco use in early
adulthood out of 11755 students participants 9887
(84.1% ) were using tobacco. The mean age of the
students at the time of examinat ion was 20.5years.
The study revealed that overall mortal ity in later
life was dramatically increased for men who were
smoking in early adulthood. 1 4
6. Neelam Narayan Bansode (2002) undertook an

exploratory study on Guthka and smokeless
tobacco consumption. Among the peons ad clerks
of various colleges in Mumbai. U se of tobacco in
the subject who were peons was alarmingly high,
majority 64.29% of the male peons were using
smokeless tobacco regularly. The prevalence of
tobacco consumption among female peons was
42.10% , Male clerks was 14.45% while among
female clerks were 2% . The result of the study
16
highlighted on cert ain fact ors responsible for

tobacco consumption such as social, cultural,
personal, family practices, influence of the friends
and media and market force. 1 5
7. “Tobacco use Among Youth: A cross -country

comparison (2002) the study findings indicate
that.
 9.4% of smokers smoked six or more cigarettes

per day.
 28% of student thought that boys who smoke

have more friends.
 80% of students saw ads for cigarettes at

sporting.
 10.6% of students were offered free c igarette by

a tobacco company.
 17% of students owned an object with a cigarette

brand logo. 1 6
8. J. N. Sinha (2003) Conducted a Survey study.
To obtain informat ion on intensity of tobacco

products advertisements t arget ing the youth in 14
states of India.
The response rate was 100% in 10 states and 92%

and 96% at Tripura and Meghalaya. Over 25% of the
students in all states thought that boys and girls who
smoke or chew tobacco have more friends and look
more attractive. Over four in ten students currently
17
use tobacco in all states except Orrisa, Uttar Pradesh

and Uttaranachal. 1 8
9. Dhirendra N. Sinha et. al. (2003) did a cross

sectional study in rural Bihar. All participants
were residents of Akt a village, among the whole
population 3566 were children (< 15 years) . The
prevelance of smokeless tobacco use was 6.2% and
smoking 0.3% . Most smokeless tobacco use was in
the form of red tooth powder 77% , smokeless
tobacco use among adults (male 2910, female
2586). Smoking prevalence was 27.7% (31.6%
males, 23.4% females). The most prevalent form (>
80% ) was bidi smoking both in men and women. 1 7
10. Global youth Tobacco survey (GYTS) a press

release (2006): Report reveals t hat 14% of 13- 15
years old students from the world currently smoke
cigarettes. Also found that nearly 25% students
who smoke, tried their first cigarette by the age of
10 and most smokers want to quit. Further centers
for disease control and prevention (CDC), the
W.H.O. and National Cancer Institute reports that
second hand smoke was extremely high in all
countries. 2 2
11. A. S. Pradeep Kumar (2005), conducted a

community based cross sectional study on tobacco
use, survey dat a suggest that the age at initiation
of tobacco use appears t o be falling. Tobacco use
habits of fathers and peers are significant
influence on youth smoking.
18
12. Fact sheet (2006) tit led Youth tobacco use and
exposure is a global problem. In a survey of 13 to
15 year old students from 75 cities in 43 countries,
current use of tobacco products ranged from nearly
63% Nagaland region in India to just over 3% Goa
region, India. Current cigarett e smoking ranged
from 39.6% at Chile to less than 1% Goa region
India. Over 20% of student smoked six or more
cigarettes per day, nearly 25% of students smoked
their first cigarette before the age of 10 years.
13. R. Samant, M. Malette et. al. (1999) conduct ed

a study on cigarette smoking among cancer
patients. A total of 17,823 cancer patients were
seen at NEORCC (North Eastern Ontario Regional
Cancer Center) during the time period of January
1991 to December 1999 inclusive. Cigarette
smoking history data was available for 15850
patients (88.9% ) of which 7952 (50.2% ) were
women and 7898 (49.8% ) were men overall, 72.7%
of patients (60.8% ) of women and (84.6% ) of men
reported a history of smoking and were either
former or carried smokers.
19
Section - II
Literature related to ill-effects of tobacco us e

among adolescence.
14. Mr. Yang et. al., (1995) conducted a comparat ive

study on the prevalence of oral pre -cancerous
lesions in different countries. In India, the
prevalence of Oral leukoplakia among betel quid
chewers with tobacco ranged from 0.4 to 1.8% and
among betel quid chewers without tobacco ranged
from 0.3 to 0.7% . In Thailand, the habits of
chewing included use of areca quid with tobacco.
The prevalence of leukoplakia was 1.1% and not
strongly correlated by logistic regression. 4
15. Yao Chonghus (1997) conducted a case control

study for 103 C. H. D. patients, showed that the
impact of cigarette smoking on C. H. D. risk in
hypertensive was 3.5 times than non
hypertensives. It showed the higher incidence of
C.H.D. in smokers. 1
16. According to national survey in 1998 in China, the

percentage of passive smokers were exposed to
smoke everyday. Most passive smokers are women
and children. Dr. Heyao reported that the risk of
C.H.D. for women exposed t o smoke was 3 to 3.5% .
17. A KAP study conducted by Prakash C. Gupta

(1999) with regards of tobacco usage among
adolescents. 1278 boys and 353 girls studying in
the final year (15- 16) in various schools in
20
Mumbai. Tobacco usage was significan tly higher in

private English medium schools (22.5% ) compared
to private Indian language schools (6.9% ) and
municipal Indian language schools (13.8% ). 1 0
18. A study conducted by Sarala Krishnamurthy on

tobacco use in rural children done in Tamil Nadu,
Gujarat and Karnat aka. It has found that out of
241 students 25% chewing t obacco, 23.7% smoked
tobacco and 38.2% used tobacco in the form of
snuff. Children knew the harmful effects of
chewing of tobacco and of using snuff. 1 1
19. Karen Chalmers 2000 did a study on health

promotion among Nursing students on t obacco
control. The study highlighted t he need for a more
effective approach for helping students, to
underst and and learn the health promotion and
role of nursing in relation to tobacco control.
Student’s lack of knowledge of assessment and
interview skills and smoking cessation intervention
must be addressed before they are graduate with
sure confidence and compet ence to address
smoking issues. 1 2
20. DiFranza et. al. (2002), studied that in

adolescence smokers salivary continine a
metabolite of nicotine and a bio - chemical marker of
tobacco use, increases sharply over time this
increase consumption to deal with nicotine related
cravings more in adolescents. 2 4
21
21. N. Jairath et. al. 2003 conducted a study on

childhood smoking clinical and theoretical
imperative for nursing action. The evidence of the
study said that behaviourally based interventions
by nurses for smoking prevention and cessation are
effective with children, providing social support,
resist ing temptation to smo ke and discussing
issues related to relapse and prevention helps in
reinforcement. 2 6
22. Ariya Wardana, A.D.S Athukorala, Arulanandam

(2005), did a study on 74 patients with oral
submucous fibrosis and 74 controls who
consecutively attended the oral medicine c linic at
the Dental Hospital, University of Pperadeniya, Sri
Lanka. Betel chewing along with tobacco was the
only significantly associated factor in the aetiology
20
of OSF.
23. Department of Medical Oncology, Institute

Rotary Cancer Hospital, All I ndia Instit ute of
Medical Sciences, Ansari Nagar, New Delhi. (2005).
A school-based cross- sectional study covering two
schools. Students of classes IX and XI, of selected
schools, participated in the study (n=596). Almost
42% of tobacco users start ed before the age o f 12
years. Peer pressure. General stress, and media
were import ant influences. Logistic regression
analysis showed that students in public school
were using more t obacco. The difference in use
22
between the genders and class in which studying

was stat istically not significant. 21
24. A study conducted on beliefs and attitudes

regarding smoking among young and adult s
Latinos by Foraker RE, et. al., (2006). The
participants were 19 Latino adults (37% female),
18-24 years of age. Latino culture was more
influential factor. The participants acknowledged
adverse health effects of tobacco use. Barriers to
preventing and stopping tobacco use are its
accept ance among peers and its use during social
situations. Although some Latinos would like to
quit, cultural barriers included lack of knowledge,
unwillingness to ask for help, and perceived
deficiency of Spanish language resources regarding
tobacco dependence interventions. Participants
lacked understanding of how research might
benefit their cultural community.
23
M et h od ol ogy
Chapter – 3
METHODOLOGY
Methodology of research includes the general

pattern of organizing the procedure for gathering
valid and reliable dat a for problem under
investigat ion (Polit and Hungler, 1991) 9
This chapter presents the methodology used for

the study includes research approach, research
design and steps taken for development of tool,
setting of the study, sampling t echnique, pilot study
and plan for data analysis. 5
Research approach
The research approach is most essential part of

any research and the entire study is based on it since
the present study is aimed at ident ifying the
knowledge and attitude of college students regarding
tobacco use, it’s ill effects and de -addict ion, a
descriptive survey approach was felt to be
appropriate and used for the study. 9
Research design
Researchers consider design as a precisely

conceived blue print that brings empirical evidence to
bear on the research problem. It provides
methodologic direction. Such as sampling and data
analysis (James A Fain, 2003) 5
24
M et h od ol ogy
Research design used for the proposed study was

non-experimental descriptive design to find out the
knowledge and attitude of tobacco use among
polytechnical students in selected colleges of
Belgaum city.
Variables
A variable is any phenomenon or characteristic

or attitude under study. They are measurable
characteristics of a concept and consists of a logical
group of attitudes.
Types of variables are Dependent and Independent
Independent or intervention variable is one

where the investigator manipulates or introduces the
situation. The independent variable in this study is
knowledge and attitude of students.
Dependent variable is the outcome measure

hypothesized to represent t he effect of the
intervention. The dependent variable in this study is
regarding t obacco use. 6
Research hypothesis
Hypothesis is a statement that explains or

predicts the relationship or differences between two
or more variables in terms of expected results or
outcomes of a study (J.A Fain, 2003)
25
M et h od ol ogy
H1 – There is a significant associatio n between

knowledge and attitude of polytechnic college
students towards t obacco use at P = 0.05 level of
significance. 5
Research Setting
The settings for the study selected were as

Polytechnic colleges in Belgaum city. There are 6
colleges all t ogether. They are:
1. Gomtesh Polytechnic College, Hindwadi.
2. Pot dar Polytechnic College, Hindwadi.
3. R. N. Shetty Polytechnic College,
4. Government Polytechnic College
5. Maratha Mandal Polytechnic College.
6. Bharatesh Polytechnic College. (This was

selected to conduct pil ot study)
Population:
Since the study focused on to assess the

knowledge and attitude of students, towards tobacco
use, the target populat ion for the study were students
of polytechnic colleges at Belgaum city.
Sample and sampling technique:
Polit and Hungler (1995) Status that the sample

consists of a subject of population selected to
26
M et h od ol ogy
participate in a research study. Sampling refers to

the process of selecting the samples for the study. 9
Sample select ion for the present study was done

by systematic random sampling from all the five
polytechnic colleges at Belgaum city.
The total number of students were 482, to make

a convenient size of sample to include in the study
every sixth student from the college register were
selected to include in the study.
The sample for the present study consisted of

145 final year polytechnic college students both male
and female students were included.
Method of Data Collection
A validated self-administered structured

questionnaire was used to collect the data to asses s
the knowledge and attitude of student regarding
tobacco use. It was found to be feasible and suitable
to collect data from large sample. 9
Description of the tool
Considering the setting of the research and

characteristics of the subject, a self -administered
structured quest ionnaire was prepared after an
extensive review of literature, observation in the field,
discussion with the experts such as Nurse educators,
27
M et h od ol ogy
experts from the preventive and the social medicine

department. 8
The final tool was organized in three following

sections,
Section I – Socio- demographic variables.
Section II – It has been divided into three subsections
a) The knowledge of students regarding tobacco.
b) The knowledge regarding ill effects of tobacco

use.
c) The knowledge regarding de-addiction of tobacco

use.
This section had 15 items of multiple –choice

questions.
Section III – It was developed to find out the

attitude of students towards t obacco use, there
were 15 items in this section, which were arranged
in three point Likert scale s uch as Agreed,
uncertain and disagreed.
Knowledge score
The knowledge was categorized and arranged using

the formula, mean ± standard deviation
1. Score < 5 = Poor
2. Score between 5 to 9 = Average
3. Score > 10 = Good.
28
M et h od ol ogy
Attitude score
4. Score <23 = Negative attit ude.
5. Score between 23 to 36 = Uncertain.
6. Score more than 36 = Positive Attitude
Content validity
The tool and blue print were sent to 6 experts

for content validity of which who were community
health nurse educators, in community medicine
doctors. No major modification were suggested by the
experts. 5
Pilot Study
Pilot study is a careful empirical checking of all

phases of the study from the collection of data to the
analysis. The purpose of the pilot study is two fold, it
helps to find feasibility and ma ke improvements and
modifications in research plan before the main study
is attempt ed. 5
The pilot study was conducted at Bharatesh

Polytechnic College, Kudchi, 10 Kms. Dist ance from
the main city. 20 students were selected for the
study. A structured questionnaire was administered.
It was revealed through the pilot study that two
questions were too easy. Opinion of the guide were
sought and the structured of both the questions were
changed. They are as follows
29
M et h od ol ogy
1) Commonly tobacco is used by changed to -

Smoke from other peoples cigarette is
harmful to others
2) Anti-tobacco messages can be more

effective through changed to - Have you
ever received health or advice to help you
stop this habit of tobacco use.
Reliability
According to Polit and Hungler (1991) the

reliability of an instrument in the degree of
consistency with which it measures the attributes it
is supposed t o be measuring.
The reliability of the tool was tested by

introduction the t ool among the students who were
assessed for pilot study. The spil t half technique was
used in the test for internal consistency.
The spearman’s co-efficient of correlation and

Braun’s proficiency formulae for reliabilit y was used.
The reliability of the tool was (r=0.99). 6
Procedure for data collection
After obt ainin g the formal permission from all

the five college principal’s the data were collected in
the class room it self during t he break -time as per
the schedule. The subjects were explained about the
30
M et h od ol ogy
purpose of the study, filling of quest ionnaire in

conducting the study.
Plan for data analysis.
Statistical analysis is the method of rendering

quantit ative information meaningfully and
intelligently. Further statist ical procedures enable
investigat or to reduce, summarize, evaluate interpret
and communicate, numeric information in meaningful
way.
Statistical treatment applied
Statistical analysis used in this study was

descriptive and inferential.
Descriptive analysis describes t he nature of an

object or phenomenon under st udy, which provides
us with profiles of organization, work groups, persons
and other subjects on any of a mult itude of
characteristics such as size, composition, efficiency,
preferences etc. (Krishnaswami OR)
Inferential analysis is concerned with drawing

inferences and conclusions from the findi ngs of a
study (Krishnaswami OR)
Descriptive analysis used in the present study was :
1. Frequency.
2. Percentage.
3. Mean.
4. Standard Deviation
31
M et h od ol ogy
Inferential analysis used in this study was Chi –

square test to find out the association between
 Knowledge and attitude of tobacco use among

the students.
 Knowledge and selected socio -demographic

variables.
 Attitude and selected socio -demographic

variables.
32
M et h od ol ogy
Research Process
Target Final year polyt echnic

Population college students
Sample Size 145 in number
Systemat ic random
Sampling sampling
Structured
Instrument Questionnaire
Data Collection
 Socio demographic variable
 Knowledge regarding tobacco
 Knowledge regarding ill effects
of t obacco use
 Knowledge regarding de-
addiction
 Attitude towards tobacco use.
Descriptive
Frequency, % , mean, Standard
Analysis deviat ion
Inferential
Chi-square test
33
A n a l y si s & I n t er p r et a t i on of D a t a
Chapter – 4
ANALYSIS AND INTERPRETATION OF DATA
Analysis and interpretati on of Data
Abedellah and Levine (1979) st ates that

interpret ation of tabulated data can bring to light the
real meaning of the finding of the study. 6
This chapter deals with analysis of dat a

collected from 145 students studying in final year of
5 polytechnic colleges regarding tobacco use. A
structured self- administered questionnaire was used
to collect the data for the study. 9
The findings of the study were organized and

represented t o fulfill the following objectives:
1. To assess the knowledge of tobacco , it’s ill

effects and the de- addiction among the
students.
2. To identify the attitude towards tobacco use.
3. To find out the association between knowledge

of t obacco use and attitude t owards it.
4. To underst and the association between

knowledge of tobacco use and select ed socio-
demographic variables.
5. To identify the association between attitude and

selected socio- demographic variables.
34
Table – I
DISTRIBUTION OF SUBJECTS ACCORDING TO
SOCIO-DEMOGRAPHIC VARIABLE
(N= 145)
Sl. F R EQ - P ER CEN-
VARIAB LES
No. UENCY TAG E
1. GENDER
MALE 120 82.75
FEMALE 25 17.24
2. AGE IN YEARS
18- 20 80 55.17
21- 23 50 34.4
24- 26 7 4.8
3. RELIGION
HINDU 128 88.27
MUSLIM 14 9.65
CHRISTIAN 3 2.06
4. HABITAT
URBAN 90 62.06
RURAL 55 37.93
5. EDUCATIONAL ST ATUS OF THE

FATHER
POST-GRADUAT E 8 5.51
GRADUAT E 33 22.75
HIGHER SECONDARY 42 28.96
SECONDARY 49 33.79
PRIMARY 10 6.89
N0-FORMAL EDUCATION 3 2.06
6. EDUCATIONAL STATUS OF MOTHER

POST-GRADUAT E 5 3.44
GRADUAT E 15 10.34
HIGHER SECONDARY 15 10.34
SECONDARY 48 33.10
PRIMARY 40 27.58
N0-FORMAL EDUCATION 22 15.17
35
7. OCCUPATION OF FATHER
BUSINESS 37 25.51
GOVERNMENT SECTOR 44 30.34
PRIVAT E SECTOR 43 29.65
AGRICULTURE 21 14.48
8. OCCUPATION OF MOTHER
BUSINESS 11 7.58
GOVERNMENT SECTOR 14 9.65
PRIVAT E SECTOR 10 6.89
HOUSEWIFE 110 75.86
9. TYPE OF FAMILY
NUCLEAR 53 36.55
JOINT 69 47.58
EXT ENDED 23 15.86
10 FAMILY INCOME PER MONTH

< 5000 33 22.75
5001 t o 10,000 66 45.51
10,001 to 15,000 33 22.75
15,001 to 20,000 13 8.96
The data presented in table 1 revealed that

majority of the subject (55% ) were in the age group of
18 to 20 years, 4.8% in the age group of 24 to 26
years and 82% of total subjects were male. Majority
of the subjects 88.27% were belonged to Hindu
religion and 2% were Christians. 62% of the subjects
were from urban habit at. Regarding education of
parents 2% of fathers and 15% of mothers had no
formal education. 14.4% father’s occupation was
agriculture and 75.8% of mothers were housewives.
36.5% of subjects were from nuclear family.
13.7% subjects family had income of 10,000-
20,000rupees per month.
36
Table – 2
DISTRIBUTION OF FAMILY MEMBERS ACCORDING

TO USE OF TOBACCO.
(N = 145)
Sl. Relationship with Frequency Percentage

No. the subject
1. Father 84 57.93
2. Mother 11 7.58
3. Brother 12 8.27
4. Sister 4 2.75
5. No family member 34 23.44

using tobacco.
Table 2 depicts that fathers of 84 (57.93% )

subjects were t obacco users where as none of the 34
(23.44% ) subjects family members were using
tobacco.
37
Table – 3

TOBACCO USED IN THE FORM OF
N=145
Sl. Habit Frequency Percentage

No.
1. Smoking 23 15.86
2. Chewing tobacco 54 37.24

(Gutkha)
3. Chewing betel leaves - -
4. No Habit 68 46.89
The above table shows that 54 (37.24% ) used

tobacco in the form of chewing , 23 (15.86% ) in the
form of smoking and 68 (46% ) subjects had no habits.
38
Table – 4

INFLUENTIAL FACTOR IN HABIT FORMATION.
N=145
Sl. Influence by Frequency Percentage

No.
1. Friends 55 38.00
2, Relat ives 03 2.06
3, Media 19 13.10
4. Non-user 68 46.89
Table 4 reveals that 55 (33.93% ) subjects were

influenced by friends and 19 (13.10% ) by media.
39
Table – 5

REASON FOR FORMING TOBACCO HABIT.
(N = 145)
Sl. Reason Frequency Percentage

No.
1. Frustration 17 11.72%
2. Pleasure / T imepass 28 19.31%
3. To boast self-esteem 3 2.06%
4. For Concentration 29 20%
5. Non-user 68 46.89%
Table 5 depict that 29 (20% ) subjects says that

the reason for starting tobacco was to increase
concentration, 28 (19.31% ) for pleasure and time
pass, 17 (11.72% ) to divert frustration.
40
Table – 6

KNOWLEDGE OF TOBACCO.
(N=145)
Sl. Particulars Frequency Percentage

No.
1. The original form of tobacco 100 68.96
2. The poisonous content in 95 65.51

tobacco
3. The effect of tobacco on 96 66.20
human health
4. Formation of addiction 56 38.62
Tobacco is used in the form of 70 48.27
Overall mean 83 57.24
Total number of responses 145 x 5 = 725
Findin gs in the table number 6 indicates that

100 (68.96% ) of the subjects knew the original form
of t obacco whereas 95 (65.5% ) knew that tobacco
content is poisonous, same number of subjects 96
(66.20% ) responded that the use of tobacco is
harmful to human being. 56 (38.62% ) of the subjects
said continuous use of tobacco in any form causes
addiction.
41
Table – 7
DISTRIBUTION OF SUBJECT’S KNOWLEDGE

REGARDING ILL-EFFECTS OF TOBACCO USE
(N = 145)
Sl. Particulars Frequency Percentage

No.
1. Tobacco use and cancer 48 33.10
2. Tobacco chewing and 51 35.17

type of cancer
3. No tobacco is yes to 59 40.68
4. Local effect of tobacco 74 51.03

chewing
5. Passive Smoking 61 42.06
Over all mean 58 40
Table 7 reveals that 35.17% knew about the t ype

of cancer c aused by t obacco chewing, 51.03% were
aware about the ill effects of t obacco chewing and
only 42% said passive smoking is harmful.
42
Table – 8
DISTRIBUTION OF SUBJECT’S KNOWLEDGE

REGARDING DE-ADDICTION
(N = 145)
Sl. Knowledge regarding de - Frequency Percentage

No. addiction
1. Tobacco habit and self 103 71.03

will-power
2. Rehabilitation centers 41 28.27
3. Banning of T obacco 85 58.62

products
4. Availed help for de- 21 14.48

addiction.
5. International ‘No t obacco 81 55.86
day’.
Over all mean 66 45.5
Table number 8 describes that 71% of the

subjects said that quitting of t obacco habit depend
upon will power, 58% says that tobacco should be
banned, 28% knew about the rehabilitation centers
for de- addiction and only 14% received help for de-
addiction.
43
Table - 9
DISTRIBUTION OF SUBJECTS ACCORDING TO THE

OVER ALL LEVEL OF KNOWLEDGE REGARDING
TOBACCO USE
(N= 145)
Sl. Knowledge level Frequency Percentage

No.
1. Poor (< 5) 17 11.7
2. Average (5 to 9) 99 68.2
3. Good (> 10) 29 20
Total 145 99.9
To measure the level of knowledge the

formula is (mean ± SD) is used
Table 9 indicates that 11.7 percent of subjects

were poor in their knowledge about tobacco, it’s ill
effects and de- addictions. Whereas 68.2% had
average knowledge and 20% of them had good
knowledge.
44
Table 10
DISTRIBUTION OF THE SUBJECTS ACCORDING TO

POSSITIVE ATTITUDE TOWARDS TOBACCO USE.
(N=145)
Sl. Responses Frequency Percentage

No.
1. Tobacco use a serious health 106 73.1

problem.
2. Tobacco use should be 121 83.4

discouraged.
3. Information on health hazards 119 82.0

and tobacco use.
4. Role of mass media in habit 104 71.7

formation.
5. Role of Teachers and healthy 118 81.3
habits.
6. Quitting of tobacco. 108 74.4
7. No tobacco habit is healthy living 114 78.6
8. Financial loss. 104 71.7
9. Positive attitude towards healthy 115 79.3

habits.
Over all positive attitude 1009 77.3
45
The above table reveals that 77.3% of the

subjects had positive attitude t owards tob acco use,
83.4% said tobacco use should be discouraged, 73.1%
accepted that it is becoming a serious health
problem, 71.7% said mass media plays an important
role in forming habit s.
46
Table 11
DISTRIBUTION OF SUBJECT ACCORDING TO

NEGATIVE ATTITUDE TOWARDS TOBACCO USE:
(N = 145)
Sl. Responses Frequency Percentage

No.
1. Smoking and status. 43 29.6

2. Gutkha chewing and 39 26.8
stress.
3. Tobacco chewing a healthy 6 4.1
habit
4. Tobacco chewing and self 13 8.9
esteem
5. Cigarette with filt er is 14 9.6
safe.
6. Friends should be 30 20
encouraged.
Over all negative 145 16.5
attitude.
The above table reveals that only 16.5% had

negative attitude t owards tobacco use. 20% of
subjects said friends should be encouraged, 9.65%
said cigarette with filt er is safe and 4.1% responded
it is a healthy habit .
47
Table 12
RELATIONSHIP BETWEEN KNOWLEDGE AND

ATTITUDE
(N=145)
Sl. Knowledge ATTITUDE Total %

No.
Positive % Uncertain % Negative %
1. Good 2 6.9 26 89.7 1 3.4 29 20
2. Average 14 14.1 50 50.5 35 35.4 99 68.9
3. Poor 4 23.5 12 70.6 1 5.9 17 11.7
Total 20 13.8 88 60.7 37 25.5 145 100
2 = 19.602 df=4 p= <.001
The above table describes that there is

statistically signif icant association between the
knowledge and attitude of students towards use of
tobacco.
Calculated, P=<. 001 at level of significance.
48
Table 13
RELATIONSHIP BETWEEN KNOWLEDGE AND

SELECTED SOICIO -DEMOGRAPHIC VARIABLES
(N=145)
Sl. Habit KNOWLEDGE

No. Tobacco
Poor % Average % Good % Total %
Use
1. Yes 16 94.1 42 42.4 19 65.5 77 53
2. No 1 5.9 57 57.6 10 34.5 68 46.9
Total 17 11.7 99 68.3 29 20 145 100
2 = 17.831 d f =2 p <.001
Table 13 narrates that there is statistically

significant relationship between knowledge and
selected socio-demographic variables. The calculated,
P< .001 at level of significance.
49
Table 14
RELATIONSHIP BETWEEN ATTITUDE AND

SELECTED SOCIO -DEMOGRAPHIC VARIABLES.
(N=145)
Sl. Habitat ATTITUDE TOWARDS TOBACCP USE Total %

No.
Positive % Uncertain % Negative %
1. Urban 12 13.3 55 61.1 23 25.6 90 62.1
2. Rural 8 14.5 33 60.5 14 25.5 55 37.9
Total 20 13.8 88 60.7 37 25.5 145 100
α = 0.042 df = 2 95<p <.99
Table 14 shows that there is no statistically

significant relationship bet ween attitude of students
towards tobacco use and their place of residence. The
calculated 95<P <. 99.
50
Fig 3: Graph Showing Overall Level Of Knowle dge

Regarding T obacco Use
160
145
140
120
99 99.9
No. of Subjects
100
Frequency
80 68.2 Percentage
60
40 29
17 20
20 11.7
0
Poor Average Good Total
Knowledge Level
51
Fig 4: Graph showing the relationship between

knowledge and attitude
160
140
120
100
Knowledge
80
60
40
20
0
Positive Uncertain Negative Total
Attitude
Good Average Poor Total
52
Fig 5: Graph showing the relationship between

knowledge and selected socio- demographic variables
160
140
120
100
Frequency
80
60
40
20
0
Poor Average Good Total
Knowledge
Yes No Total
53
Fig 6: Graph showing the relationship betwe en

Attitude and selected socio- demographic variables
160
140
120
100
Frequency
80
60
40
20
0
Positive Uncertain Negative Total
Attitude
Urban Rural Total
54
M a j or F i n d i n gs, D i scu ssi on , S u mma r y , C on cl u si on
Chapter – 5
RESULTS (Major Findings)
The study was undert aken to find out the

knowledge and attitude of students towards tobacco
use, and the findings indicate that –
1. 57% of the students had knowl edge regarding

tobacco. Where as only 40% had the knowledge
of ill effects of tobacco use.
2. 45.5% had the knowledge about t he de -addiction

of t obacco use.
3. Looking in t o above facts (H 1 ) Hypothesis is

accepted since calculated  2 value shows that
there is significant association bet ween
knowledge and attitude of st udents t owards
tobacco use at P=<.001.
4. Regarding attitude t owards tobacco use. 77% of

students had health positive at titude and only
16.5% had negative attitude towards it.
5. The 2 test (19.60) showe d t hat there was

statistically significant relationship (p< .001)
between knowledge and attitude of students
regarding t obacco use.
6. Calculated  2 test (17.83) showed that there is

statistical significant relationship (p < .001)
level between knowledge and tobacco use.
55
DISCUSSION
This chapter deals with the discussion and

summary of the study and the conclusions drawn.
Nursing implications of the study are also given for
the different aspects such as Nursing education,
Nursing practice and Nursing resear ch. It classifies
the limitat ions of the st udy and suggests
recommendation for the future research.
The present study was undertaken to assess the

knowledge and attitude of tobacco use among the
students of polyt echnic colleges in the city of
Belgaum. In this section the finding of the study are
discussed under the following headings
1. Finding regarding socio- demographic dat a of

the students.
2. Findings related to the knowledge about

tobacco, it’s ill-effects and de- addict ion.
3. Findings related to the knowledge and attitude

of students towards tobacco use.
I. Findings regarding socio- demographic dat a of

students.
In the present study, a sample size consisting of

145 students were studied. T he majorit y 55% of
students were in the age group of 18 to 20 years.
While only 7 (4.8% ) students were bet ween 24 to 26
years. Regarding education of parents majority 42%
subjects fathers had secondary education and only
56
2% had no formal educat ion, whereas 33% of mothers

finished secondary education and 15% had no formal
education.
30% of fathers were working in Government

sector and 14% were agriculturist, 75% of mothers
were housewives. As far as the type of family
concerned the study revealed that 47.5% subjects
were from joint family, whereas 36.5% belonged to
nuclear and 23% extended families. Disintegration of
family syst em, habitat, family type, influence in the
form of habits. Further from the economic status of
the family 45.5% of the parents monthly income was
between 5,000 to 10,000 rupees, whereas 30% of
parents had a monthly income of 10,000 to 20,000
rupees. This shows that economic factor had
influence in habit formation.
Table 2 shows that distribution of family

members regarding tobacco use. The present study
revealed that 58.2% fathers, 7.5 mothers, 8.2%
siblings had the habit of using tobacco in one or
other form. It is evident that, there was a great er
influence from family members for the development of
habit to the children.
57
Anthony Biglan (1995), conducted a similar

study on 643 adolescents, dev eloped a structu red
equat ion model which clearly showed that inadequate
parental monitoring, associated with deviant peers
adolescent accept tobacco habit very easily.
Table 3 reveals that 37.24% of the subjects had

the habit of tobacco chewing, 15.8% smoking whereas
46.8% never touched tobacco.
Table 4 depicts that the influential fact ors in

habit formation was 38% by friends, 13.10% by
media, 2% by relatives whereas 46.8% never got
influenced at all. It showed that peer group and
media too plays an important role in h abit formation.
Similar study conducted by Ajzen and Fishbean

(1985) on smoking related behaviours and attitude
on significant others. His study result shows that
friends and parents were t he most consistent
predictors of adolescent smoking.
Table 5 describes the reason for forming tobacco

habit. 20% said for more concent ration during exams,
19.3% for fun and pleasure, 11.7% to elevate the
mood. It shows various misconception youngsters
have about tobacco use.
58
Findings related to the knowledge about t obacco,

its ill-effects and de-addiction.
Table 7 reveals that most of t he subjects 57%

had knowledge about tobacco. Regarding the ill -
effects and de-addiction the knowledge was below
average. 35% knew the type of cancer caused by
tobacco chewing and only 42% said passive smoking
is harmful and 14% only availed help for de -
addiction. However the result showed the youngsters
are unaware about the consequences of t obacco
addiction.
- The above study support s the study conducted

by P. B. Verma, et. al. (2005) tobacco
consumption among the college students. Out of
114 students, 68 students wanted to give up and
57 students had tried t o give up the habit, and
only 13 students (11.40% ) could succeeded and
rest of them failed t o do so. This shows that the
students need more awareness and information
about de- addiction centers, where they get proper
help in giving up the habit .
Table 10 reveals that majorit y 77.3% subjects

had positive attitude towards t obacco use. 82% of
subjects admitted that they need more deta il
information about ill-effects and 71.7% accepts that
mass media plays an important role in habit
formation among youngsters.
59
This study was supported by tobacco epidemic

W.H.O. report (1998) out of 48% of students 82.2%
said t obacco product must be ban ned from the
market, 54.7% responded health education and
public awareness should be raised about the health
hazards of tobacco consumption and 44.3% said
tobacco advertisement should be banned.
Table 12 depicts that there was st atistically

significant as sociation between knowledge and
attitude at p<.001. 23.5% of subjects having poor
knowledge had positive attitude compared to 6.9% of
subjects having good knowledge. 35.4% subjects
having average knowledge exhibits negative attitude
as against 3.4% subject s with good knowledge.
James Derzon et. al. (2004) conducted an

meta-analysis study on the empirical findings of
published and unpublished studies on development of
tobacco use on 64 studies and 106 reports. Analysis
of the study showed that 82% of those at risk did not
use tobacco because of personal skills and
knowledge.
Table 13 describes there is relat ionship between

knowledge and habit formation. 94.1% subjects with
poor knowledge were tobacco users as against 65.5%
of subjects with good knowledge an d 42.4% with
average knowledge. There was highly significant
calculated p=<.001 at level of significance.
The findings of the study proved that ignorance

led them to habit formation.
60
Table 14 depicts that there was no associat ion

between attitude and place of residence of subject.
Whereas study done by V.P. chest institute Delhi

shows different picture about knowledge and use of
tobacco and habitat . In this study it shows the
tobacco prevalence was more in urban females and
rural men compared to urban men and rural females.
61
SUMMARY OF THE STUDY
Along with multiple rules and responsibility of

adulthood. They are developing as individuals and
need to be concerned with their health. Adulthood is
usually a time of relatively good physical and mental
health. When people have the opportunity to assume
personal responsibility for their behaviors.
The present study is a non -experimental

descriptive survey study. It was undertaken to assess
the knowledge and attitude of tobacco use among the
students of selected colleges of Belgaum city.
The study aimed at accomplishing the following

objectives:
1. To assess the knowledge of t obacco use among

students.
2. To assess the attitude of the students towards

tobacco use.
3. To find out the relationship between knowledge

and attitude of the students regarding tobacco
use.
4. To find out the association between the

knowledge and selected socio-demographic
variables.
5. To find out the association between the

attitude and selected socio-demographic
variables.
62
The conceptual framework used for the said study

was based on Betty Neumann’s Health Care syst em
model (1989)
Stressors that causes INDIVIDUAL to interact with

his ENVIRONMENT NURSES can assist the individual
to attain maximum levels of total wellness by
purposeful interventions.
Review of literature was directed towards the

various aspect s of knowledge and attitude studies
Data was collected by using self administered

structured questionnaire.
Content validity of the tool was established on the

basis of expert judgment, reliability, pre-testing and
pilot study.
The co-efficient of correlation for reliability was

r=0.99
Main study was conducted from 1 s t May to 15 t h

May 2006. Data collected was tabulated and analysed
by using descriptive and inferential st atisti cs. The
study revealed that :
1. There was st atistically significant relationship

(p<.001) between knowledge and attitude of
students regarding tobacco use.
2. Calculated 2 (17.83) showed that there is

statistical association (p<.001) of level bet ween
knowledge and tobacco use.
63
3. The calculated 2 (0.042) showed that there is

no association (p<.99) between attitude and
place of residence of students.
64
CONCLUSION
Based on the findings of the study, the following

conclusions were drawn
1. Over all mean knowledge of th e students

regarding t obacco was 57% .
2. They had only average knowledge about the ill

effects and de- addiction of t obacco use.
3. Regarding attitude majority of the student had

healthy positive attitude towards tobacco use.
4. There was highly significant associat ion

between knowledge and attitude of students
regarding t obacco use.
5. There was statistical association between level

of knowledge and t obacco use.
6. The study showed that there was no association

between attitude and place of residence of
students.
After assessing the knowledge and attitude of

college students regarding tobacco use there is an
alarming (urgent) need for the health care providers
for developing programs for prevention and
eradication of t obacco use from t he students.
65
RECOMMENDATIONS
On the basis of findings of the study the

following recommendations can be made for further
research.
1. A similar study may be conduct ed in large scale

in order to draw generalization.
2. A comparative study can be done between Urban

colleges and Rural colleges.
3. An experimental study can be conducted with

structured teaching program on knowledge and
attitude.
4. A similar study can be conduct ed between life

science colleges and medical colleges.
LIMITATIONS
1. The study was limited to Urban colleges.
2. No broad generalizat ion could be made due to

limited area of setting and limited sample size.
66
IMPLICATIONS OF THE STUDY
Nurses are in the prime positions to empower

individuals, families, communities and nations in the
prevention and treatment of tobacco use. Health for
all continues to be a call for equity and social just ice
by incorporating a global perspective of health and
linking it to community action, nurses can assist to
extinguish this fire of t obacco use from our country.
Nursing Practice
Organized and need based patient education has

to be developed as an interesting innovative function
of health care delivery system. The responsibilities of
the nurses in the hospit al are manifold: teaching,
counseling, guidance and behaviour modification
technique that influence patient’s knowledge and
health behaviour.
Community health nurses are the link between

community and the health care system. The present
study revealed that , there is association between
knowledge and attitude also knowledge and
behaviour. Being in this pivotal role they could plan
and design teaching modules that updat e the
knowledge of the students.
Nursing Education
Healthy young people form healthy nation.

Health is given a very import ant place in the national
67
as well as in the international level. T he trend has

changed from curative aspect to promotion and
preventive aspect. It is the responsibility of the
institution to include student’s health and welfare in
the curriculum for the promotion of health of the
nursing students. The current program can be
restructured to produce competent personnel of
various skills, great professionally equipped and
socially motivated to effectively deal with the day to
day problems within the existing constrains.
Nursing Research
Based on the findings nurses can con duct

further research studies for the implementation of
more broader and easy way to make the program
people friendly and popular. Preparing proper method
of teaching module, which will be effect ive to improve
the knowledge among the students.
68
B i b l i ogr a p h y
Chapter – 6
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74
APPENDIX – 1
From,
M.Sc. Final Year Nursing Student,
K.L.E.S.’s College of Nursing Sciences,
Nehru Nagar, Belgaum – 10
To,
The Principal,
Polytechnic College
Belgaum.
Sub : Request to grant permission to conduct a Research

Study at your esteemed institution.
Respected Sir,
I, Mrs. Omana R. Shinde a final year student of M.Sc.
Nursing of K.L.E.S’s Institute of Nursing Sciences, have
selected the following topic for my research study to be
submitted to the Rajiv Gandhi University of Health Sciences,
Bangalore, in partial fulfillment for the M.Sc. degree.
Topic: “A STUDY TO ASSESS THE KNOWLEDGE AND
ATTITUDE OF STUENTS ON TOBACCO USE IN THE SELECTED
COLLEGES OF BELGAUM CITY”.
Hence, I request your kind self to extend the necessary
permission and facility to work on the proposed project.
Hoping you will consider an oblige.
Thanking you in anticipation.
Place: Belgaum Yours faithfully,
Date :
(Mrs. Omana R. Shinde)
APPENDIX – 2
From,
Final Year M.Sc. Nursing,
K.L.E.S’s Institute of Nursing Sciences,
Belgaum.
To,
Through Proper Channel
Sub: Letter requesting opinion and suggestions of experts for

establishing content validity of the tool.
Respected Sir/Madam,
I am a Master of Nursing Student of K.L.E.S Institute of
Nursing Sciences, Belgaum, in the specialty of community
health nursing. As per the partial fulfillment of the Nursing
Degree under Rajiv Gandhi University of Health Sciences,
Belgaum, I have selected the following topic for my dissertation.
“A STUDY TO ASSESS KNOWLEDGE AND ATTITUDE OF
TOBACCO USE AMONG THE STUDENTS OF SELECTED
COLLEGES OF BELGAUM CITY”.
I therefore request you to kindly validate the tool and
give your valuable suggestions.
Thanking You. Yours faithfully

Date:
Place: Mrs. Omana R. Shinde
APPENDIX – 3
1) Dr. Mrs. Laxmi Rane M.Sc. (N) Ph.D.
H.O.D. (Community Health Nursing)

MSRINER Bangalore – 54
2) Prof. Rajeshwari Vaidyanathan M.Sc. (N)
Principal, College of Nursing.

Madras Medical College.
Chennai – 600003
3) Prof. Achiamma Singh M.Sc. (N)
Principal, T.G.I.N.E.
Grant Medical Foundation,
Pune – 1
4) Prof. David A. Kola M.Sc. (N)
Professor,
K.L.E.S.’s Institute of Nursing Sciences,
Belgaum-10.
5) Associate Prof. Meenaxi Devangmath M.Sc.(N)
Department of Community Health Nursing,

K.L.E.S.’s Institute of Nursing Sciences,
Nehru Nagar, Belgaum-10.
APPENDIX – 4
PART – I
Baseline Proforma
Di rection s:
1. Yo u are exp ect ed t o read each st at ement o f ind icat e yo ur respo nses b y
p lacing a t ick mark () against t he appro pr iat e o pt io n.
2. I request yo u to be free and frank while expressing yo ur o p inio ns.
3. Yo ur answers will rema in st r ict ly co nfident ial.
4. P lease ret urn t he co mp let ed qu est io nnaire to t he researcher
5. Thank yo u fo r yo ur co -o perat io n.
Back g round in fo rmation :
1. Co de
2. Ag e in year s
3. Gender
3.1 Male
3.2 Female
4. Relig io n
4.1 Hindu
4.2 Muslim
4.3 Chr ist ian
4.4 An y o t her sp ecify
5. Habit at
5.1 Urban
5.2 Rural
6. Educat io nal st at us o f fat her
6.1 Po st graduat e
6.2 Graduat e
6.3 Co lleg eat e
6.4 Seco nd ar y
6.5 Pr imar y
6.6 No -fo r mal educat io n
7. Educat io nal st at us o f mo t her
7.1 Po st graduat e
7.2 Graduat e
7.3 Co lleg eat e
7.4 Seco nd ar y
7.5 Pr imar y
7.6 No -fo r mal educat io n
8. Occup at io n o f fat her
8.1 Business
8.2 Go ver nment sect o r
8.3 Pr ivat e sect o r
9. Occup at io n o f mo t her
9.1 Business
9.2 Go ver nment sect o r
9.3 Pr ivat e sect o r
10.T ype o f family
10.1 Nuclear
10.2 Jo int
10.3 Ext end ed
11.Family inco me p er mo nt h
12.An y o ne o f t he family member s are hav in g t he habit o f u sing

to bacco .
12.1 Fat her
12.2 Mot her
12.3 Brot her
12.4 S ist er
12.5 Any o t her specify
13.Do yo u have an y o t her fo llo wing habit ?
13.1 S mo k ing
13.2 Chewing t o baco o (Gut kha)
13.3 Alco ho l
13.4 Eat ing bet el leaves wit h t o bacco
14.Who int ro duced yo u t o t his habit ( influ enced by)
14.1 Fr iend s
14.2 Relat ives
14.3 Med ia (T.V., Magazine)
14.4 Neig hbo urs
15.Ho w o ft en do yo u co nsu me t o bacco in a d ay
15.1 2 – 4 t imes
15.2 5 – 7 t imes
15.3 8 – 10 t imes
15.4 Mo re t han 10 t imes
16.Ho w d id yo u develo p t his habit becau se o f
16.1 Frust rat io n
16.2 P leasure
16.3 To bo o st self est eem
16.4 To increase co ncent rat io n in wo rk
17.Do yo u face any healt h pro ble m wit h t his habit
17.1 Lack o f app et it e
17.2 Mo re salivat io n
17.3 Co ugh and breat hlessness
17.4 Weig ht lo ss
PART – II
Assessment o f kno wledg e rega rding tobacco :

1. The o r ig ina l fo r m o f t o bacco is
1.1 Leaf
1.2 Seed
1.3 Ro ot
1.4 St em
2. The po iso no us su bst ance in t o bacco is called as
2.1 Alk ali
2.2 Acid
2.3 Nico t ine
2.4 Do not kno w
3. Act io n o f t o bacco is lik e
3.1 S lo w po iso ning
3.2 St imu lant
3.3 To nic
3.4 Sedat ive
4. To bacco is used in t he fo r m o f
4.1 S mo k ing
4.2 Chewing
4.3 Inha lat io n
4.4 All o f t he abo ve
5. Co nt inuo us u se o f t o bacco is co nsid ered as
5.1 Ad d ict io n
5.2 Habit
5.3 St yle
5.4 So phist icat ed
Assessment o f K nowledg e rega rding i ll effects :
1. Pro lo ng u se o f t o bacco in any fo r m leads t o
1.1 Ulcer
1.2 Bro nchit is
1.3 Cancer
2. The t yp e o f cancer co mmo n in t o bacco chewers
2.1 Sto mach cancer
2.2 Lu ng cancer
2.3 Oral cancer
2.4 Int est inal cancer
3. No to bacco is, yes to
3.1 Lo ng life
3.2 Opt imu m healt h
3.3 Well being
4. Oral effect s o f t o bacco chewers
4.1 Mo ut h u lcers salivat io n
4.2 Disco lo urat io n o f t eet h
4.3 Swelling o n gu ms and bleed ing
5. Have yo u ever lear nt in yo ur scho o l, co llege abo ut t he effect o f
to bacco o n t he hu man bo d y.
5.1 Seco ndar y
5.2 Hig h scho o l
5.3 Co lleg e
5.4 Never
Assessment o f kno wledg e rega rding de- addiction:

1. Giv ing up t o bacco hab it depends o n
1.1 Self will po wer
1.2 Parent s fo rce
1.3 Teacher s fo rce
1.4 Fr iends fo rce
2. The place where help is available to quit tobacco habit is in
2.1 Hospit als
2.2 Po lice stat ion
2.3 Clubs
2.4 Rehabilit at io n centers
3. Have yo u ever received help or advice to help you stop this habit o f
tobacco
3.1 Never used
3.2 Yes fro m a program or pro fessio nal
3.3 Yes fro m a friend
3.4 No
4. Tobacco products should be banned
4.1 Always
4.2 So met imes
4.3 Never
4.4 Do not know
5. Internat io nal “No tobacco day” is observed on

5.1 31 st May
5.2 1 st January
5.3 31 st December
5.4 15 t h August
Assessment of attitude towards tobacco use
Sl.
Particulars Agree Uncertain Disagree
No.
1 Smoking gives status to the yo ung
adults
2 Tobacco use is beco ming a grave
healt h pro blem amo ng co llege students.
3 Co llege students should be discouraged
fro m tobacco use.
4 Gutkha chewing releases tensio n
5 Tobacco chewing is a healt hy habit.
6 Tobacco chewing essent ially impro ves
one’s self esteem.
7 Cost ly cigarettes wit h filter is always
safe.
8 One must encourage friends to use
tobacco
9 Students shou ld be given proper
informat io n about the healt h hazards o f
tobacco use.
10 Mass media plays an important ro le in
develo ping tobacco habits amo ng
student s.
11 Teachers play key ro le in developing
healt hy habit s amo ng student s.
12 “Qu it tobacco now, Else tobacco will
eat you o ne day”
13 Giving up t he tobacco habit is o ne o f
the basic necessit ies for healt hy living
14 Money spent for tobacco can be
ut ilized buy nutrit ious food
15 One builds life wit h healt hy habit s or
breaks it wit h unhealt hy habit s.
BLUE PRINT
Sl. Contents Item No. Frequency Percentage

No. (f) (%)
1 Assessment of Section 1,2,3,4,5

knowledge 5 33.33
Section 1,2,3,4,5
regarding
2
Assessment 5 33.33
regarding ill Section 1,2,3,4,5
3 effects of
tobacco use 5 33.33
Assessment
regarding the
de-addiction
of tobacco
habit
Total 15 100
1 Assessment of 1-15 15 100

attitude
towards
tobacco use
APPENDIX - 5
MASTER SHEET
Knowledge Score (N = 145)
Maximum score - 15
Sr. No. Score Sr. No. Score Sr. No. Score

1 11 24 3 47 7
2 9 25 4 48 9
3 9 26 5 49 11
4 10 27 9 50 11
5 10 28 10 51 8
6 7 29 10 52 12
7 7 30 9 53 6
8 5 31 6 54 4
9 10 32 4 55 5
10 6 33 6 56 4
11 10 34 2 57 4
12 6 35 7 58 3
13 6 36 6 59 8
14 6 37 5 60 6
15 9 38 6 61 6
16 12 39 9 62 7
17 7 40 8 63 12
18 10 41 10 64 8
19 4 42 10 65 9
20 9 43 12 66 6
21 8 44 5 67 5
22 7 45 9 68 7
23 7 46 11 69 7
70 6 98 9 126 5
71 7 99 9 127 10
72 8 100 9 128 12
73 5 101 6 129 6
74 6 102 9 130 6
75 5 103 9 131 4
76 4 104 7 132 4
77 3 105 8 133 3
78 4 106 8 134 9
79 6 107 12 135 7
80 5 108 11 136 6
81 8 109 10 137 4
82 3 110 11 138 6
83 8 111 9 139 5
84 7 112 5 140 7
85 6 113 6 141 11
86 7 114 11 142 9
87 9 115 5 143 9
88 5 116 10 144 10
89 8 117 7 145 5
90 7 118 9
91 6 119 12
92 6 120 7
93 11 121 5
94 6 122 5
95 5 123 5
96 7 124 8
97 7 125 5
Attitude Score (N = 145)
Maximum score - 50

1 42 29 42 57 18
2 30 30 27 58 24
3 21 31 27 59 36
4 42 32 18 60 21
5 42 33 18 61 36
6 27 34 15 62 36
7 30 35 24 63 33
8 24 36 24 64 33
9 24 37 15 65 33
10 42 38 27 66 27
11 15 39 39 67 36
12 33 40 33 68 27
13 30 41 33 69 30
14 24 42 33 70 33
15 30 43 33 71 42
16 27 44 33 72 36
17 27 45 33 73 39
18 33 46 27 74 30
19 24 47 39 75 18
20 30 48 36 76 21
21 33 49 33 77 24
22 27 50 42 78 30
23 24 51 33 79 30
24 36 52 33 80 33
25 24 53 39 81 33
26 24 54 33 82 24
27 30 55 30 83 33
28 38 56 21 84 30
Sr. No. Score S r. No. Score Sr. No. Score
85 24 105 30 125 24
86 30 106 36 126 24
87 33 107 33 127 33
88 24 108 30 128 36
89 27 109 36 129 30
90 39 110 42 130 24
91 24 111 24 131 24
92 27 112 21 132 24
93 39 113 30 133 27
94 24 114 39 134 30
95 30 115 30 135 27
96 27 116 21 136 30
97 30 117 36 137 21
98 39 118 36 138 27
99 27 119 42 139 27
100 36 120 42 140 33
101 24 121 18 141 30
102 39 122 27 142 27
103 39 123 27 143 33
104 36 124 27 144 30
145 30
APPENDIX - 6
APPENDIX - 7
ABSTRACT
“ A stu dy to asse ss the knowl edge an d attitu de of

tobacc o use am ong the stu den ts of selecte d polytechn ic
col leges of Bel gau m c ity”, was con ducte d by Oman a
Shin de in parti al fu lfillment of the requirem ent an
regul ation s for the awar d of the degr ee of master of
scien ces in Nur sing K.L. E.S ’s I nstitute of Nursi n g
Scienc es, Be lgaum, Karnataka.
The obj ectives of the stud y were to: -

1. A sses s the knowle dge of stu den ts regardin g tobac co
u se.
2. A sses s th e attitu de of stu den ts t owar ds tobacc o u se.
3. F ind out the re lationshi p between know le dge an d
attitude of the stu dents r e gardin g tobacc o u s e.
4. F ind out the ass ociati on betw ee n the knowle dge an d
sele cte d s oc io- dem ogr aph ic var iable s.
5. F ind out the as sociation betw e en th e attitude an d
sele cte d s oc io- dem ogr aph ic var iable s.
The con ceptu al framework for this study w as based on
Gener al s ystem th eory by Bertal anffy an d Betty Neu man’s
system mode l. A s ystem is com pose d of a set of inter activ e
elemen ts su ch as input , throu gh put and the output.
Inp ut – Stress ors from v ariou s f actor s su ch as intr a -
pers onal, in ter -person al an d e xtra-pers onal. The intra-
pers onal stre ss ors in this s tudy are age , gen der,
cu riou sity, poor copin g str ategic all y amon g the stu dents.
Inter-person al f actor s in this study are peer pressur e,
poor f ami ly re lati onshi p, role expect ation s le ads them to
stress .
Extra- pers ona l factors are me di as /mov ie s, enou gh mone y

to s pen d perm it th e student f or h abits an d stre ss .
Through put in this stu dy i s the reacti on to stress the
students e as ily acc e pt any hi gh risk beh av iours su ch as
tobacc o chewing, sm okin g, etc., which leads to addic t ion
and i llne ss.
Output : I n this study the outpu t is carefu l ass ess men t of
the impact of tobacc o rel ate d pr oblem among stu dent an d
appr opriate interv ention .
Prim ary inter vention : aw arene ss pr ogram in the coll ege
cam pus an d h ealth e duc ation .
Secondar y in t ervent ion: is early i dentification an d
treatment.
Tertiar y in terven tion : is Reh abilitat ion an d
Interv entions to he lp the stu dents for behav i our
modific ation an d restitution .
1. The study assumes th at 3 rd year polyt ech nic students

hav e some kn owl edge of tobac co, its ill e ffe cts on human
body re gar din g de- addicti on.
2. Student’s knowle dge influence tow ards attitude.
The des ign s ele cted for the stu dy was non-
exp er i men tal d escr ip tive . The independen t var iables wer e
knowled ge an d atti tude of studen ts and dependen t variable
was tobacc o use . T he study was con du cte d on 145
students of fiv e polyte chnic coll e ges of B elgaum city.
Syste matic rand om sampl ing t ec hniqu e was u se d to se lect

the sample
The tool in clu de d base line pr of orma and kn ow le dge ,

attitude , qu esti onn air e about u se of tobac co, ill ef fe cts
and de-addiction. The data was anal yze d with the h e lp of
descri ptiv e and in ferenti al statistics .
The major fin din gs rev eale d that : -

1. 57% of the students had knowl edge r egarding
tobacc o where as only 40% had the kno wle dge of ill
effects of tobacc o on h uman be ing.
2. 45. 5% h ad the knowledge about th e de - addicti on of
tobacc o u se.
3. Looking into abov e facts (H1) hypoth esi s is al so
acc epte d s ince v alu e of calcu late d  2 shows that there
is high ly s ign ific ant as sociation betwe e n kn owl edge
and attitu de of stu dent t owar ds t obacc o u se .
4. Regar ding attitude t owards tobacc o use . 77% h ad
healthy p os itiv e attitude an d only 16. 5% h ad
negativ e attitude t owards it .
5. The 2 test sh owed that th ere was st atisti call y
signifi can t r el ation shi p (p<. 001) between kn owle dge
and attitu de of stu dent t owar ds t obacc o u se .
6. Cal cul ated  2 te st showe d that there was statist ical
signifi can t rel ation shi p P<. 001 between knowle dge
and tobacco us e.
7. The 2 test showe d th at ther e is no ass ociation
between attitude an d place of resi denc e of students
at P>0.05 lev el .
On th e bas is of the fin dings the foll owin g

recommendati ons are made :
1. A similar stu dy n e ed s to be con ducted in a br oader
area in or der to dr aw generalizati on.
2. A compar ativ e stu dy can be con du cted bet ween u r ban
and Rural colle ge students.
3. A comparativ e study with the help of a teach in g
program in or der to dev el op appr opr iate te ach in g
modu le .
APPENDIX - 8
LIST OF ABBREVATIONS
1. W. H. O - World He alth Organ iz ation
2.  - Mean
3. SD - Standard Dev iation
4.  2 - Chi-squ are
5. KA P - Knowl edge Attitude & Practice

A Study To Access The Knowledge and Attitude of Tobacco Use Among Students of Selected Colleges of Belguam City

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A Study To Access The Knowledge and Attitude of Tobacco Use Among Students of Selected Colleges of Belguam City

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“A Study to assess the knowledge and attitude of

tobacco use among the students of selected colleges

Mrs. Omana R. Shinde

Under the Guidance of

Prof. David A. Kola M .Sc. ( N),

K.L.E. Society’s Institute of Nursing Scienc es,

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation entitled – “A Study to

assess the knowledge and attitude of tobacco use among the

students of selected colleges of Belgaum city” is a bonafide and

genuine research work carried out by me under the guidance o f

Prof. David A. Kola M . S c . ( N) , Head of Department, Co mmunity

Health Nursing, K.L.E.S Institute of Nursing Sciences, Nehru

Nagar, Belgaum – 10.

Mrs. Omana R. Shinde

This is to certify that the dissertation entitled “A Study to

assess the knowledge and attitude of tobacco use among the

students of selected colleges of Belgaum city ”, is a bonafide

research work done by Mrs. Omana R. Shinde in a partia l

fulfillment of the requirement for the degree of Master of Sciences

Mr. David A. K ola M . S c . ( N ) Ms. Meenaxi R. Devangmath M . S c . ( N )

This is to certify that the dissertation entitled “A Study to

assess the knowledge and attitude of tobacco use among the

students of selected colleges of Belgaum city” is a bonafide

research work done by Mrs. Omana R. Shinde under the guidance

of Prof. David A. Kola M . S c . ( N) , Head of Depart ment, Communit y

Seal & Signature: Seal & Signature:

Mr. David A. Kola. M . S c . ( N) Mr. R. S. Hooli M . S c . ( N)

Place: Belgaum Place: Belgaum

Declaration by the Candidate

I hereby declare that Rajiv Gandhi University of Health

Sciences, Karnataka shall have the rights to preserve, use and

disseminate this dissertation in print or electronic format for

academic / research purpose.

Mrs. Omana R. Shinde

My teacher. . . . My best friend. . . . My husband

Dr . Ravi kan t G. Shi n de M.D.(Med.)

who made me believe in myself . . . . . Is and will

“ When you have come to the edge

My hear tfel t than ks to al l

PLACE: Si gn atur e of the can di date

II. REVIEW OF LITERATURE 14-23

III. METHODOLOGY 24-33

V RESULTS, DISCUSSIONS, SUMMARY, CONCLUSION, MAJOR 55-68

Table Particulars Page No.

1. Dist r ibut io n of subject s according to socio -demographic 35,36

2. Dist r ibut io n of family me mber s according to use of 37

3. Dist r ibut io n of subject s use o f t obacco form 38

4. Dist r ibut io n of subject s according to influent ial fact or in 39

5. Dist r ibut io n of subject s according to reasons for for ming 40

6. Dist r ibut io n of subject s according to knowledge o f 41

7. Dist r ibut io n of subject s knowledge regarding ill-effect s of 42

8. Dist r ibut io n of subject s knowledge regard ing de-addict io n 43

9. Dist r ibut io n of subject s according to t he over all level o f 44

10. Dist r ibut io n of t he subject s according t o posit ive at t it ude 45

11. Dist r ibut io n of subject s according to negat ive at t it ude 47

12. Relat io nship bet ween knowledge at t it ude. 48

13. Relat io nship bet ween knowledge and select ed socio - 49

14. Relat io nship bet ween at t it ude and select ed socio - 50

Figure Particulars Page

Concept ual Framework 10

4. Graph showing t he relat io nship bet ween knowledge 52

5. Graph showing t he relat io nship bet ween knowledge 53