Social cognitive determinants of smoking behavior among junior secondary school students, Kinondoni district, Dar es salaam, Tanzania

Abstract

Background: Cigarette smoking is emerging as the world's largest preventable cause of morbidity and mortality with more of these deaths occurring in developing countries. Evidence from research indicates that cigarette smoking is a behavior that starts during adolescence making this group a special focus for intervention. Data on the prevalence of cigarette smoking among in school adolescents is limited including factors associated with intention to smoke. Understanding the factors contributing to this health risk behavior is important in designing possible areas for intervention. Objectives: The study aimed to determine the prevalence of cigarette smoking among adolescents in Kinondoni municipal, Oar es Salaam including social and cognitive factors that may help explain smoking behavior and intention using a theory based approach. Materials and Methods: A cross sectional descriptive quantitative study was conducted among junior secondary school students using a multistage cluster sampling procedure. Data were analyzed to assess if socio cognitive variables were associated with smoking intention and behavior including bivariate and multivariate logistic regression analysis in selected variables of interest. Results: One out of ten of the surveyed adolescents had ever tried smoking a cigarette. Cognitive variables such as attitudes, subjective norm and perceived behavior control were significantly associated with smoking intention in future. Smoking behavior of significant others had influence on intiation of smoking behavior among the students. There were few sociodemographic factors that had effects on cognitive variables. Conclusion and Recommendations: Findings of this study underlie the importance of taking into account social norms and individual understanding of adverse effects of smoking in the design of prevention activities. The study also points out the importance of acquiring social and personal skills necessary for making abiding decision not to smoke. These and other preventive activities need to be introduced in the adolescents life before they enter secondary school as entrants to secondary schools appear to be a risk of contemplating and initiating smoking behavior. Further studies need to be carried out to elucidate operating factors that protect woman from smoking and places males at higher risk of smoking.