 |
|
Smoking constitutes a major public health problem worldwide and it is a formidable barrier to development in many developing countries. Studying the spread of smoking among the general population is crucial for the proper design of health policy and strategy in any country. Additional insight to the smoking epidemic can be obtained from studying specific subgroups of interest within the population, such as adolescents. Because of many problems associated with cigarette smoking, considerable efforts have been made in health education to both prevent non-smokers from starting smoking and encourage smokers to quit smoking.1 These educational efforts have not been successful; today 12 billion smokers are there around the world; most (800 million) live in developing countries, where cigarette smoking is spreading rapidly among adolescents.1 It is generally agreed that the most effective way to solve the problem is to influence young people not to start smoking. Many risky behaviors including cigarette smoking begin during adolescence,1,3 so school age children are the most appropriate group for any intervention program aiming to prevent risky behavior and promote a healthy style. Teachers are highly respected in their communities as they influence the evolution for each aspect of life and for this reason they are important in advancing anti tobacco control policies. Little is known about how smoking practices in a school are related to the adolescent smoking behavior.4 Some researchers reported that the prevalence of smoking declines when there is a ban on smoking on the school ground.4,5 Kebede Y (2002) reported that prevalence of cigarette smoking in university instructors in Ethiopia seem to have decreased but the prevalence of khat chewing is almost the same as it was some year’s ago.6 In Yemen, with the same situation as in Ethiopia regarding high proportion of khat chewing and smoking in population7, studies about smoking in school environment were scarce; Bawazeer et al in 1999 reported that about 19.6% of secondary school students in Aden were smokers.8 The aim of this study was to identify the prevalence of smoking, knowledge and attitudes of secondary school teachers in Hadramout governorate in Yemen.
A descriptive KAP study was conducted in the ten secondary schools in Hadramout coastal districts in Yemen. (Mukalla, Shehir and Ghail Bawazeer districts) including five secondary schools for females, four secondary schools for males and one co-education school. Data were collected during the period from October 2004 to April 2005 from all teachers; a total of 317 teachers (182 male and 135 female teachers) were interviewed by a group of female medical students (third year students of Hadramout University). A closed ended questionnaire was used for this study. The data were coded, entered and analyzed by using Excel computer program. Independent variables were age, sex, specialty and qualification of schoolteachers. Qualification was defined as secondary school or university graduation.
Low prevalence of smoking in secondary school teachers were observed (8%), none of the female teachers was a smoker, giving the prevalence of smoking in male teachers of 14%. The highest smoking prevalence was observed in male teachers over 50 years old (17%), those who teach social subjects (18%) and those who have at least secondary school education (46%). Table No 1: Prevalence of smoking among secondary school teachers in Hadramout coastal districts
Table No 2: Attitudes of male teachers toward teachers who smoke
Table No 3: Attitudes of female teachers toward teachers who smoke
Positive attitudes were reported among study subjects regarding smoking teachers and their relation with students and more often teachers warn students not to initiate smoking (47%). Differences in attitudes between male and female teachers were reported regarding two things: while 58% male teachers felt that teachers who smoke affect negatively on students, 74% of female teachers felt the same [p-value <0.003]; 70% male teachers felt that a teacher who smokes is bothersome while 85% of female teachers felt similarly. As regards to practice of smoking prevention, only 10% of teachers had received training to limit smoking among students, and 27% had educational materials about harmful effects of smoking.
Teachers can be credible role models with regard smoking prevention if smoking prevalence is sustained low as in our study (8%). Indicators of smoking among teachers were reported as low in other areas(7% & 8.6% in Bahrain and Tobago respectively).5,10 Also decline in trends of age-specific prevalence rates (from 17% in teachers above 50 years of age to 3% in teachers of less than 30 years of age, from both male and female teachers) validate the low prevalence in the study population. None of the female teachers smoked, underestimating the smoking prevalence in the study population, where smokers are only males; even prevalence in male teachers among only 25 teachers is lower than other areas of high prevalence (50% in Nairobi).11 Regarding the specialty of teachers, the lowest prevalence was observed in teachers teaching topics of religion (2%); religious advices have a good implication for smoking prevention in Saudi Arabia. Students in Islamic schools have the lowest smoking prevalence than other schools.12 Health and religious education were generally cited as more effective in deterring smoking than tobacco control laws and policies.13 Positive attitudes of the studied teachers toward smoking (75%) reveal that a teacher should be a role model not to smoke. Trinidad DR et al reported (2005) that student smokers who saw teachers smoking in school were less likely to favor smoking ban in schools.14 Poulsen et al reported (2002) that smoking by teachers during school hours is associated with adolescent smoking.2 Therefore teachers can be credible role models with regard to smoking prevention9 and they should be encouraged to be more active in school preventive strategies, especially since many researchers have reported that most of smokers start smoking at early school ages.8,11-13,15
Low smoking prevalence among Hadramout secondary school teachers and their positive attitudes, especially of female teachers, is an opportunity to implement school – based smoking prevention activities depending on teachers.
We thank the group of medical students in Hadramout University, College of medicine who participated efficiently in data collection (Sarah, Saleha, Amal, Bdoor, Eatidal, Narjes, Ahlam, Ibtehaj, Enas, Kholod and Wafa).
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
