Smoking Prevalence by Region SMOKING PREVALENCE AMONG HIGH SCHOOL STUDENTS IN A TOBACCO-PRODUCING REGION (ILOCOS SUR, PHILIPPINES)

Lenora C. Fernandez, M.D. Deanna D. Quilala, M.D.

University of the PhilippinesPhilippine General Hospital

PHILIPPINES

East Asia & the Pacific 61% Europe & Central Asia 57% Sub-Saharan Africa 29%
-Gajalakshmi et al, 2000

The Philippines

Smoking Prevalence Among Filipinos

Ranks 15th on apparent tobacco consumption with some 85.36 billion cigarettes or 1.6% of the worlds total

33% of adult Filipinos are current smokers 13% are ex-smokers

WHO, 1997

Dans, et.al., Monograph of Cigarette Smoking

Smoking Prevalence Among Filipinos

Tobacco Production

Among elementary and high school students in Metro Manila aged 10-20:
29.6% of students have tried smoking Majority of students started smoking in their early teens

The Philippines produces an average 71,117 metric tons of tobacco per year Major exporter of Virginia and Burley tobacco

Gappi, et.al. 1999

Ilocos Sur
Produces 95.61% of the countrys Virginia tobacco

Ilocos Sur

1.5 million Ilocanos depend on the tobacco industry, including 40,000 farmers
-National Tobacco Administration

Significance of the study

No existing anti-smoking program in Ilocos Sur Results will serve as baseline data for future programs and policies on smoking prevention and control

Objectives:

To determine the prevalence of smoking among high school students in a tobacco-producing region To determine smoking patterns among high school students

Methodology

Methodology

Research design: Cross-sectional survey Target population: High school students

Sample population: 2,714 public high school students in Ilocos Sur (Philippines) Sampling method: Random sampling

Definition of Terms

Data collection tool: 16-point Self-administered questionnaire

Non-smokers any person who does not smoke at all at the time of the survey Daily or regular smoker any person who smokes a tobacco product of any kind at the time of the survey

Definition of Terms

Statistical Analysis

Occasional smoker any person who smokes a tobacco product of any kind less than once a day Ever-smoker any person who has smoked a tobacco product of any kind in his/her lifetime. Relapser a person who quit smoking and returned to the habit again.

Epi-Info Statistical Analysis Program Chi-square test (p<0.05)

RESULTS

2,714 studentrespondents 10-21 years old (mean age 13.2 years)

Figure 1. Proportion of students who have ever tried smoking

Fig. 2. Comparison of smoking history by sex

83%

31.60% Yes No
17%

59.20% 40.70% Males Fem ales

68.40%

Ever Smokers

Nonsmokers

Fig.3 Age distribution of students at first exposure to smoking

Fig. 4. Reasons for smoking

41.60% 32.75% 23.98%

48.95%

23.08% 15.60% 6.80%

2.56% 10-12 yrs. 13-15 yrs 16-18 yrs 19-20 yrs

Peer influence Parents smoke Sibling smokes Teacher smokes

Fig. 5. Reasons for quitting smoking

60.20%

12.18%

10.78%

10.50%

192 (43.92%) have worked in a tobacco farm (farm hand, classifier, etc.) 144 (5.3%) claimed that working in a tobacco farm has influenced them to smoke

Protect health

Avoid Pressure unpleasant from symptoms authority

Set a good example

Fig. 6. Percentage of current smokers

Fig. 7. Percentage of Relapsers

8% 13% Daily smokers

Daily
Occasional smokers Non-smokers 79%

75.3

24.7

Relapsers NonRelapsers

Occasionally

41.2

58.8

50

100

Fig. 8. Reasons for Smoking Again After Quitting

Fig. 9. Smoking habits of parents and siblings

98.40%

75%

37%

25% 2%

38% Parents 2% Don't smoke Siblings

14%

6%

5% Others

Smoke

Peer pressure

Parents smoke

Sibling smoke

Used to smoke

Conclusions
31.6% of students in Ilocos Sur are ever-smokers 22.8% of students are current smokers Majority of students started smoking in their early teens

Conclusions
Peer influence is the primary reason for trying to smoke and for smoking again after quitting More family members smoke in the homes of ever-smokers and current smokers

Recommendations

Recommendations
Integrate tobacco use prevention concepts in the school curriculum Involve parents or families, and local authorities in support of programs to prevent tobacco use Support cessation efforts among students and al school staff who use tobacco

Develop and enforce a school policy on tobacco use Provide information about the short and long-term negative physiologic and social consequences of tobacco use, peer norms regarding tobacco use, & refusal skills Provide program-specific training for teachers