PREVALENCE OF ARECA NUT AND TOBACCO USE AND AWARENESS OF ITS EFFECTS IN SCHOOL-GOING CHILDREN OF AHMEDABAD, INDIA

M. Sheth¹, P. Rangey², A. Khan³, N. Vyas⁴

¹SBB College of Physiotherapy, Community Health, Geriatrics, Ahmedabad, India, ²L J Institute of Physiotherapy, Community Health, Ahmedabad, India, ³SBB College of Physiotherapy, Community Health, Ahmedabad, India, ⁴AIMS college of Physiotherapy, Community Health, Ahmedabad, India

Background: Areca nut is chewed by itself and in various scented preparations. Areca nut chewing is widely practiced in many parts of Asia, including India. Users often consider it harmless and report a sense of well-being, but evidence shows that it is far from harmless and can have multiple oral health implications such as oral submucosal fibrosis posing difficulty in opening mouth and carcinogenesis. Areca nut is classified as class I carcinogen by IARC. Studies in India have reported increasing prevalence of this habit among school-going children and it is becoming a serious problem in developing countries.

Purpose: To identify the prevalence of tobacco and areca nut chewing habit, characteristics of areca nut chewers and the knowledge regarding the adverse effects of tobacco and areca-nut use among high school children in school-going children of Ahmedabad, India.

Methods: An observational analytical study was conducted across nine schools in Ahmedabad, Gujarat. An anonymous self-administered close-ended questionnaire was designed for the study. Principals of 9 schools, were approached and written informed consent was obtained. School going children, 12-17 years old, were included by convenience sampling. They were asked to fill the questionnaire which included questions regarding personal habits.Assent from children was obtained.

Results: Data of 3055 children was obtained, there were 52% boys and 41% girls. The prevalence of tobacco chewing or areca nut chewing was 12%. Of them, 5% had the habit of smoking, 6% had the habit of chewing tobacco and 89% chewed areca nut. 46% got the tobacco or areca nut near their house, 13% found it near school, 11% borrowed or stole it. 237(64%) students received their first packet from a friend. Twenty-five percent initiated the habit at the age of <12 years, 43% at 13–15 years, and 32% at 15–17 years. Attitude of consumers after having areca nut was noted as 10% felt relaxed, 13% happy, 14% found it pleasurable, 54% felt nothing. Feelings of the consumers if they did not consume it: 5% felt discomfort, 9% restless, 7% had a craving, 71% had nothing. Fourteen percent found themselves to be more attractive, 19% felt less attractive, and 62% found that consumption doesn’t make any difference to their appearance.Of the 3055 children, 3% felt that tobacco use was definitely not harmful to health while 84% felt that it was. In all, 65% of respondents were aware that tobacco use caused cancer. With regards to the role of media, 78% had seen many anti-smoking warnings in the media, 15% had seen a few, 5% had seen none.

Conclusions: There was a 12% prevalence of areca nut and tobacco consumption among school children of Ahmedabad. Awareness about the harmful effects of tobacco is high, though use may still be prevalent. Peer pressure was a dominant characteristic.

Implications: Consumption of areca nut and tobacco is an emerging social and public health problem among school-going children and there is a need to sensitize parents, teachers and students towards the ill-effects of tobacco. The government should also introduce policies to prevent the consumption.

Funding acknowledgements: None

Keywords:
Personal habits
Adolescents
Carcinogenic

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Paediatrics
Oncology, HIV & palliative care

Did this work require ethics approval? No

Reason: My institute does not provide ethics approval to studies. The study was done according to guidelines developed by CIOMS and the principles of Declaration of Helsinki.