Kiến thức và thực hành về sử dụng thuốc lá ở cán bộ văn phòng tại Trường Đại học Y Yangon_ KNOWLEDGE AND PRACTICE OF TOBACCO USE AMONG HOUSE OFFICERS IN UNIVERSITY OF MEDICINE YANGON

Kiến thức và thực hành về sử dụng thuốc lá ở cán bộ văn phòng tại Trường Đại học Y Yangon_ KNOWLEDGE AND PRACTICE OF TOBACCO USE AMONG HOUSE OFFICERS IN UNIVERSITY OF MEDICINE YANGON1.Introduction All over the world, noncommunicable diseases are becoming major public health problem Tobacco use, one of major risk factor for NCD, become one of the greatest public health threats for the 21st century (WHO, 2002)It is considered to be a leading preventable premature cause of death all over the worldHealth professions have an important role in the fight against tobacco useTobacco use in health professions becomes a main hindrance in counseling to patients against using tobacco2.ObjectivesGeneral ObjectiveTo study knowledge and practice of tobacco use among house officers in University of Medicine (2), Yangon in 2012Specific Objectives1. To estimate the proportion of smoking and betel chewing with tobacco among the study population2. To assess knowledge on tobacco use among the study population3. To find out the factors associated with knowledge of tobacco use among the study population4. To find out the factors associated with practice of tobacco use among the study population3.Research Methodology3.1.Study design Crosssectional descriptive study 3.2.Study area Teaching Hospitals under the University of Medicine (2), Yangon3.3.Study period From September to November, 20123.4.Study population all house officers under theUniversity of Medicine (2), Yangon3.5.Sample size determination n = z2 p q d2 n = sample size z = reliability coefficient at 95% confidence levelp= 0.1 (prevalence of medical doctors’ tobacco use in Myanmar was 10%, According to the study of “Myanmar Medical Doctor’s Tobacco Use Survey” in 2003)q = 0.9d = margin of error = 0.05n = (1.96) x (1.96) x (0.1) x (0.9) (0.05) x (0.05) = 138For nonresponse rate, 10% of sample size was added to calculated sample size.Therefore final sample size was 150 participants

Dr Thida Aung

Lecturer Department Of Population And Family Health

University of Public Health, Yangon

KNOWLEDGE AND PRACTICE OF TOBACCO USE AMONG HOUSE OFFICERS

IN UNIVERSITY OF MEDICINE (2), YANGON

1.INTRODUCTION

becoming major public health problem

one of the greatest public health threats for the 21st century (WHO, 2002)

 It is considered to be a leading preventable premature cause

of death all over the world

 Health professions have an important role in the fight

against tobacco use

hindrance in counseling to patients against using tobacco

2

3.RESEARCH METHODOLOGY

 3.1.Study design - Cross-sectional descriptive study

 3.2.Study area - Teaching Hospitals under the

University of Medicine (2),

Yangon

 3.3.Study period - From September to November,

2012

 3.4.Study population- all house officers under the

University of Medicine (2), Yangon

3.5.Sample size determination

n = z2 p q /d2

n = sample size

z = reliability co-efficient at 95% confidence level

 p= 0.1 (prevalence of medical doctors’ tobacco use in Myanmar was 10%, According to the study of “Myanmar Medical

Doctor’s Tobacco Use Survey” in 2003)

 q = 0.9

 d = margin of error = 0.05

 n = (1.96) x (1.96) x (0.1) x (0.9) / (0.05) x (0.05) = 138

 For non-response rate, 10% of sample size was added to

calculated sample size.

 Therefore final sample size was 150 participants

3.6.SAMPLING PROCEDURE

3.7.Data collection methods and tools

 Face to face interview was conducted by using a set of

semi-structured questionnaires that were pre-tested in

Sanpya General Hospital

3.8.Data management and analysis

Data entry

 After editing and cleaning the data collected from

respondents, the collected data were entered by Epi-Data

version 3.1software

Data analysis

 The data analysis were done by using SPSS 16.0 software

 α was set at 0.05 for statistical significant

3.9 ETHICAL CONSIDERATION

 Protocol was submitted to Ethical board of the University of Public Health for permission to conduct the presented study

 Written informed consent with thorough explanation about the study to the participants was obtained

4.FINDINGS 4.1 Socio demographic characteristic of house officers

 Among 150 respondents, 76 (50.7%)were male and Mean age of respondents was (22.82) years and (SD-1.23)

 Most of the respondents were Bamar (75.9%) and Buddhist (93%)

 Main sources of information on health effects of tobacco

were from radio/TV (80.7%) The least frequent (58.7%)

was from poster and pamphlets

 Only one-third of the respondents (39%) received training

in tobacco cessation approaches during medical school

Figure (1)Status of smoking and betel chewing with tobacco among house officers’ parents, family members and friends

Fr ien

ds

Fa m ily M

4.2 GENERAL KNOWLEDGE ON TOBACCO

 Regarding on adverse effect of smoking, (78.7%) answered peptic ulcer

 Regarding on health hazards in children due to second-hand smoke, 98% correctly responded for early onset of asthma

 Concerning knowledge on health hazards of betel chewing with

tobacco, 99.3% of respondents responded correctly on oral cancer

 Regarding on health hazards that can occur in the neonate borne to smoker mother, 86% responded correctly on still birth and 84% on preterm effect respectively

KNOWLEDGE ON TOBACCO LAW AND CONTROL

ACTIVITY

Table (1) Knowledge on tobacco law and control activities in Myanmar (n=150)

KNOWLEDGE ON TOBACCO LAW AND CONTROL

ACTIVITY

Table (2) Knowledge upon non-smoking areas (n=150)

KNOWLEDGE ON RESTRICTIONS OF SMOKING IN HOSPITAL AND MEDICAL

 Regarding to knowledge level, 71 (47.3%) were low

knowledge while 79 (52.7%) were high knowledge about

tobacco use

as high knowledge)

4.3 PRACTICE ON TOBACCO USE

63.6 21.4

13

2

Non-current smoker

10.7

11.3

2

Never betel chewer Current betel chewer

Figure (4)Different types of betel chewers (Smokeless tobacco users)

 More than half of current smokers (59.4%)and betel chewers (50%)started to use between their ages of 18 to 21 years

 The main initiations for tobacco use were found that for trial and peer pressure

 56.2% of current smoker bought cigarette in loose form,

21.9% bought from hospital canteen and 31.2% smoked in their duty room

(56.2%) chewed betel quid daily

 Regarding to cessation practice of tobacco use, 71.9% of

current smokers and 56.2% of current betel chewers had

desire to quit

were health reason and oral hygiene

 The smoking habit of respondents was associated with gender and friends’ behaviours (42.1% vs 0%, p =0.000) and (28.3% vs 7.8%, p=0.004)

 The same results occurred that the betel chewing habit of respondents was associated with gender and friends’

behaviours (21.1% vs 0%, p=0.000) and (19.4% vs

1.4%, p =0.000)

4.4 PRACTICE OF GIVING HEALTH EDUCATION

AND ADVICE TO QUIT TOBACCO USE TO THE

PATIENTS

 More respondents gave health education and advice to

quit smoking than betel chewing (74.7% vs 54.7%)

 There was significantly association between their current tobacco use and practice of giving health education

(43.8%, vs 86.4%, p=0.000)

 The current tobacco users less advised to quit tobacco use than non-current tobacco users (50% vs 81.4%, p=0.000)

5 DISCUSSION

 Only 39% of the respondents received training in tobacco

cessation approaches during medical school

 It may be due to other respondents didn’t remember whether they received or not this training (recall bias)

 proportion of male current smokers in this study was

increased than the finding of GHPSS in 2009 but the same

result in female respondents (Male = 42% vs 23.6% and

Female = 0% vs 1.1% )

 proportion of male current smokeless tobacco users in this

study was not so much different from the finding of GHPSS in

2009 (Male = 21.1% vs 22.5% and Female = 0% vs 0.7% )

6 CONCLUSION

 It was found that 21.4%were currents smokers(male-

42% vs female- 0%)and 10.7% were current smokeless tobacco users (male- 21.1% vs female- 0%)

 Out of them, 71.9% of current smokers and 56.2% of

current betel chewers had ever tried to quit

 Most of current tobacco users had a perception that

doctor should not use tobacco and should be role model for cessation of tobacco

 Most of current smokers had good knowledge on

tobacco hazards and tobacco control activities but they did not come into daily practice and still had become

7 RECOMMENDATION

 Anti-tobacco health curriculum should be strengthen in middle

and high school level to educate young adolescent not to start

 Training in tobacco cessation approaches to provide the patients should be strengthened in the Medical teaching program and

Continuous Medical Education program for improvement of

health among tobacco users in the community

7 LIMITATION OF THE STUDY

University of Medicine (2) due to time limitation

2 qualitative methods (focus group discussion or in-depth

interview method) should be conducted in combination with questionnaire

according to the response of participants, so there could be information bias

REFERENCES CITED

Yangon in 2009, MPH Thesis University of Public Health

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MPH Thesis University of Public Health

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Yangon.M.Med.Sc Thesis (Public health)

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Factors,2010, Myanmar

Tobacco Control Paper No.14 World Bank and World Health Organization

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Study, Department of Health, Ministry of Health, Myanmar

Kyaw-Khaing, Nyi-Nyi-Latt&Maung-Maung-Than-Hteik 2005, “Study on Poverty Alleviation and

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Community Health, Magway.M.Med.Sc Thesis (Public health)University of Medicine Mandalay

non-communicablediseases: an opportunity for whom? BMJ 2011;343:d5336 doi: 10.1136/bmj.d5336

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http:w3.searo.who.int/EN/Section1174/section1462/pdfs/surv/GHPS2006Myanmar

Organization, Regional Office for South East Asia Region, New Delhi

THANK YOU

VERY MUCH !