Research Related To Smoking.docx

“A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING EFFECT OF SMOKING AND ALCOHOLISM ON HEALTH AMONG YOUTHS LIVING IN A SELECTED COMMUNITY AREA” BHOPAL (M.P.)

2017-2018 GUIDED

INVESTIGATORS

Mrs. Jaya Bijoy

Mr. Allfonce Gulab

(Professor & HOD )

Ms. Pratiti Mary Lal

Dept.of Mental Health Nursing

Ms. Reena Yadav

Pragyan College of Nursing , Bhopal (M.P.)

Ms. Sangeeta Khandagre B.Sc. Nursing (Final Year )

SUBMITTED TO

PRAGYAN COLLEGE OF NURSING AFFILIATED TO BARKATULLAH UNIVERSITY, BHOPAL FOR THE PARTIAL FULFILLMENT OF BSc. NURSING FOURTH YEAR DEGREE COURSE

PRAGYAN COLLEG OF NURSING NEAR RAJIV GANDHI TECHNICAL UNIVERSITY, New Jail Road, Gandhi Nagar Bhopal Affiliated to Barkatullah University, Bhopal

CERTIFICATE This is to certify that this project entitled “A descriptive study to assess the knowledge regarding effect on smoking and alcoholism on health among youths living in a selected community area, Bhopal (M.P.) is a bonafide work of Mr. Allfonce Gulab, Ms. Pratiti Mary Lal, Ms. Reena Yadav and Ms. Sangeeta Khandagre B.Sc (Nursing) final year, Pragyan College of Nursing, Bhopal.

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Dr.SUNITA LAWRENCE PhD.(Nursing),M.Sc.Nursing(OBG),MA.(Sociology) Principal Pragyan College of Nursing,Bhopal

PRAGYAN COLLEGE OF NURSING NEAR RAJIV GANDHI TECHNICAL UNIVERSITY, New Jail Road, Gandhi Nagar Bhopal Affiliated to Barkhatullah University, Bhopal

CERTIFICATE This is to certify that this project entitled “A descriptive study to assess the knowledge regarding effect on smoking and alcoholism on health among youths living in a selected community area Bhopal is

a bonafide work of Mr Allfonce Gulab, Pratiti Mary Lal, Reena Yadav and Ms. Sangeeta Khandagre B.Sc (Nursing) final year, Pragyan College of Nursing, Bhopal .

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Mrs. Jaya Bijoy (Professor & HOD ) Dept.of Mental Health Nursing Pragyan College of Nursing , Bhopal (M.P.)

ACKNOWLEDGEMENT “ No work is completed without help, the preparation and presentation of this humble work encompasses immense and unlimited help and sound thought of innumerable persons.” It is our pleasure that we have got an opportunity to prepare research project on the topic “A descriptive study to assess the knowledge regarding effects of smoking and alcoholism among youths living in selected Community area Bhopal ( M.P.) ”

We wish to extend our sincere thanks to all people who have helped and guided us in exploring our talents in bringing out the research work, a successful one. First of all we bow in front of Lord Almighty for showering his blessings, strength and courage to overcome the difficulties throughout the completion of this study. It is our proud privilege to express our sincere gratitude to Dr. Sunita Lawrence, Principal Pragyan College of Nursing, for her inspiring supervision, encouragement and valuable suggestions during the entire period of study. She has been always a symbol of supreme confidence and strength for us.

It’s our immense pleasure to extend our thanks to Mrs. Sija Binoy, Vice-Principal of Pragyan College Of Nursing, for her excellence guidance, valuable suggestions , constructive criticism, constant encouragement and her confidence in us. Her unwavering, meticulous, prompts guidance and continues support were always a source of inspiration and courage to fulfil the task. We also express our heartfelt thanks to our guide, Mrs. Jaya Bijoy, Professor, HOD, in Mental Health Nursing Pragyan College Of Nursing Bhopal, for her untiring guidance, timely suggestions and elegant (perfect) directions in every phase of our study. Her encouragement, with positive criticism to make this study more of a learning experience. We express our thanks to class-coordinators Mrs. Neelofur Ibran Ali, Associate Professor in Obstetrical and Gynecological Nursing Surgical , Mrs. Rini Robert Clinical Instructor in Obstetrical and Gynecological Nursing, for their co-operation, encouragement, valuable suggestions and blessings.. We also express our thanks to Mr. Prince Mathew, Associate Professor in Mental Health Nursing, Mr. Shine Varghese Kurian, Associate Professor in Medical Surgical Nursing, Mr. Mejo Philip, Mrs. Shincy Isac, Associate in Child Health Nursing , Mrs. Shefali Latesh Assistant Professor in Mental Health Nursing ,Mrs. Vandana Pakhide, Assistant Professor in Medical Surgical Nursing, Mr. Subin S. Assistant Professor in Medical Surgical Nursing Mrs. Bency Mathew Assistant professor in Medical Surgical Nursing, Ms. Shobhana S. Patras Mr. V. Piyush Clinical Instructor in Medical Surgical Nursing, Bency Rajan Clinical Instructor in Medical Surgical Nursing, Ms. Ann Joseph Clinical Instructor, Ms.Seetu Sahu Clinical Instructor, Mrs, Anamika Patel Clinical Instructor for the able guidance throughout our research. We would like to express gratitude towards Mrs. Chitra Agrawal,(Bio Statistian), Bhopal for his expert opinion, guidance and support throughout the study at statistical analysis. We also express deep sense of gratitude to Mr. Rajesh Bagul, Mr. Noor Hasan, Mr.Manoj Singh who helped to refer books, typing and taking print outs.

We express our feeling and thanks to all our Colleagues’ for their friendly suggestions and assistance in the preparation of this project. We express our thanks towards employees of Suram Photostat, Allahabad Bank Road, Bairagarh for typing and Photostat. Last but not the least we express the our deep sense of gratitude towards our Parents for their constant moral support, affection and blessing. Mr. Allfonce Gulab Ms. Pratiti Mary Lal Ms.Reena Yadav Ms. Sangeeta Khandagre B. Sc .Nursing (Final year)

.............THANKS TO ALL..........

ABSTRACT

Tobacco and alcohol are the most widely used psychoactive substance across the globe alcohol is the leading risk factor related to the major burden of disease in underdeveloped and developing countries. It is the third most prevalent factor for leading disease and injuries in developed countries. (WHO 2002)

STATEMENT OF PROBLEM “A descriptive study to assess the knowledge regarding effect of smoking & alcoholism on health among youths living in a selected community area, Bhopal (M.P.)”

OBJECTIVES 1.Assess the existing knowledge regarding effect of smoking and alcoholism on health among youth. 2. Associate the existing knowledge regarding effect of smoking and alcoholism among youths with their selected demographic variables . 3.Disribute informational pamphlet containing information about effect of smoking and alcoholism on health to youth.

METHODOLOGY Methodology is a scientific part of any study which enable investigation to project a between print of the research under taken methodology comprise of the research approach, design variable setting of the study. A study design was used to assess the knowledge regarding effect of smoking & alcoholism on health among youths living in a selected community area, Bhopal (M.P.). Sample of 80 youths was selected by using probability convenient sampling technique. The knowledge assessment level of youths was assessed by structured rating scale. FINDINGS OF THE STUDY:The findings of the study related to youths in which 35% belongs to 18-21 years whereas 36.25% belongs to 22-25 years of age, 16.25% belongs to 26-29 years of age and 12.5% belongs to 30years of age. With regards to education among youths, 38.75% belongs to primary (5th class), 16.25% belongs to middle (8th class), 15% belongs to high school (10th class), 18.75% belongs to higher secondary (12th class) and 11.25% belongs to graduate and above. Regarding family income among youths, 41.25% belongs to less Rs. 5000 per month, 30% belongs to Rs.5000-10000 per month, 12.5% belongs to Rs.10000-15000 per month and only 16.25% belongs to above Rs.15000 per month. With regards to types of family 55% belongs to joint family and 45% belongs to nuclear family. With regards to religion among youths 36.25% belongs to Hindu, 53.75% belongs to Muslim , 7.5% belongs to Sikh and 2.5% belongs to Others.

With regards types of diets, 26.25% belongs to vegetarian, 60% belongs to non vegetarian and 13.75% belongs to eggetarian. With regards to occupation among youths 12.5% belongs to government, 38.75% belongs to private, 26.25% belongs to self and 22.5% belongs to unemployment. According to prior information about ill effects of smoking and alcohol on health among youths 13.75% belongs to print media, 22.5% belongs to electronic, 17.5% belongs to family and relative, 21.25% belongs to health profile and 25% belongs to no profile. CHI SQUARE FINDINGS There was significant association between knowledge level of youths and demographic variables like family income (per month) and religion. CONCLUSION Thus it concluded that the findings suggest that descriptive study to assess the knowledge regarding effect of smoking and alcoholism on health among youths was effective in enhancing knowledge level. As there was a good response and positive acceptance of knowledge regarding effect of smoking and alcoholism on health by distributing pamphlets.

INDEX

CHAPTER CONTENT NO. 1. INTRODUCTION        

Background of the Study Need of the Study Statement of the Problem Objectives Operational Definition Assumption Delimitation Conceptual Framework  Summary

2.

3.

REVIEW OF LITERATURE  Theoretical literature  Empirical literature METHODOLOGY            

Introduction Research Approach Research Design Variables Research Setting Population Sample and Sample Size Sampling Technique Criteria For Sample Selection Description of Tool Data Collection Procedure Plan for Data Analysis  Summary

4. 5.

DATA ANALYSIS AND INTERPRETATION SUMMARY, FINDINGS, LIMITATION, RECOMMANDATIONS, IMPLICATION AND CONCLUSION BIBLIOGRAPHY ANNEXURE  

ANNEXURE-I : Tools for study(Hindi\English) ANNEXURE-II : Answer key Demographic variable  ANNEXURE-III : Pamphlet (Hindi)  ANNEXURE-IV : Demographic Variable  ANNEXURE-V : Master Data Sheet

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LIST OF TABLES TABLE NO. 4.1 4.2

4.3

CONTENT Frequency and percentage distribution of youths in terms of demographic variables. Frequency and percentage distribution of knowledge score regarding smoking and alcoholism among youths (18-30) year. Chi-square distribution level of knowledge among youths on effect of smoking and alcoholism with their selected demographic variables.

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LIST OF FIGURE FIGURE NO. 1.1

CONTENT Conceptual Framework.

3.1

Schematic representation of research design.

4.1

Bar diagram showing the percentage distribution of youths according to their age group. Cylindrical graph showing percentage distribution of youths in term of their educational status. Doughnut diagram showing the distribution of family monthly income. Pie diagram showing distribution of youth based on their type of family. Pie diagram showing distribution of youth based on religion. Cylindrical diagram showing distribution of youth based on their dietary pattern. Conical diagram showing distribution of youths based on their occupation pattern. Bar diagram showing the percentage distribution of youth’s knowledge on effect of smoking and alcohol. Bar diagram showing the percentage distribution of youth’s knowledge on effect of smoking and alcohol.

4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9

PAGE NO.

CHAPTER-1 INTRODUCTION Tobacco and alcohol are the most widely used psychoactive substance across the globe alcohol is the leading risk factor related to the major burden of disease in underdeveloped and developing countries. It is the third most prevalent factor for leading disease and injuries in developed countries (WHO 2002). Even as alcohol consumption is decreasing in some developed countries it is on the rise in developing nations. Globally a significant proportion of the youth population consumes it at a hazardous level. Addiction is defined as chronic relapsing disease, characterised by compulsive drug –seeking and abuse because of long lasting chemical changes in the brain. The world health organisation (WHO) estimates that there are about 2 billion people worldwide who consumes alcoholic beverages and ,76.3 million with diagnosable alcohol use disorder ,including harmful use and dependence ,78% of whom remain untreated .The rate of alcohol use disorder for man is 2.8% and for women it is 0.5% .it causes 1.8 million deaths (3.2% of the total) and a loss of 58.3 million (4% of the total ) disability adjusted life year (day) (WHO 2002).The use of tobacco is one of the greatest threats to global health today .At present according to the who ,one in three adult or 1.2 billion people use tobacco .In 2025 the number is expected to rise to more than 1.6 billion . According to the most recent estimate ,4.9 million people worldwide died in 2002 as a result of their addiction to nicotine (WHO 2002).This huge number is rising rapidly in the low and middle income countries ,where most of the world 1,2 billion user live. This is expected to rise to 8.4 million deaths by 2020. Smoking is the practice in which a substance burned and the resulting smoke breathed in to be tasted and absorbed into the bloodstream most commonly the substance is the dried leaves of tobacco plant which have been rolled into a small square of rice paper to create a small round cylinder called cigarette” is primarily practised as a route of administration for recreational drug use because the combustion of the dried plant leaves vaporised and delivers active substance into the lungs where they are rapidly absorbed into the bloodstream and reach bodily tissue . In the case of cigarette smoking these substances are contained in a mixture of aerosol particles and glasses and include the pharmacologically active alkaloid nicotine .The vaporization creates heated aerosol gas to form that allows inhalation and deep penetration into the lungs where absorption into the bloodstream substances occurs. In some culture smoking is also carried out as a part of various rituals, where participants use it to help induce trance – like states that they believe can lead them to spiritual enlightenment .Alcoholism is a term for a long term addiction to alcohol. Alcoholism is a long term (chronic) disease it should also be acknowledged that there is a growing trend away from using the term ‘alcoholic’ as it is perceived to be a negative label. Instead you may hear the person referred to as a person who suffers from alcohol use disorders. Alcoholism are obsessed with alcohol and cannot control how much they consume even if it is causing serious problems at home, work and financially.

BACKGROUND OF THE STUDY (WHO, 2005) Alcohol consumption is estimated to be present among 21% of the Indian population. In the developed countries, studies have shown that alcohol impairment among the leading reasons for disciplinary action physician. However, this problem and affective intervention to reduce substance use among physicians have not been sufficiently explored in published research in studies. Numerous studies conducted in the field of substances use around the world have focused mainly on the general population and adult age groups. Most of the Indian studies in the field are regional in nature, representing a large research gap which our study is aiming to address. There is a dearth of large multi-centric efforts in India to evaluate this important public health concern. Global prevalence rates of alcohol abuse disorder among youth were estimated to range from 0-16.0% with highest prevalence rates in Eastern Europe. Tobacco consumption and nicotin addiction is a major global concern popularly known as “Brown Epidemic”. The prevalence smoking is a high 51.0% in men (WHO western specific region) and 22.0% in women (WHO European region) with an increasing trend in youth girls and boys globally. T.Andreena, et. al.(2005) according to (2005) survey ukrani jhadone of the highest smoking rates in the world. Around 67% of ukranian man and 20% of ukranian women were current smoker’s .smoking is one of the main cause of premature deaths. Reiner hane winkel, et.al. (2001) Smoking remains the leading preventable cause of premature disease and death worldwide (WHO, 1997) It is estimated that in the next 20 to 30 years . 10 million people per year will die from tobacco related disease such as cancer. Smoking is one of the main common forms of recreational drug use tobacco smoking is the most popular form ,being practised by over one billion people globally of whom the majority are in the developing countries les common drug for smoking include cannabis and opium .Some of the substances are classified as hard narcotics like heroin ,but the use of their is limited as they are primarily industrially manufactured but also can be hand-rolled from loose tobacco and rolling paper, cigars ,bidis, hookah and bongs. But still have a problem with it they are not as dependent on alcohol as an alcoholic is , they have not yet completely last their control over its consumption. Alcohol abuse generally refers to people who do not display the characteristics of alcoholism Moderate alcohol consumption will not generally caused psychological or physical harm however, for some individuals, social drinking eventually leads to heavier and heavier alcohol consumption which does cause serious health and psychological problems. The world health organisation estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age) .In the united states about 17 million (7%) of youth and 0.7 million (2.8%) of those age 12 to 17 years of age are affected .It is more common among male and young youth ,becoming the less common in middle and old age .It is the least common in Africa at 1.1% and has the highest rates in eastern Europe at 11% .Alcoholism directly resulted in 139,000 death in 2013 ,up from 112,000 deaths in1990. A total of 3.3 million death (5.9% of all death ) are believed to be due to alcohol .It is often reduce a person life expectancy by around ten years .In the United states it result in economic costs of $ 224 billion USD in 2006. Many terms ,some insulting and others informal have been used to refer to people affected by alcoholism ,the expression include tippler ,drunkard ,dipsomaniac ,and source in 1979 ,the world health organisation discouraged the use of ‘alcoholism’ due to its in exact preferring “alcohol dependence syndrome’’.

NEED OF STUDY In India, alcohol use figures vary widely from 3.8% to 21.0% with men 9.7 times more likely to regularly use alcohol as compared to women prevalence of smoking has been estimated as 26.0% in males and 4.0% in females, for youth the prevalence is 19.0% and 8.3% respectively. In previous studies, men were 25.5 times more likely than women to report regular smoking and 3.7 times more likely to regularly chew tobacco. Smoking generally has negative health effects, because smoke inhalation inherently poses challenges to various physiologic process such as respiration disease related to tobacco smoking have been shown to kill approximately half of long- term smokers when compared to average mortality rates faced by non-smokers. Smoking caused over five million deaths a year from 1990 to 2105. Perception surrounding smoking has varied over times and from one place to another holy and sinful, sophisticated and vulgar, a panacea and deadly health hazard. In the 20th century, smoking came to be viewed in a decidedly negative light, especially in western countries. This is due to smoking tobacco being among the causes of many diseases such as lung cancer, heart attack, COPD. Erectile dysfunction and birth defects. The health hazards of smoking have caused many countries to institute high taxes on tobacco products, run ads to discourage use, limit ads that promotes use and provide help with quitting for those who do smoke. Education and counselling by physicians of children and youth has been found to be effective in decreasing the risk of tobacco use systematic reviews show that psychosocial interventions can help women stop smoking in late pregnancy reducing law birth weight and preterm births. A 2016 Cochrane reviews should that the combination of medication and behavioural support was more effective than minimal intervention or usual care.

STATEMENT OF THE PROBLEM “A descriptive study to assess the knowledge regarding effect of smoking and alcoholism on health among youths living in a selected community area, Bhopal M.P.”

OBJECTIVES OF THE STUDY The objective of the study are1. Assess the existing knowledge regarding effect of smoking and alcoholism on health among youths. 2. Associate the existing knowledge regarding effect of smoking and alcoholism among youths with their selected demographic variables. 3. Distribute informational pamphlet containing information about effect of smoking and alcoholism on health to youths.

OPERATIONAL DEFINITIONS Assess- It refers to evaluate the knowledge of effects of smoking and alcoholism by using a structured questionnaire. Knowledge- In the present study youth possessing adequate information on effects of smoking and alcoholism as measured by structured questionnaire .

S.NO 1 2 3

SCORING CRITERIA POOR KNOWLEDGE AVERAGE KNOWLEDGE GOOD KNOWLEDGE

LEVEL OF KNOWLEDGE 0-8 9-17 18-26

Effects –It refers to the ill effect of smoking and alcoholism on health leading to serious disease such as lung cancer. Smoking –Smoking is the inhalation of the smoke of burning tobacco that is used mostly in three forms, bidi ,cigarette, piper and cigar . Alcoholism- It is define addiction to drinking of alcohol that cause mental physical health family and social problem, Youth – In the present study youth are the adult of both genders between the age group of 18-30 years residing in selected community. Community – It refers to the geographic area where the youth selected for the study reside.

DELIMINATIONS –  

The study is delimited selected community of Gondipura. Youth of the age group between 18 to 30 years.

CONCEPTUAL FRAMEWORK – According to Keizer (1987), the concept is defined as a complex, mental formulation of an object ,property, and event that is derived from an perception and experience. The conceptual framework is a theoretical approach to study the problem scientifically based on emphasis in selection of its concept theories and conceptual framework provides direction and guidance to youth .Structuring professional nursing practice , education and research .In research the framework offers a systematic approach to identify question .Select approach variables and interpreting findings the present study is intended to observe the assessment of knowledge of youth the aim of the study is to assess the knowledge regarding effects of smoking and alcoholism among youth.

This study consist of 4 phases    

INPUT PROCESS OUTPUT FEED BACK

INPUT It includes demographic characteristics like age, education, family income, types of family, religion, types of diet, occupation, prior information about ill effect of smoking and alcohol on health.

PROCESS Administration of structured questionnaire to assess the knowledge of youths regarding effect of smoking and alcoholism on health.

OUTPUT It refers to categorization level of knowledge of youths in terms of knowledge score that is classified into poor knowledge, average knowledge, good knowledge.

FEED BACK Feedback is not included in the study.

CHAPTER-2 REVIEW OF LITERATURE

A Review of literature enables one to get an insight into the various aspects of the problem under study .It covers promising methodological tools, throws light on ways to improve the efficiency of data collection and suggest how to increase effectiveness of data analysis and interpretation . Review of literature is therefore an essential step in the developmental of the research project . Abdellah and Levine (1979), states that revive of literature provides a basis for future investigation, justifies the need of replication throws lights on the feasibility of study ,indicates constraints of data collection and helps to relate finding from one study to another .It also helps to establish a comprehensive body of scientific knowledge and a professional discipline from which valid and pertinent theories may be developed . The review of literature for the present study is organised under the following headings

Theoretical literature



Empirical literature

1. Theoretical literature Smoking inhalation and exhalation of the forms of burning tobacco in cigar and cigarette and pipes some person draw the smoke into the lungs .Smoking was probably first practised by the indigenous people of the western hemisphere originally used in religious rituals and in some instances of medical purpose ,smoking and the use of tobacco become a widespread practice by the late 1500 .Tobacco was introduced into Europe by the explorers of the new world .Many teenagers and adults think that there are no effects of smoking on their bodies until they reach middle age.

Definition- Smoking is the inhalation of the smoke of burning tobacco increase in cigratte, pipes and cigars .A smoking habit is a physical addiction.

Smoking – Smoking lung cancer is largely attributable to environment able carcinogens. By for the most important environmental carcinogen is tobacco. Cigarette smoking signs and symptoms Signs and symptoms of smoking are frequently obvious even to a casual observe.

Nicotine stained fingers and teeth characteristics smell of smoke in clothing and household items .Chronic smokers cough, gravelly voice. Signs and symptoms of smoking related disease often depend on the specific illness they cause. 

Shortness of breath be a sign of emphysema or heart disease.



Chest pain cause by insufficient blood flow to the heart.



Difficulty in swallowing or persistent hoarseness may signal of cancer in the mouth and larynx.



Painless bloody urination may signal bladder of cancer.

Carcinogen- Cigarette smoke contains a number of proven carcinogen in both the particulate and gaseous phase including 

Aromatic Hydrocarubons



Nitrossamines



Nitrosonomic cotine



Palonium



Arsenic

Synergic – Exposure to certain substance have a synergic effects in being causatively associated with the use of tobacco product in Development of lung cancer. Prevention– Smoking quitting is very difficult smoker begin to smoke as Teenagers. 

Much attention has been focused on the influence of tobacco



Company advertising on encouraging young people to smoke.



Although cigarette commercials have been banned from television for over 30 years, tobacco product remain among the most heavily product.



According to the American ling association, the tobacco industry spent on estimated and 12.49 billion on advertising in 2006.



School generally provide education on the use of tobacco alcohol and other substance but their impact is unclear.



Increasing the taxes on cigarette on hence their price .has been shown to reduce tobacco consumption especially among youth.

EMPIRICAL LITREATURE T.Andreeva and YA.Gerashehenko (2005), A Cross sectional study on knowledge about the health hazards of tobacco predetermine the intention to quit smoking in Ukraine at a baseline level in 2005 among 2239 collected questionnaire a sub sample of 775 smokers was analysed .The finding of the study revealed that the level of knowledge was higher in more educated respondents men in those living in eastern region of Ukraine willingness to quit was higher in occasional smokers. Richard A Grucza (2004) conducted a study to see but whether higher rates of alcohol use disorder (AUD) among smoking are sole attributable to heavier drinking. Data were from the aggregated 2002 through 2004 U.S. National survey on drug used and health. Participants were randomly selected household- dwelling adolescents and young adult (12-20) from the non institutionalized, civilian population of the United States .Smokers had 4-5 fold higher odds of AUD than never smokers (95% CI 3.1-6.6) youth who reported smoking but did not cross the 100 cigarette threshold were at intermediate risk (OR =2,3,95% CI:17,-3.3) 

Jinyoung Kim (2014) determine correlation between experience of harmful shops and adolescent smoking and alcohol drinking in middle and high school student. The collection data were processed using spss version 21.0 and examined using frequency analysis and hierarchical linear regression. The study revealed 8.3 of all participants were found to have experienced smoking and 17.0% alcohol drinking.



Genes Kumar’s, et .al (2011) conducted study on prevalence and futures association with current smoking among medical student in coastal south India the reverence of current smoking was found to be 22.4% (67) there were wades periods, deficiencies in knowledge of smoking among student at different cases ,as an important causative factor in many disease like gastrointestinal malignancy heart problem asthma and emphysema .It was found that only half at them use willing to quit smoking.



Kate cahill (2007) conducted a study in USA in the year of 2007 January .It was conducted among college student to detect hazards of smoking and guthka chewing .A sample size of 6,225 was randomly selected from different colleges. The study resulted in a conclusion tract maximum risk for initiation of smoking was during the early ten years.



Mainak mukherjee (2006) conducted survey among the 132 student of Calcutta university shows that more than 1/3 of them are abusers of the drug. Another survey

suggests that one out of two Delhi high school student are addicts one out of 3 college student are hookah tobacco consumption. 

Goel Nidhi, et .al. (2015)carried out conducted a study to estimate the prevalence of alcohol and tobacco use, assess the knowledge and attitudes towards this issue , and identify factors associated with substance use among UG and PG Medical students in India. A pretested, self report ,anonymous questionnaire was administered to medical undergraduate and post graduate medical residents of eight medical colleges across India .This study used a convinces sample of medical colleges with random selection of, males had a higher study participate within each colleges for each group ,UG and PG. Prevalence of alcohol and tobacco use among UG students was 16.6% ,95% CI (6.4,9.6),respectively ,whereas prevalence was 31.5%,95% CI (26.3,37.0) and 14.5% , 95 % CI (26.3,37.0) and 14.5 % ,95 % CI (10-7 ,18-9) respectively for PG’s for both substances ,males had a higher prevalence of use compared to females in both group (p<0.001>. Positive family history of substances use (p<0.001 for both groups )and early age of initiation (p=0.011 for tobacco ,p >0.05 for alcohol) were associated with a greater difficulty to quit the habit .Over 90 % of study participants felt that substance use adversely affected their skills and reported not using substances prior to managing their patients. Since substance use is a relatively common phenomenon UG and PG medical students in India ,future prospective studies and intervention are required to better understand the pattern of substance used and reduce its prevalence.

CHAPTER -3 RESEARCH METHODOLOGY Methodology of research indicates the general pattern of the procedure together and to organize valid and reliable data for problem under investigation. This chapter includes research approaches and design setting, population sample, size sampling technique development and description of tool. KOTHARI C.R (2006)-states that research methodology are away to systematically solve the problem. It defining the problem formulation of hypothesis methods adopted for dated collection and statistical techniques used for analyzing the data logic behind it. BURNS AND GROOVES (2000)-Methodology of research organize all components of the study in a way that is most likely to valid answers to sub problems that have been posted. RESEARCH APROACH Polit and Hungler (1999)- A research approach tell the researcher as to what data collect and to analysis then. It is the overall plan or print chosen to carryout the study. It also suggested the possible conclusion to carryout the research. It aims to achieve the objectives of the study. In present study, investigation have adopted survey approach, survey can be used to designate research activity in which the investigation gather data for examining its characteristic, opinions, and intentions. RESEARCH DESIGN Nancy Burns (2008)-Research design is the blue print of conducting a study maximize control over factor that could interfere with validity of findings, guide the planning and implementation of a study in a way that is most likely to achieve the intended goal. The term research design refers to the plan of a scientific investigation. Research design helps the researchers in the selection of subjects, identification of subjects, identification of variables their manipulation and control, observation to be made types of statistical analysis to interpret the data. A descriptive survey design was used to merely the knowledge towards effect of smoking and alcoholism in selected community gondipura, Bhopal (M.P) RESEARCH SETTING Polit and Hungler (1999), setting is the specific place where data collection occurs. The physical location in which the data collection takes place in a study where setting. The study was conducted in selected community gondipura, Bhopal (M.P) The community is about 200mts distance from the college.

VARIABLES

NANCY BURN(2009), Variables are qualities properties or characteristics of person things or situation that changes or very and are manipulated or measured in research, two types of variable were identified in this study.

INDEPENDENT VARIABLES Wood G.L. and Herber J.(2002), it is the variables that has presumed effect on the dependent variables. In the study the independent variable in smoking & alcohol effects on health. DEPENDENT VARIABLES Wood G.L and herber .J (2012),It is often referred as consequence or the presumed effect that varies with change in the dependent variables knowledge regarding among youths on effect of smoking &Alcohol consumption. POPULATION According to Basavanthappa B.T, population is group of people or objective on which the researcher want to general comprised the youth of selected community Gondipura, Bhopal(M.P.) Sample:-According to Polit and Hungler (1999),sample is a subset of a population selected to participate in a population, which represent entire population, In the present study youths (18-30) year at selected Gondipura, Bhopal(M.P.)

Sample size:-sample size is consists of 80. Sample techniques:-sampling refers to the process of selecting the portion of population to represent the entire population.(Polit and Hungler) In this study convenient sampling technique was adopted. CRITERIA FOR SAMPLE SELECTION  INCLUSIVE CRITERIA  Youths at Gondipura Bhopal.  Youths who were interested to participate in the study.  Youths who were available during the data collection.  EXCLUSIVE CRITERIA  Youths who are not willing to participate and not available during the time of data collection.

DESCRIPTION AND DEVELOPMENT OF TOOL Polit and hungler(1999), states that the inset type of data collection instrument prepared depend upon the nature of data to be gathered to answer the researcher question. Based on the objectives of the study data collection was prepared, self structured questionnaire was prepared to assess knowledge of youths regarding effect of smoking & alcoholism at selected to community gondipura Bhopal,(M.P.)

It has two sections:-

Section A:-It includes demographic variable like, age, education, family, Income, types of family ,Religion types of diet occupation, prior information about ill effect of smoking and alcohol on health. The total no. of items is 8.

Section B:-Self structured questionnaires regarding effect of smoking &alcoholism includes 26 questions. SCORING CRITERIA     

Score (1) for each correct answer. Score (2) for each wrong answer. CATEGORIZATION OF SCORE MAXIMUM SCORE=26 MINIMUM SCORE=0 S.NO 1 2 3

SCORING CRITERIA POOR KNOWLEDGE AVERAGE KNOWLEDGE GOOD KNOWLEDGE

LEVEL OF KNOWLEDGE 0-8 9-17 18-26

PROCEDURE OF DATA COLLECTION The study was conducted in the month at May 14/5/18-18/5/18 in selected community Anganwadi permission was taken from In charge of gondipura, Bhopal. The study samples were assured of confidentiality of their responses. Data was collected by administering the structured questionnaire related to effect of smoking and alcoholism selected by convenient sampling. Information was provided through pamphlets to the study sample. PLAN FOR DATA ANALYSIS (Frequency ,percentage)  

Descriptive statistic will be used to describe demographic characteristics level of knowledge regarding effect of smoking and alcoholism on health among youths. (Chi-square) Inferential statistics will be used to describe association between knowledge regarding effect of smoking and alcoholism on health among youths and their demographic characteristics.

SUMMARY Methodology consist of research design, research approach, design of the study, population, variables under study, setting of the study, sample size, sample technique, criteria for selection of sample, description of the tools, development of tools, , data collection process and plan for data analysis.

RESEARCH APPROACH SURVEY APPROACH

RESEARCH DESIGN DESCRIPTIVE SURVEY DESIGN

VARIABLES INDEPENDENT VARIABLES

DEPENDENT VARIABLES

KNOWLEDGE OF YOUTHS REGARDING EFFECT OF SMOKING AND ALCOHOL CONSUMPTION

YOUTH AT SELECTED COMMUNITY GONDIPURA BHOPAL (M.P.)

SETTING SELECTED COMMUNITY AREA OF GONDIPURA , BHOPAL (M.P)

TARGET POPULATION YOUTHS IN SELECTED COMMUNITY GONDIPURA, BHOPAL(M.P.)

ACCESSIBLE POPULATION YOUTH BETWEEN THE AGE OF (18-30) IN SELECTED COMMUNITY GONDIPURA, BHOPAL (M.P)

SAMPLE YOUTHS BETWEEN THE AGE OF (18-30) OF SELECTED COMMUNITY GONDIPURA,BHOPAL(M.P.) AVAILABLE AT THE TIME OF DATA COLLECTION

SAMPLE TECHNIQUE CONVENIENT SAMPLE TO BE USED

DATA ANALYSIS DESCRIPTIVEREPORT AND INFERENTIAL WRITINGSTATISTICS

TOOLS STRUCTURED KNOWLEDGE COMMUNICATION OF FINDINGS QUESTIONNAIRES

Figure 3.1.1 SCHEMATIC FINDINGS RESEARCH DESIGN RESEARCH SETTING

REPRESENTATION OF

CHAPTER-4 DATA ANALYSIS AND INTERPRETATION This chapter deals with analysis and interpretation of data collected from 80 youths (1830year) community gondipura, Bhopal. The aim of the analysis is to determine the knowledge of youths towards effects of smoking & alcoholism data was obtained through on administration of structure questionnaire. It consists of socio demographic data 8 items and was tabulated organized and analysis using descriptive and interferential statistics.

Polit and Hungler(1999),The analysis is a process of organizing and synthesizing data in such as way that research question can be answered and hypothesis tested.’’ Abedellah and Levine (1997), Stated that interpretation of tabulated data can bring to light the real meaning of the finding of the study. PRESENTATION OF DATA The data collected were tabulated, organized, analyzed, presented in tables and interpreted under the following section. Section A: - Frequency and percentage distribution of youth in terms of demographic variables. Section B:-Frequency and percentage distribution of knowledge score regarding smoking and alcoholism among youths. Section c:-Association of knowledge score with selected demographic variable.

SECTION –A FREQUENCY AND PERCENTAGE DISTRIBUTION OF YOUTHS IN TERMS OF DEMOGRAPHIC VARIABLES. TABLE-4.1 Table showing percentage distribution of frequency and percentage distribution of youths in terms of demographic variables. N=80 S.NO

DEMOGRAPHIC VARIABLES

FREQUENCY (f)

PERCENTAGE

(%) 1

2

3

4

5

6

7

8

AGE (IN YEAR) a) 18-21 years b) 22-25 years c) 26-29 years d) 30 years

28 29 13 10

35% 36.25% 16.25% 12.5%

31 13 12 15 9

38.75% 16.25% 15% 18.75% 11.25%

33 24 10 13

41.25% 30% 12.5% 16.25%

TYPES OF FAMILY a) Joint family b) Nuclear family

44 36

55% 45%

RELIGION a) Hindu b) Muslim c) Sikh d) Other(specify)

29 43 6 2

36.25% 53.25% 7.5% 2.5%

21 48 11

26.25% 60% 13.75%

10 31 21 18

12.5% 38.75% 26.25% 22.5%

11 18 14 17 20 00

13.75% 22.5% 17.5% 21.25% 25% 00%

EDUCATION a) Primary (5th class) b) Middle (8th class) c) High school (10th class) d) Higher secondary (12th class) FAMILY INCOME (PER MONTH) a) Less than 5000 b) Rs. 5000-10000 c) Rs.10000-15000 d) Above 15000

TYPES OF DIET a) Vegetarian b) Non-vegetarian c) Eggatarian OCCUPATION a) Government b) Private c) Self d) Unemployment

PRIORINFORMATION ABOUT ILL EFFECT OF SMOKING & ALCOHOL ON HEALTH A. If yes a) Print Media b) Electronic c) Family & Relative d) Health profile B. No

PERCENTAGE DISTRIBUTION

40

35%

36.25%

35 30 25 20

16.25% 12.5%

15 10

18-21 year 22-25 year 26-29 year

5

30 year

0

18-21 year

22-25 year

26-29 year

30 year

AGE IN YEAR Figure 4.1: Bar diagram showing the percentage distribution of youths according to their age group

DISCUSSION: Bar diagram shows that most of the youths (35%) were in the group of 18-21 years, (36.25%) were in age group of 22-25 years and (16.25%) were in the age group of 26-29 years whereas only (12.5%) were in the age group of 30 years.

PERCENTAGE DISTRIBUTION

45 38.75% 40 35 30 25 20 15 10 5 0

16.25%

18.75% 15% 11.25%

Primary school Middle school High school Higher secondary school Graduate & above

EDUCATIONAL STATUS

Figure 4.2: Cylindrical graph showing percentage distribution of youth in terms of their education status. DISCUSSION: Cylindrical shows on most of the youths (38.75%) had Primary school, (16.25%) had studied up to 8th class and (15%) had studied to 10th class and (18.75%) had studied up to 12th class and remaining (11.25%) had complete graduation.

12.50%

16.25%

41.25% Less than 5000 5000-10000 10000-15000 30%

Above 15000

FAMILY INCOME(PER MONTH) Figure 4.3: Doughnut diagram showing the distribution of family monthly income Doughnut diagram depicts that most of sample belongs to be income of less than 5000 (41.25%) under the Category of Rs. 5000-10000 and (30%) belongs to Rs. 10000-15000 (16.25%) and belong above Rs. 15000 (12.5%)

45% 55%

Joint Nuclear

TYPES OF FAMILY

Figure 4.4 : Pie diagram showing distribution of youth based on their types of family Pie diagram shows that majority of youths (55%) belongs to Joint family and (45%) belong to nuclear family

2.50%

7.50%

36.25% Hindu Muslim Sikh

53.75%

Other

RELIGION Figure 4.5: Pie diagram showing distribution of youth based on religion Its graph indicates (36.25%) Hindu,(53.75%) indicates Muslim, (7.5%) indicates Sikh and (2.5%) indicates other

60%

PERCENTAGE DISTRIBUTION

60

50 40 30

Vegetarian

26.25%

Non vegetarian

20

13.75%

Eggetarian

10 0 Vegetarian

Non vegetarian

Eggetarian

TYPE OF DIET

Figure 4.6: Cylindrical diagram showing distribution of youths based on their dietary pattern Cylindrical diagram shows that majority of youths (26.25%) vegetarian and (60%) have Non vegetarian and (30.75%) have eggatarian.

PERCENTAGE DISTRIBUTION

38.75%

40 35 30 25 20 15 10 5 0

26.25% 22.5% 12.5%

Government Private Self Unemployement

OCCUPATION Figure 4.7: Conical diagram showing distribution of youths based on their occupation pattern Conical diagram shows that majority of youths (12.5%) belong government job and (38.75%) private job ,(26.25%) self occupation and (22.5%) under the category of unemployment

25%

PERCENTAGE DISTRIBUTION

25

22.5% 21.25%

20

17.5% 13.75%

15

Print media 10

Electronic Family & Relative

5

Health profile

0 Print media

No Electronic

Family & relative

Health profile

No

PRIOR INFORMATION ABOUT EFFECT OF SMOKING & ALCOHOL ON HEALTH Figure 4.8: Br graph showing the percentage distribution of youth’s knowledge on effect of smoking and alcohol This diagram shows that the majority of youths (13.75%) print media and (22.5%) electronic media,(17.5%) family and relative (21.25%) health profile and (25%) belong to no knowledge

SECTION –B FREQUENCY PERCENTAGE DISTRIBUTION OF KNOWLEDGE SCORE REGARDING SMOKING AND ALCOHOLISM AMONG YOUTHS (18-30) YEARS N=80 S.NO

SCORING CRITERIA POOR KNOWLEDGE AVERAGE KNOWLEDGE GOOD KNOWLEDGE

1 2 3

PERCENTAGE DISTRIBUTION

60.00%

LEVEL OF KNOWLEDGE 0-8

FREQUENCY (f) 46

PERCENTAGE (%) 57.5%

9-17

33

41.25%

18-26

1

1%

57.50%

50.00% 41.25% 40.00% 30.00%

Poor Knowledge Average Knowledge

20.00%

Good Knowledge

10.00% 1% 0.00% Poor Knowledge

Average Knowledge

Good Knowledge

LEVEL OF KNOWLEDGE SCORE Figure 4:9 Cylindrical graph showing the percentage distribution of youth’s knowledge on effect of smoking and alcohol This diagram shows that the majority of youth (57.5%) have poor knowledge, (41.25%) have belongs average knowledge and remaining (1%) in the category of good knowledge.

SECTION -C Table- Chi-square value is showing relationship between knowledge regarding effect of smoking and alcoholism among youths with the selected demographic variables. N= 80 S.NO. Variables

1.

Poor

Average Good

13 18 8 7

15 8 5 3

0 1 0 0

12 9 9 9

19 4 3 5

0 0 0 1

7

2

0

3.

FAMILY INCOME (PER MONTH) a) Less than 5000 b) Rs. 5000-10000 c) Rs.10000-15000 d) Above 15000

15 14 7 10

18 10 2 3

0 0 1 0

4.

TYPES OF FAMILY a) Joint family b) Nuclear family

23 23

13 20

0 1

5.

RELIGION a) Hindu b) Muslim c) Sikh Other(specify)

17 25 3 1

12 18 2 1

0 0 1 0

6.

TYPES OF DIET a) Vegetarian b) Non-vegetarian c) Eggetarian

11 25 10

10 22 1

0 1 0

7.

OCCUPATION a) Government b) Private c) Self

8 19 9

2 12 11

0 0 1

X2

Age in year a) b) c) d)

2.

df

18-21 years 22-25 years 26-29 years 30 years

EDUCATION a) Primary (5th class) b) Middle (8th class) c) High school (10th class) d) Higher secondary (12th class) e) Graduate & above

6

10.92

8

9.64

6

13.9 *

2

1.66

6

13.31*

4

6.18

6

5.95

d) Unemployment 8.

PRIORINFORMATION ABOUT ILL EFFECT OF SMOKING & ALCOHOL ON HEALTH A. If yes a) Print Media b) Electronic c) Family & Relative d) Health profile B. No

10

8

0

6 12 10 8 10

5 6 4 8 10

0 0 0 1 0

8

6.09

Significant at p< 0.05 level df [6]=12.59, P<0.05 The above table reveals that the knowledge regarding smoking and alcoholism effect on health among youth was to be independent of age in year, education, family monthly income, types of family, religion, types of diet, occupation, prior information about ill effect of smoking and alcohol on health, as evident by Chisquare value of 10.92, 9.64, 13.9, 1.66, 13.31, 6.18, 5.95, 6.09, at 0.05 level. There was significant association between know family income and religion. SUMMARY This chapter deals with the analysis and interpretation of the data of 80 youths in community Gondipura, Bhopal. The collected data was tabulated organized using descriptive statistics.

CHAPTER-5 SUMMARY, FINGDINGS, CONCLUSION, DISCUSSION, LIMITATION, RECOMMENDATION AND IMPLCATION SUMMARY:-The present study was under taken by the investigation to assess the knowledge regarding effect of smoking and alcohol “.A descriptive study to assess the knowledge regarding smoking and alcoholism on health among youths living in a selected community area, Bhopal (M.P).” OBJECTIVES The objectives of the study are 1. Assess the existing knowledge regarding effect of smoking and alcoholism on health among youths. 2. Associate the existing knowledge regarding effect of smoking and alcoholism among youths with their selected demographic variables. 3. Distribute informational pamphlet containing information about effect of smoking & alcoholism on health to youths. 

 

The conceptual framework used for the study was based on Ludwig von Bertalanffy general system model (1968) A review of related research and non research literature helped the investigator to conceptualize the study as well as to develop the structured questionnaire and appropriate method of data collection. A research approach adopted for the study was descriptive survey method. The sample consisted of 80 youths (18-30) year the selected community Gondipura Bhopal. A structured questionnaire was developed for data collection. It comprised of 26 numbers of items. The knowledge regarding effect of smoking & alcohol of youth by various methods was assessed. A pamphlet was prepared in which the various diagnostic methods & prevention of smoking and alcohol tips are discussed. This pamphlet was distributed to the sample subjects. MAJOR FINDING OF THE STUDY WERE SECTION A:Most of the youths 22-25year were in 36.25% 38.75% youths have only primary level education.

SECTION B:1. 46% of youths have poor knowledge on effect of smoking and alcoholism on health 2. 33% of youths have average knowledge on smoking and alcoholism on health. 3.

Only 1% youths have good knowledge on effect of smoking and alcoholism on health. CONCLUSION Among youths in selected community Gondipura Bhopal (M.P.) The study was done on 80 samples using structured knowledge questionnaire. The study data reveals that youths had average knowledge 33%had good regarding effect of smoking and alcoholism on health.

DISCUSSION This chapter deals with the discussion of the result of the data analysis based on the objectives of the study, review of literature and the relation to similar study conducted by researcher and conceptual framework.

IMPLICATIONS Finding of the study have implication in various area of nursing practice, nursing education, nursing administration and nursing research. NURSING PRACTICE The most important role of nurse is working in any of the health field to provide awareness to the community regarding early detection and prevention of effect of smoking and alcoholism on health. The nurse plays an important role in prevention and health promotion. NURSING EDUCATION The nursing curriculum should emphasize on importing health information to community using different teaching method. Nursing student should be educated on health promotion and disease prevention, every student information to the youths and the community for which they should be prepared properly. NURSING ADMINISTRATION Nursing administration should take initiative in creating institutional policies and plan in providing education to the community near by the institutional. Nurse administrator should plan and organize continuing nursing education programs requires efficient team work. NURSING RESEARCH There is a great need of nursing research in the areas of youths education particularly about prevention of effect of smoking and alcoholism. RECOMMENDATION The following recommendations were drawn based on the finding of the study.  A similar study can be replicated on large sample to generalize the findings.  A comparative study can be conducted between youths of different settings.  A similar study with experimental design can be undertaken.

LIMITATION The limitations of the study are.  The study was limited to the selected area Gondipura community Bhopal (M.P)  Nursing related literature in India content were limited in numbers.

SUMMARY This chapter deal with the major findings, discussion, conclusion, implication, recommendation and limitation.

BIBLIOGRPHY  Basavanthappa BT, (2010). “Essential of Nursing Research” 1st edition, jaypee brother’s publications.  Beck and polit (2010). “Essential of Nursing Research” 7edition Wolters and Kluwer publication.  Bernadette et. al. (2001). “Essential of Nursing Research”5th edition.  Brown Little (1992). “Royal college of Nursing Manual of Family Health”.1st edition, Great Britain publication.  Elevles Linda (2005 ).“A key Topics in public health Essential Briefings On Prevention And Health Promotion”.1st edition,Elsevir Churchill Livingston’s publication.  Fain A James (2009). “Reading understanding And Applying Nursing Research”3rd edition, Jaypee publication.  Gupta MC (2007). “Text Book of Prevention And Social Medicine”3rd edition, jaypee publication.  Hastings T. Marie(2003). “Fundamental of Nursing Research”. 3rd edition, Jones and Barlett publication.  Leasure Renee (1995). “ A Text Book of Nursing Research” 1st edition, Mosby publication.  Park K (2006),“Text Book of Prevention And Social Medicine”.21 edition, Banarsidasbhanot publication.  Tendolkar D.Vaishali (2001).“Hand Book Oh Biotastistics”.1st edition, Jones and Barlett publication.  Wong’s Wilson David (2003).“Essential of Pediatric Nursing”.8th edition, Elsevir publication.

ANNEXURES-I SECTION-A Instruction- Please read the following question and put right mark against the appropriate option. DEMOGRAPHIC VARIABLES

1. Age in year a. 18-21 year

( )

b. 22-25 year

( )

c. 26-29 year

( )

d. 30 year and above

( )

2. Education a. Primary (5th class)

( )

b. Middle ( 8th class)

( )

c. High school ( 10th class)

( )

d. Higher secondary (12th class)

( )

e. Graduate and above

( )

3. Family income ( per month ) a. Less than 5000/-

( )

b. 5000 - 10000/-

( )

c. 10000 - 15000/-

( )

d. Above 15000/-

( )

4. Type of family a. Joint family b. Nuclear family

( ) ( )

5. Religion a. Hindu b. Muslim c. Sikh

( ) ( ) ( )

d. Others (Please specify) ( )

6. Type of diet a. Vegetarian

( )

b. Non vegetarian c. eggetarian

( ) ( )

7. Occupation a. Government ( ) b. Private ( ) c. Self ( ) d. unemployment ( ) 8. Prior information about ill effect of smooking and alcohol on health a. Yes ( ) b. No ( ) If yes, specifya. Print media b. Electronic c. Family and relative d. Health profile

SECTION-B Structured Quesionnaire Instruction- Please read the following question and put right mark against the appropriate option. 1. Habit of smoking a. Nill b. Since 1 year c. 5 - 10 year d. 10 year and above 2. Habit of alcohol a. Nill b. 5 -10 drink / day c. 8 - 10 drink / day d. More than 10 drink / day 3. Smoking in form a. Bedi b. Cigarette c. Cigar d. Hookah 4. Pack of cigarette smoked per day a. Upto 1 b. 1 - 2 c. 2 - 3 d. More than 3 5. Source of finance purchase are alcohol a. Self b. Parents c. Relatives d. Friends 6. Have you ever stolen money to purchase cigarette/ alcohol a. Yes

b. No 7. History of a. Lung disease b. Heart disease c. Kidney disease d. Any other ( Please specify) 8. Smoking means a. Inhalation of carbon dioxide b. Inhalation of harmful air c.

Inhalation of smoke of burning tobacco

d. Inhalation of smoke of burning leaves 9. Smoking and alcohol posses a. Physiological danger b. Psychological danger c. Both A or B d. None of the above 10. Cigarette and beedi contains a. DDT b. Nicotine c. Carbon monoxide 11. Alcohol contains a. Nicotine b. Formaldehyde c. Glycoside d. Tar 12. Forms of smoking are a. Beedi b. Cigar c. Both A and B d. Non of the above

13. The danger of smoking to a fetus of a non smoker mother is 

Hydrocephalus



Low birth weight



Placenta previa



Forcep delivery

14. Hukah smoker have higher risk of a. Chronic heart failure b. Chronic bronchitis c. Chronic sinusitis( )( ) d. COPD( ) 15. Occlusive disease of small arteries is related to a. Beedi smoking( ) b. Cigar smoking( ) c. Hukah ( ) d. Snuff( ) 16. Tabacco chewing increase the risk of a. Palate cancer( ) b. Teeth cancer( ) c. Larynx cancer( ) d. Leucoplakia( ) 17. Tabbaco chewing has been shown to a. Increase bleeding time ( ) b. Increase coagulation time( ) c. Both A and B( ) d. None( ) 18. Excessive drinking during pregnancy result in a. Low birt weight ( ) b. Placental insufficiency ( ) c. Premature rupture of membrane( ) d. Placenta previa( )

19. Excessive drinking result in a. GI refuse ( ) b. oesophagitis( ) c. Both A and B( ) d. None( ) 20. Cardiovascular effect due to excessive in resoiratory system includes a. Premature beats( ) b. Supraventricular tachycardia ( ) c. Anginal pain ( ) d. ventricular tachycardia ( ) 21. The serious consequences of alcohol in respiratory system includes a. Bronchitis( ) b. Laryngitis( ) c. Pharyngitis( ) d. Aspiration pneumonia ( ) 22. Rhabdomyolysis is caused due to a. Smoking ( ) b. Alcohol ( ) c. Both ( ) d. None( ) 23. The risk factor of ectopic pregnancy a. Alcohol( ) b. Smoking ( ) c. Both ( ) d. None ( ) 24. Brain hemorrhage is a serious complicaton of excessive a. Smoking ( ) b. Alcohol ( ) c. Both ( ) 25. Fetal alcohol syndrome is a complication of

a. Male drinker ( ) b. Female drinker ( ) c. Pregnant women drinker ( ) d. Adolescent drinker( ) 26. Cirrhosis of liver is due to a. Smoking ( ) b. Heavy drinking ( ) c. Tobacco chewing( ) d. Drugs ( )

ANSWER KEY QUESTION 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

ANSWER C B a b d b a c c b b c b b a b a b b b d a b b c b

SCORE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

MASTER DATASHEET (STRUCTURED KNOWLEDGE QUESTIONS) QUESTION SAMPLE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

TOTAL

1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 0 0 0

1 1 1 0 1 0 1 0 0 1 0 1 1 0 1 1 0 1 0 0 1 1 1 1 1 1 1 0 1 1

0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0

1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 0 1 1 1 0 1

5 0 1 0 0 0 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 0 1 1 1 1 0 0 1 1 1 0 1 0 0 1 1 1 0 0 1 1 0 0 1 0 0 0 0 1

1 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0

0 0 0 1 0 1 0 0 1 0 1 0 0 0 1 1 1 1 0 1 0 1 0 1 0 0 1 1 1 0

1 1 0 1 0 1 1 1 0 1 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 1 0 1 1 1

0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 1 0 0 0 0 1 0

0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 1 0 1 0 0 1 0 0 0

0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1

0 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 0 0 0 1 0 1 1 1 1 1 0 1 1 1

1 0 0 1 0 1 0 1 1 0 0 1 0 0 1 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0

1 0 1 1 1 1 1 0 0 1 0 1 1 0 1 0 0 1 1 1 0 1 0 1 0 1 0 1 0 0

1 1 1 0 1 0 1 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0

0 1 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 0 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0

0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0

1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1

0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0

0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 1 0 1 0 1 0 1 0 0 1 0

0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0

1 1 0 1 1 1 0 1 1 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1

13 10 12 16 8 1 10 7 8 11 6 6 9 3 10 11 8 11 6 7 4 19 8 11 7 12 7 9 8 8

31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67

0 0 1 0 0 1 1 1 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 1 0 1 1 1 0 0 0 1 1 1 1 1

1 0 0 1 1 1 1 1 0 0 0 0 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 0 0 1 1 1 1 1

1 1 0 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1

1 0 0 0 1 1 0 0 1 0 0 0 1 1 0 1 1 1 1 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1

1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 0 1 1

1 0 0 0 1 0 1 0 0 0 1 0 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 1 1 1 1 1 0 0 1

1 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0

1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0

1 0 1 0 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0

0 1 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

1 0 0 1 1 0 1 1 0 0 1 1 0 1 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1

1 0 1 0 0 1 1 1 0 0 0 0 1 0 0 0 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1

1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1

1 0 1 0 1 1 0 1 1 1 0 0 0 1 1 1 0 1 1 1 1 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 1

0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1

0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 0 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0

0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0

0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0

0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0

1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0

0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 1 0 0

0 0 1 0 0 1 0 0 1 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 0 1 1 0

1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 0

1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1 1

15 3 8 6 11 10 14 10 5 2 5 6 11 9 8 8 11 16 10 13 5 6 5 6 6 4 6 5 7 7 10 10 12 8 8 8 12

68 69 70 71 72 73 74 75 76 77 78 79 80

0 1 1 1 1 1 0 1 0 1 0 1 1

0 1 1 1 1 1 1 1 1 1 1 1 1

0 1 1 1 1 1 0 1 1 1 1 0 0

1 1 1 0 1 1 0 1 0 1 1 0 0

1 1 1 0 0 1 1 1 0 1 1 0 0

1 0 0 0 0 1 0 0 0 1 0 0 0

1 0 0 0 0 1 0 0 0 1 0 0 0

0 0 0 0 0 1 0 0 0 0 0 0 0

0 0 0 1 0 0 1 0 0 0 0 0 0

0 0 0 1 0 0 1 0 0 0 0 0 0

0 0 0 0 0 0 1 0 0 0 0 0 0

0 0 0 0 0 0 1 0 0 0 0 0 0

0 0 0 0 0 0 1 0 0 0 0 0 0

0 0 0 0 0 0 1 1 0 1 0 1 1

0 0 0 0 0 0 0 1 0 1 0 1 0

1 0 0 0 0 0 1 1 0 1 0 0 0

1 0 0 0 0 1 1 1 0 1 0 0 0

1 0 0 0 0 1 1 1 0 1 0 0 0

1 1 0 0 0 1 1 0 0 1 0 0 0

0 1 0 0 0 1 0 0 0 0 1 0 0

0 1 0 0 0 1 0 0 0 0 1 0 0

0 0 0 0 0 0 0 0 0 0 1 0 0

0 0 1 0 0 0 0 0 1 0 1 0 0

0 0 1 0 1 0 0 0 0 0 0 1 0

0 0 1 0 0 0 0 0 0 0 0 0 1

0 0 0 0 0 0 0 0 0 0 0 0 0

8 8 8 5 5 13 12 10 3 13 8 5 4