published_or_final_version / Public Health / Master / Master of Public Health

Youth tobacco use is a major public health problem worldwide. Studies show that there is an association between exposure to anti-smoking advertising and youth smoking prevalence. Anti-smoking advertising can be used as an important tobacco control measure to prevent youth smoking. The objectives of this review mainly focus on evaluating the effectiveness of anti-smoking advertising on youth smoking, analyzing the influential factors that may affect the effectiveness. 4 main databases, PubMed, EBSCO, Scopus and Google Scholar were included for literature searching, as well as the reference lists, and 483 related articles were found initially. After restricted by the inclusion and exclusion criteria, 11 articles were included for analysis ultimately. According to this review, the influential factors included the exposure rate, sponsor, promotion approaches and the theme of anti-smoking advertising. Those factors have significant effects on youth’s smoking behavior and smoking prevalence. Non-tobacco industry sponsored, high exposure rate, the theme of negative life circumstance and using humor as a vehicle to deliver anti-smoking messages can be effective in reducing the smoking rate among youth. However, the methods used in the included articles were uneven, and the mechanism of the anti-smoking advertising on youth smoking is still unclear, further research should be conducted. The results of this review can still have some instructions to policy-makers on formulating tobacco control measures in the future, especially the anti-smoking program. / published_or_final_version / Public Health / Master / Master of Public Health

No description available.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Introduction: Tobacco smoking continues to raise serious concerns for health promotion practitioners and health bodies globally. It has been tagged the single largest cause of all premature deaths globally. Efforts at discouraging tobacco use especially among the youth are not only aimed at reducing smoking prevalence in the short term but at disrupting the chain of supply for the tobacco marketers who see the youth population as their source of replacement smokers. Measures to curb smoking prevalence currently rely heavily on policy regulation but there is need to have a holistic approach towards finding out what influences the youth to smoke in order to have relevant context-specific interventions to further tobacco control efforts. This study is aimed at ascertaining the risk influences for smoking behaviour amongst the youth in Southern Nigeria with specific focus on cultural/environmental, interpersonal and intrapersonal factors serving to increase smoking initiation and perpetuation as guided by the Theory of Triadic Influence (TTI). Method: Exploratory mixed methods research design was employed in carrying out this study. Qualitative interviews were conducted with 27 persons in 24 individual interviews (comprising of 18 young smokers aged 18 to 24 years, 4 political analysts and 2 community leaders) and 1 focus group discussion with 3 community leaders. A total of 550 youth aged between 18 and 24 years participated in the survey (quantitative) phase of this research. Non-probability sampling was used in recruiting participants for this study. Purposive sampling was used for the qualitative phase while multi-staged convenience sampling was used in the survey phase. Interpretative phenomenological analysis (IPA) with the aid of the software Nvivo 9 was used in analyzing the qualitative data while the software Statistical Package for the Social Sciences (SPSS) version 19 was used in the analysis of the quantitative data. Results: Qualitative and survey results show that there are an array of factors at various levels influencing the youth in southern Nigeria to view cigarettes as attractive and less harmful. At the cultural environmental level, there exist traditional practices in some parts of Southern Nigeria that make cigarettes easily accessible to the youth. Contact with cigarettes as a minor was found to be the best predictor of smoking among other cultural factors involving tobacco use while exposure to second hand smoke was the best predictor of smoking. With an absence of a functional national tobacco control law presently, cigarette is cheap, easily accessible to young people and tobacco manufacturers and marketers still promote their businesses in many ways which target the youth. At the interpersonal level, youth were influenced majorly by their peers to initiate smoking but indirectly by parents, older sibling and role models who smoke. At the intrapersonal level, youth were found to smoke for a variety of reasons ranging from wading off depression, coping with social stress and wanting to live up to the expectations of friends. Youth’s knowledge about the effect of smoking on health and well-being did not translate to a desire to quit smoking. Conclusion/recommendations: The Nigerian government needs to take urgent steps to address the tobacco question in the country through policy formulation and implementation. There is need to raise more awareness in the population on the dangers of smoking. Cessation clinics are also needed to help those who desire to quit smoking. Cultural activities involving the use of cigarettes and other tobacco products need to be properly addressed through the right channel to ensure this practice is stopped. A theoretical model explaining the risk influences for smoking among the youth is presented and suggestions are made with regards to a re-categorization of constructs in the theory of triadic influence which guided this study. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

Thesis (M.S.)--Montana State University--Bozeman, 2004. / Typescript. Chairperson, Graduate Committee: Suzanne Christopher. Includes bibliographical references (leaves 54-60).

This study examined the effects of a smoking prevention program on the acquisition of refusal skills in junior high school students. Sixty-three seventh graders were randomly assigned to a refusal skill training group (N=29) or a no treatment control group (N=34). Students' refusal skill performance was assessed pre and post training. Assessment consisted of a peer trainer offering the student a cigarette while being videotaped. The smoking refusal skill was broken down into 5 component parts: (1) eye contact; (2) upright posture; (3) voice intonation; (4) response to approach; (5) reason for refusal. Results showed significant improvement for both the training and control groups. However, a significant training by pre-post assessment interaction was also found, F (1,61) = 10.37, p < .01, which indicates that students who received training demonstrated more proficiency in refusal performance after training than those who did not. A generalization probe in the natural environment conducted seven weeks after training showed no differences between the two groups.

published_or_final_version / Nursing Studies / Master / Master of Nursing

This study aimed to use the Transtheoretical Model of behaviour change (Prochaska and DiClemente, 1983) to investigate the process of smoking initiation in a cross-section of high school adolescents in urban KwaZulu-Natal. This aim was informed by the increase in incidence of smoking among adolescents, who represent a particularly vulnerable population to smoking (Orlandi and Dalton, 1998). The Transtheoretical Model has proved successful in changing problem health behaviours (prochaska and DiClemente, 1983) and lends itself to be a suitable framework for investigating smoking acquisition in adolescents (Werch and DiClemente, 1994). An extensive review of the causes and correlates of smoking uptake and past intervention evaluations suggests that the core constructs of the TTM (Decisional Balance, Temptation and Stage of Acquisition) can be complemented by other another variable, Perceived Social Norms (informed by the Theory of Planned Behaviour, Fishbein and Ajzen, 1975, as cited in Pitts, 1996), to provide a more holistic explanation of smoking acquisition. Alcohol use, parental smoking and certain demographic factors are also found to be salient factors in this process. Findings showed that the perceived cons of smoking were constant across stages and seemed to have no effect on stage membership. Stage differences were explained almost entirely in terms of pros, which increased drastically with later stages. Perceived social norms increased with a later stage, confirming a tentative theoretical relationship between the Transtheoretical Model and Theory of Planned Behaviour. Lack of expressed intention to smoke by participants questions the validity of using the rational decision-making Transtheoretical Model to investigate a process not informed by decision-making. European language speakers were found to be a particularly vulnerable group to smoking, while African language speaking girls show very low rates of smoking. High religiosity was found to be a protective factor, while alcohol use was strongly associated with smoking. Maternal smoking was strongly associated with smoking, but only in girls. No difference in stage was found between schools and grades. The study should be replicated using a longitudinal design to determine the causal relationship between factors and smoking and to further investigate the applicability of the Transtheoretical Model in smoking acquisition. / Thesis (M.A.)- University of KwaZulu-Natal, Pietermaritzburg, 2004

This study aims to explore the challenges faced by Street level bureaucrats in the implementation and regulation of the Tobacco Products Control Act 83 of 1993 (and the Tobacco Control Amendment Act of 1999) in relation to the selling of tobacco products (especially cigarettes) to minors in the Pietermaritzburg central business district area. These Acts are national policies formulated through the various stages of policymaking for tobacco control. Policymaking is not complete once a policy is approved. Instead implementation and regulation determine the success or failure of a policy or programme therein. Common implementation challenges include amongst others large number of participants in a programme, diverse goals, lack of commitment to the programme, lack of resources and technical difficulties. It is the purpose of this study to critically analyse and discuss the implementation problems faced by street level bureaucrats who have certain discretionary powers and are at the frontline of policy implementation. Specific focus will be given to environmental health officers and police officers in the Msunduzi Municipality and the Drugs and Liquor Section respectively (Pietermaritzburg central business district area). / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.