Prevalence, perceived factors and knowledge on effects of tobacco use on oral health among secondary school students in Dar es salaam

Abstract

ABSTRACT Background: At the time of the conception of this study there was scant information on self reported prevalence, knowledge on detrimental effects on oral health and factors influencing tobacco use among secondary school students in Dar es Salaam region. Objectives: To determine the prevalence, perceived factors that may lead and /or deter secondary school students to use tobacco and knowledge on effects of tobacco use on oral health among secondary school students in Dar es Salaam. Materials and methods: This was a descriptive cross-sectional study conducted among ordinary level secondary schools in Dar es Salaam. A sample of 1084 students from 9 schools was selected using stratified random sampling procedure. Selected students were requested to fill in a Swahili version questionnaire that had questions on prevalence of tobacco dipping, chewing and smoking; knowledge on detrimental effects of tobacco dipping, chewing and smoking and factors that may influence students to start tobacco dipping, chewing or smoking. Data analysis was done using SPSS version 13 and Chi-square test was used to test associations between independent and dependent variables. The level of statistical significance was set at p<0.05. Results: One thousand sixty seven out of 1084 students handed in the filled questionnaire to the researcher, constituting a response rate of 98.4%. The proportion of students reported to have ever dipped tobacco snuff, chewed tobacco and smoked cigarettes at their school was 2.2%, 4.4% and 4.4% respectively. Majority of students (70.6%, 70.8%, and 71.2%) were respectively fully knowledgeable on relationship between dipping tobacco snuff, chewing tobacco and smoking cigarettes and occurrence of oral cancer. Students who were respectively fully knowledgeable on relationship between dipping tobacco snuff, chewing tobacco and smoking cigarettes and occurrence of periodontal diseases were 71.6%, 69.3%, and 67.0%. The proportion of students who reported that their parents and school teachers would not be concerned if they would use tobacco was 13.7% and 12.6%. ‘Influence of friends’, ‘Trying or experimenting taste of tobacco’ and ‘Not knowing detrimental health effects of using tobacco’ were perceived as factors that may influence a person to start dipping tobacco snuff, chewing tobacco and smoking cigarettes. ‘Knowing detrimental health effects caused by use of tobacco ’, ‘Good guidance from parents and guardians’ and ‘Religious teachings’ were perceived as vi factors that may inhibit a person to start dipping tobacco snuff, chewing tobacco and smoking cigarettes. Conclusions: The prevalence of tobacco dipping (2.2%), chewing (4.4%) and smoking (4.4%) among secondary school students in Dar es Salaam appear to be low. Majority of students who participated in this study had adequate level of knowledge on the detrimental effects of tobacco use on systemic and oral health. Factors that were perceived by majority of students as important in promoting students to start dipping tobacco snuff, chewing tobacco and smoking cigarettes were: ‘Not knowing detrimental health effects caused by using tobacco’, ‘Trying or experimenting taste of tobacco’ and ‘Influence of friends’. Factors that were perceived by majority of students as inhibitors for students to start dipping, chewing and smoking tobacco were: “Knowing detrimental health effects caused by tobacco use”, “Good guidance from parents and guardians”, “Religious teachings” and “Living in a society that dislikes tobacco use” Recommendations: Although the prevalence of tobacco use appears to be low there is need for intervention among secondary school students so as to prevent possible continued trend of tobacco use. There should be a call for religious leaders, parents, school teachers to be involved in discouraging use of tobacco among secondary school students. Parents/guardians and other family members should not ask children light, buy cigarettes for them or smoke in front of them. Health education should be taught to raise awareness on detrimental effects of tobacco use among secondary school students.