A Project Report On

“Why do teen smoke? Analysis and factors affecting Tobacco consumption among
teenagers”

Submitted in partial fulfilment of the requirement for the award of

MASTER’S IN BUSINESS ADMINISTRATION

From

NARAYANA BUSINESS SCHOOL, AHMEDABAD

Subject : Research Methodology

Component : CEC
Submitted By
NAME: Roll No:
Abhay Singh Pawar 01
Deepak Bhati 13
Mayank Khandelwal* 31
Minal Bharatra 32
Mohak Betala 33

BATCH : MBA 2023-25

SECTION : Omega

DATE OF SUBMISSION: 4th of May, 2024

Under The Guidance Of

NAME : Anju Dwivedi

DESIGNATION : Associate Professor

Table of Contents
Chapter-1 INTRODUCTION ........................................................................................................................................ 3
Chapter – 2 LITERATURE REVIEW ....................................................................................................................... 6
Chapter-3 Research Methodology ............................................................................................................................... 15
Research Objectives .................................................................................................................................... 15
Research Hypothesis ................................................................................................................................... 15
Research Design .......................................................................................................................................... 15
Chapter-4 Data Analysis .............................................................................................................................................. 17
Chapter 5: Findings ...................................................................................................................................................... 34
Conclusion ..................................................................................................................................................................... 35
Bibliography (References) ............................................................................................................................................ 36
Annexe: Questionnaire ................................................................................................................................................. 38
 Chapter-1 INTRODUCTION
WHY DO TEENS SMOKE? ANALYSIS AND FACTORS AFFECTING
TOBACCO CONSUMPTION AMONG TEENAGERS

Smoking is a practice in which a substance is combusted and the resulting smoke is typically inhaled to be
tasted and absorbed into the bloodstream of a person. The material most frequently used is dried tobacco
leaves, which are wrapped into an extended cylinder known as a cigarette using tiny rectangles of paper.
Rolling paper and loose tobacco can be used to manually roll cigarettes. Additional smoking implements
include of bongs, bidis, pipes, cigars, and hookahs.
Smoking is commonly used as a method for delivering psychoactive chemicals into the body. This is due to
the fact that when plant leaves are burnt, the active substances vaporize and can be inhaled into the
respiratory tract, where they are quickly absorbed into the blood circulation in lungs and then reach the
central nervous system. In the case of tobacco, the active substances include nicotine, which stimulates the
nicotinic acetylcholine receptors in the brain. Other notable substances inhaled through smoking include
tetrahydrocannabinol from cannabis, morphine from opium, and cocaine from crack.
Smoking is a widespread form of recreational drug use, with tobacco being the most prevalent form,
practiced by over a billion people globally, particularly in developing countries. Less common drugs for
smoking include cannabis and opium, with cigarettes being primarily industrially manufactured. Smoking
has significant negative health effects, including being a leading cause of diseases such as lung cancer, heart
attack, COPD, erectile dysfunction, and birth defects. The health hazards of smoking have led to the
implementation of high taxes on tobacco products, anti-smoking ads, limitations on pro-smoking
advertisements, and support for quitting.
Extremely among teens, smoking continues to be very common and is becoming more of a concern in all
over the world. An estimated 50 million teenage people, both male and female, between the ages of 13 and
15 worldwide are anticipated to smoke cigarettes or use smokeless tobacco products. Though the health risks
are well known, tobacco use, especially smoking is common across the world. On an annual basis, a large
number of youngsters start smoking, and it is been estimated that tobacco use causes one-third of their
deaths.
Adolescence is a critical period when substance use-related dangers are especially major. Adolescence is
when smoking behaviour is usually formed; by the time an individual reaches the age of 18, the majority had
either smoked their first cigarette or were addicted. Young people need less tobacco products and shorter
time to develop a nicotine addiction than adults do.
It's not only cigarettes that people get addicted too. Particularly appealing to young people, contributing to
their widespread use. In 2021, a vast majority of both high school and middle school students who used
tobacco products reported using flavoured varieties. This trend has continued into 2023, with even higher
percentages of youth e-cigarette users opting for flavoured products.
E-cigarettes have emerged as the most commonly used tobacco product among youth since 2014. Usage
rates in 2023 indicate that 10% of high school students and 4.6% of middle school students used e-cigarettes
in the past 30 days. Traditional cigarette usage remains relatively low among this demographic, with usage
rates under 2% for both high school and middle school students. Other forms of tobacco products, including
cigars, smokeless tobacco, hookah, heated tobacco products, and nicotine pouches, also show usage rates of
around 1% or less among high school and middle school student. The usage of e-cigarette among young
adults have increased rapidly in the recent times.
E-cigarettes (Vape) Battery-operated e-cigarettes use cartridges filled with nicotine, flavourings, and
other harmful chemicals and turn them into a vapor that's inhaled by the user.
Some individuals believe e-cigarettes are less harmful than traditional cigarettes due to the absence of
tobacco. However, the other components in e-cigarettes can also pose significant health risks. There have
been instances of severe lung injuries and fatalities linked to e-cigarette usage, leading health professionals
to strongly advise against their use.
Hookahs While some people may perceive hookah smoking as safer than cigarette smoking due to the
smoke being cooled by water, it's important to recognize the potential health risks associated with hookah
use. The buildup of black gunk in hookah hoses can indeed pose health concerns as users may inhale
particles from this residue, potentially impacting their respiratory health. Additionally, hookahs do not have
filters, which means that users are exposed to a range of harmful substances present in the smoke. Extended
smoking sessions can also increase these health risks. Furthermore, the communal nature of hookah smoking
can contribute to the spread of germs and illnesses, as the pipe is mostly shared among excess users. It's
essential for individuals to be informed about the potential health risks associated with hookah smoking and
to make decisions regarding their health based on accurate information.
How can smoking affect health?
It's crucial to highlight the serious health risks associated with smoking. The chemicals in cigarettes,
including nicotine and cyanide, are toxic and can indeed be lethal in high doses. The initial symptoms
experienced by first-time smokers, such as throat and lung irritation, vomiting, and discomfort, are a result
of the body's natural defense mechanisms reacting to the introduction of harmful substances.
Over time, smoking can lead to a multitude of health issues, including heart conditions, strokes, lung
problems, and various cancers affecting organs such as the stomach, bladder, throat, and lungs. Additionally,
smoking is linked to adverse effects such as yellowing of teeth, gum disease, vision problems, increased
susceptibility to infections like pneumonia, a higher risk of developing diabetes, weakened bones prone to
fractures, skin conditions like psoriasis, and premature aging of the skin.
Smoking can affect sexual health in both men and women. Girls who smoke and are on hormone-based
birth control methods like the Pill, the patch, or the ring have a higher risk of serious health problems, like
heart attacks. And if a woman wants to get pregnant, smoking can make that harder. Besides this smoking
can lead to immediate issues such as bad breath, lingering odor on clothes and hair, reduced athletic
performance, delayed healing from injuries, increased susceptibility to illness, and the potential for nutrient
deficiencies due to using smoking as a weight management method. Additionally, all forms of tobacco,
including e-cigarettes and filtered or low-tar cigarettes, pose significant health risks.
The studies from the US indicate a significant range in tobacco consumption among school students, with
12.6% to 79% identified as current users, having consumed tobacco within the last month, and nearly three-
fourths of these are smokers. There's a noticeable increase in tobacco use from middle to high school,
although there has been a general decline in smoking rates among school students over the past decade.
Tobacco addiction appears to be equally common across genders in the US.
Internationally, the Global Youth Survey Project, which surveyed school children aged 13–15 in 12 diverse
countries, found that current cigarette smoking rates varied from 10% to 33%, and rates of ever-smoking
ranged from 15% to 70%. Notably, smoking rates were higher among boys in the Russian Federation, Sri
Lanka, and Ukraine, while in China, Fiji, Jordan, and Venezuela, smoking was more prevalent among girls.
India stands out with a predominant male phenomenon in tobacco use and a rising trend in smokeless
tobacco consumption, particularly among street and college students.
Previous epidemiological researchers have identified several factors associated with teenage smoking,
including grade level, sex, socio-economic status, religion, parental and peer smoking patterns, sibling
smoking behaviours, personal income, extracurricular activities, academic orientation and smoking
knowledge of smoking hazards. Additionally, social and environmental factors such as religious
involvement, racial/ethnic identity, and higher academic achievement are associated with lower smoking
levels among youth. Continual efforts to prevent and reduce all forms of tobacco use among young people
are crucial for public health.

The initiation of tobacco use among children and teenagers is influenced by a complex interplay of factors.

Family Influence
Family dynamics play a crucial role. The practice of using tobacco by parents or elder siblings can
significantly increase the likelihood of a child starting to smoke. In some cultures, children are introduced to
tobacco procurement at an early age, embedding it as a family norm, despite a contradictory tradition that
discourages smoking in the presence of elders. This paradoxical situation underscores the complex
relationship between cultural norms and tobacco use.

Peer Influence
Peer pressure is a critical factor in the initiation of tobacco use among the youth. The desire to conform to a
group, especially when faced with distress, makes adolescents susceptible to adopting smoking behaviours
modelled by their peers. This social mechanism is reinforced by the quest for acceptance and fear of
isolation.
Accessibility
The easy availability of tobacco products, including cheaper alternatives like beedis and modern smokeless
tobacco products, facilitates experimentation and regular use among financially constrained groups.

Psychological and Emotional Factors

Adolescents dealing with anxiety, depression, poor school performance, or low self-esteem may turn to
smoking as a coping mechanism. Tobacco use is perceived as a way to alleviate anxiety, elevate mood, and
enhance self-esteem by associating smoking with maturity and adulthood.

Marketing Strategies
Aggressive advertising and promotion by tobacco companies significantly impact adolescent smoking
behaviour. Advertisements portray smoking as fashionable and successful, targeting young minds with
influential imagery. Sponsorship of events and the portrayal of smoking in media as a normative behavior
further encourage tobacco use among vulnerable youths. This strategy is particularly pronounced in
developing countries, where market saturation in the West has redirected tobacco companies' focus.

Socio-Cultural Influences
The socio-cultural environment also shapes tobacco use patterns. Historical associations of smoking with
higher social classes have evolved, and tobacco use has permeated all levels of society. Rural areas show a
preference for smokeless tobacco and traditional smoking methods, while urban areas might display
different trends. Marketing strategies now aim to associate chewable tobacco products with the upper-class
lifestyle to broaden their appeal.
The reasons behind tobacco use among youth are multifaceted, shaped by an interplay of personal, familial,
social, and economic factors, alongside aggressive marketing tactics by the tobacco industry. These
influences create a challenging environment for preventing tobacco use among young people, requiring
targeted strategies to address the various factors contributing to this issue

Chapter – 2 LITERATURE REVIEW

Louise Stjerna a, Sonja Olin Lauritzen a, Per Tillgren (1976)
The study reveals a nuanced understanding of tobacco use through qualitative analysis. intertwined with
identity formation. And adolescent social interaction. The emergence of the "cool" smoker archetype reflects
broader cultural ideals and values, but the analysis nevertheless reveals a more complex picture of tobacco
use beyond simple stereotypes. Ultimately, the study emphasizes the need for a holistic approach to tobacco
prevention. Smoking, which considers the complex social, cultural and gender dynamics that shape
adolescent attitudes and behaviours towards tobacco. By shedding light on the complex interplay of factors
influencing adolescent smoking, the study provides valuable information for the development of targeted
interventions and strategies aimed at reducing smoking initiation and promoting healthier behaviours among
young people in Sweden and elsewhere...This prospective cohort study assessed the association between
receptivity to tobacco advertising and promotions and youth smoking progression over a 3-year period. The
purpose of the study is to determine the effect of tobacco advertising on the likelihood of youth smoking and
to provide valuable information for public health policy.
Thomas Eissenberg, Robert L Balster (1980)
This study provides a comprehensive review of 34 peer-reviewed quantitative studies focusing on the
relationship between sports and drug use among high school and college students. The results show that
while participation in sports is associated with higher alcohol consumption, it is associated with smoking
and illegal drugs. However, further research is needed to fully understand the dynamics of
these relationships.
The study results highlight the complexity of the relationship between sports participation. And drug use
among young people. The results indicate that targeted intervention and preventive measures are needed to
combat drug addiction in athletes. In addition, the study emphasizes the importance of continued research in
this area to better understand the factors that influence drug use in youth athletes and to develop effective
prevention and intervention strategies. Funding sources for the study come from the National Institute on
Drugs. Abuse Acknowledge and acknowledge the contributions of the researchers who participated in the
literature searches, statistical analysis, and manuscript preparation, emphasizing collaboration and the
thoroughness of the research process.
N. E., Winders, S. E., & Wewers, M. E. (1991).
The results of the study emphasize the need to comprehensively understand gender differences in tobacco
use. . By elucidating the factors that contribute to these differences, the study lays the groundwork for
developing more effective strategies to prevent tobacco use. The study uses a systematic approach to
review the literature on gender differences in tobacco use. It includes the results of studies that
examine tobacco consumption patterns over time, types of tobacco products, and different cultural
contexts. The methodology includes analysis of psychosocial variables such as social desirability and
biological factors such as nicotine sensitivity. Synthesizing information from different sources, the study
aims to provide a comprehensive understanding of gender differences in tobacco use.

Finally, the study highlights the importance of a nuanced approach to tobacco control, taking into patterns.
Account the complex interplay of psychosocial and biological factors that influence sex-
specific tobacco use

John P. Pierce, PhD; PhD; Elizabeth A. Gilpin (1992)

This prospective cohort study assessed the association between receptivity to tobacco advertising and
promotions and youth smoking progression over a 3-year period. The purpose of the study is to determine
the effect of tobacco advertising on the likelihood of youth smoking and to provide valuable information
for public health policy.
According to the study, 34% of California youth smoking attempts between 1993 and 1996 can be
attributed. to tobacco advertising. Nationwide, this translates to more than 700,000 youth affected by
tobacco advertising each year. The study emphasizes the causal role of tobacco advertising in youth
smoking and underscores the urgent need for regulatory action to curb smoking. tobacco advertising and
sales promotion. in youth By providing longitudinal evidence of the association between receptivity to
tobacco advertising and smoking initiation, the study informs public health efforts aimed at preventing
smoking initiation and reducing tobacco-related harm among adolescents.

Kathryn P Mayhew, Brian R Flay, Joshua A Mott (2000)

The research objective is to review empirical studies of predictors of transitions in stages of smoking
progression and identify similarities and differences related to predictors of stages and transitions across
studies, focusing on the complex ontogeny of smoking behavior in adolescence. The review methodology
involves an exhaustive list of research studies from various countries, aiming to understand whether
specific social, psychological, or biological factors are associated with different stages of smoking
progression. The findings provide partial support for theoretical assumptions but note the lack of a
consistent operational definition of smoking stages across research studies, preventing firm conclusions.
As a result, the paper emphasizes the need for a valid and consistent operational definition of smoking
stages and highlights theoretical considerations for future research.
RK Chadda & SN Sengupta (2002)
The research paper aims to understand the patterns of tobacco use in India, particularly among adolescents,
and to identify the factors contributing to the initiation of tobacco use. It also analyses preventive strategies
to combat tobacco use, emphasizing the role of family influence, peer pressure, easy access to tobacco
products, and aggressive marketing by tobacco companies in initiating tobacco use among adolescents. The
paper employs a methodology involving the review of epidemiological surveys conducted in different parts
of India to study tobacco use prevalence among adolescents and compares these patterns with other
countries. The outcomes highlight the urgent need for preventive strategies, such as community awareness
programs, early education initiatives, curbs on tobacco advertisements, and legal enforcements to regulate
tobacco use among adolescents. Overall, the research aims to address the high prevalence of tobacco use
among Indian adolescents and proposes comprehensive strategies to reduce tobacco consumption and
associated health risks.
Seter Siziya, Adamson S Muula (2003)
The study utilized data from the 2003 Global Youth Tobacco Survey conducted in Punjab, India, focusing
on 2014 adolescents with a male majority of 58.9%. Weighted logistic regression analysis, adjusted for age
and sex, was employed to identify factors associated with current tobacco smoking among adolescents. Key
findings indicated positive associations between smoking and factors such as receiving pocket money,
parental tobacco use, perceptions of social attractiveness related to smoking, and having friends who smoke.
Conversely, negative associations were found with factors like perceptions of reduced attractiveness and
having fewer friends among smokers. These findings emphasize the importance of considering peer
influence and societal perceptions in designing effective public health interventions aimed at reducing
adolescent cigarette smoking. Further studies are recommended to explore the observed associations
between current smoking, peer influence, and perceptions of attractiveness.

George Rachiotis, Adamson S Muula, Emmanuel Rudatsikira, Seter Siziya, Athina

Kyrlesi, Konstantinos Gourgoulianis & Christos Hadjichristodoulou ( 2004-2005)

The study conducted a secondary analysis of data from the Global Youth Tobacco Survey in Greece (2004-
2005) to identify factors associated with current cigarette smoking among in-school adolescents. With a
sample of 6141 participants (51.5% males, 48.5% females), the study explored variables such as age,
gender, parental educational status, parental smoking, perception of smoking harmfulness, and pocket
money. The key findings revealed that male gender, parental smoking, and having pocket money of 16
Euros or more were independently associated with current smoking among Greek students. In multivariate
analysis, the odds of cigarette smoking were 1.62 times higher in males, 2.59 times higher for those with
smoking parents, and 2.64 times higher for those with pocket money of 16 Euros or more. These results
underscore the importance of considering gender, parental influence, and financial factors when devising
anti-smoking strategies for adolescents in Greece. The study's insights can inform the development of
targeted interventions to reduce smoking prevalence among this population, contributing to more effective
public health initiatives.

V. Gajalakshmi & C.V. Kanimozhi (2006,2009)

The study aimed to monitor the prevalence of smoking and smokeless tobacco use, as well as assess
attitudes, knowledge, and behaviors related to tobacco among students aged 13–15 years in Grades 8–10.
Two surveys were conducted in 2006 and 2009 using the Global Youth Tobacco Survey with a total of
12,086 and 11,768 students surveyed in India, respectively. The findings revealed that approximately 14%
of students used tobacco in both surveys, with smoking prevalence among boys being three times that of
girls. Smokeless tobacco use among girls was twice that of smoking in both surveys. In 2009, compared to
2006, there was a significant increase in boys initiating bidi smoking before age 10, a decrease in the
percentage of never-smokers likely to initiate smoking in the following year among girls, and a lower
percentage of students exposed to parental smoke. More students reported being taught about the dangers of
smoking during the school year, and ever-smokers receiving help or advice to quit smoking significantly
increased. However, there were no significant differences in the prevalence of tobacco use, exposure to
tobacco advertisements, free cigarette offers, or changes in tobacco use prevalence between 2006 and 2009.
The study emphasizes the need for strengthening policy enforcement and expanding program efforts to
address tobacco use among students in India.
F Cosci , V Zagà, G Bertoli , ( 2013)
The study aimed to identify factors associated with tobacco use among Italian adolescents. Analyzing data
from 2,444 students, the study found that 24.8% were current smokers. Significant predictors of youth
smoking included the presence of smokers in the family, seeing teachers who smoke, influence of friends,
and feelings of inferiority. Lack of awareness about the harmful effects of pipe/cigar smoking, ignorance
about the dangers of second-hand smoke on children's growth, and having family members who smoke were
identified as strong predictors. The study emphasizes the importance of addressing both significant adults
and adolescents in prevention programs, targeting knowledge and beliefs about smoking. The findings
highlight the need for comprehensive interventions to mitigate the influence of peers and significant adults
on Adolescents smoke

SR Forsyth, C Kennedy, RE Malone, (2013)

The literature review examines the impact of the Internet on teen and young adult tobacco use, focusing on
the potential association between online exposure to smoking imagery and the initiation of cigarette
smoking. Traditional media restrictions have led the tobacco industry to explore alternative ways, including
web-based activities, to attract new smokers. Children and adolescents are particularly susceptible to
advertising imagery, and the digital-native generation increasingly relies on the Internet for entertainment
and information. The study highlights the lack of regulation on the Internet, making it an unregulated
marketplace for tobacco-related content. The review emphasizes the ease of access to tobacco products for
adolescents online, pointing out the need for regulatory attention. Research on smoking imagery on the
World Wide Web is described as a relatively new phenomenon, coinciding with the widespread adoption of
online access. The findings suggest that clinicians in various settings should address the potential influence
of online tobacco imagery, given earlier research linking exposure to tobacco imagery in other media to teen
smoking. The review identifies current knowledge gaps and provides recommendations for healthcare
providers to address this emerging issue.

Anitha R. Sagarkar, Roshan M. Sagarkar, Kashinath C. Arabbi, and Shivakumar M.

Shivamallappa (2013)

The substantive review on tobacco uses among school-going adolescents in India, conducted by Anitha R.
Sagarkar et al., highlights a concerning increase in tobacco use among this demographic. The systematic
review focused on studies conducted in India and provided a global perspective. The studies, often relying
on questionnaires, showed limitations in methodological design, including poor control and imprecise
exposure measurements. Despite these limitations, the findings revealed a high risk of major health-related
illnesses and various cancers, especially oro-pharyngeal cancers associated with chewing tobacco. The
review emphasized the persistence of tobacco use from adolescence into adulthood, indicating a pressing
need for awareness and oral health education programs in Indian schools and colleges. The prevalence of
tobacco use among school children, as highlighted in the review, calls for urgent interventions and stricter
implementation of anti-tobacco policies in educational institutions.

Mulvihill, Cailin (2014)

It is generally acknowledged that smoking is a bad habit that carries a number of significant dangers. From
the standpoint of public health, teenage smoking is especially concerning because it has been linked to
increased rates of addiction in adulthood. The impact of social support networks—in particular, parents and
peers—on the onset and progression of teenage smoking will be investigated in this review of the literature.
Adolescents replicate the behavior of individuals in their social network, according to the social learning
hypothesis, which underpins the power of social support networks. According to the research, peers take
over as the primary source of influence in later adolescence through processes known as peer selection and
peer influence, although parents still have a greater influence in early adolescence. By maintaining a positive
parent-child relationship and engaging in effective communication, parents can have a positive impact on
their teenagers' smoking behavior. Via the same processes of peer influence and selection, peers can
likewise favourably affect smoking behavior. Understanding the ways in which parents and peers impact the
onset and progression of teenage smoking may prove useful in creating public health initiatives that
specifically address this high-risk behavior.

K Grapatsas, Z Tsilogianni, V Leivaditis (2017)

The study provides a comprehensive overview of smoking habits among children and adolescents,
emphasizing the high rates of tobacco use in this age group. It highlights risk factors for early smoking
initiation and discusses global variations in prevalence. The study also explores policies and interventions
for prevention and cessation, underlining the need for well-designed national programs and collaboration
among social stakeholders.

A. Mustonen, T. Ahokas, T. Nordström, G. K. Murray, P. Mäki, E. Jääskeläinen, A.

Heiskala, J. J. Mcgrath, J. G. Scott, J. Miettunen, S. Niemelä ( 2018)
The study examined the link between daily smoking and psychosis risk, considering baseline psychotic
experiences and other substance use. It involved 6081 individuals from the Northern Finland Birth Cohort
1986 over 15 years. The participants completed questionnaires at 15–16 years old, and psychosis diagnoses
were obtained until age 30. The results revealed that heavy smokers showed a heightened risk of psychosis.
Even after adjusting for multiple risk factors, the association persisted, and the number of smoked cigarettes
correlated with increased psychosis risk. In conclusion, heavy tobacco smoking during adolescence was
associated with a greater risk of psychosis, even after accounting for potential confounding variables.
Jenssen, B. P., & Boykan, R. (2019).
The research provides a detailed examination of the sudden increase in e-cigarette use among youth and its
public health implications, tracing the history, health effects, and regulatory challenges associated with these
products. It highlights the risks of nicotine addiction, the transition to traditional smoking and other drug
use, and exposure to second-hand aerosol from e-cigarettes. The study advocates for the application of
proven tobacco control policies, such as age restrictions, flavor bans, advertising limitations, and clean
indoor air laws, to e-cigarettes. It also critiques the efforts by tobacco companies to market these products as
safer alternatives. Utilizing a thorough literature review, the research calls for immediate regulatory
interventions to curb youth e-cigarette use and prevent potential long-term health crises

S Rukmi (2019)
The results show that smoking among Indonesian youth is influenced by many factors, which are
divided into socio-demographic, personal, behavioural and environmental factors. Sociodemographic factors
such as age, gender, family structure and parental characteristics significantly influence smoking
behaviour. Personal factors such as curiosity, self-efficacy and attitudes towards smoking also influence
youth tobacco use. Behavioural factors such as academic performance and physical activity continue
to influence smoking behaviour.
Ultimately, comprehensive tobacco control measures. In Indonesia. Many factors influencing youth tobacco
use must be addressed, including individual behaviour as well as social and environmental factors.
Effective strategies should include policy change, community engagement, and targeted interventions to
create sustainable impacts on public health and social well-being. By understanding the various factors that
influence youth smoking, policy makers and public health agencies can develop more tailored
and effective approaches to reduce tobacco use and related harms in Indonesia...

Kishun J, Kumar A, Singh U (2021)

The research investigated the correlates of cigarette smoking among school-going adolescents in India using
data from the Global Youth Tobacco Survey (GYTS) collected in 2009. The study aimed to identify factors
associated with current cigarette smoking in order to improve public health interventions. The methodology
involved bivariate analysis, logistic regression, receiver operating characteristic (ROC), and nomogram to
examine the association between exposure and outcome variables. The study included 11,768 adolescents,
with 9951 responding on cigarette smoking. The results revealed several significant associations, including
higher prevalence of cigarette smoking among male adolescents, and significant associations with smoking
at home, smoking in the presence of adolescents, accepting cigarettes from best friends, and perceptions
related to attractiveness and weight change. The study's findings provide valuable insights into the factors
influencing adolescent cigarette smoking, indicating the need for tailored public health interventions. The
data suggest that household and peer influences, as well as perceptions related to smoking, play a significant
role in adolescents' smoking behaviour. The study concludes by emphasizing the importance of
implementing evidence-based strategies to create a smoke-free environment and the need for collaboration
between public health experts, international agencies, and non-governmental organizations. It is essential to
note that the study's limitations include its reliance on GYTS 2009 data and indicate the need for further
research to address unmeasured confounders and effect measure modifiers in order to generalize the
findings.

Katherine East, Ann McNeill, James F. Thrasher, Sara C. Hitchman (2021)

This research examines the impact of various social norms on youth smoking, using a systematic review,
meta-analysis, and meta-regression to assess the influence of smoking behaviors among parents, close
friends, peers, and adults, as well as perceived approval of smoking. Key findings indicate that parental and
close friend smoking behaviors are strong predictors of youth smoking initiation, more so than norms from
broader social networks or perceived approval. The study suggests focusing interventions on family and
close networks could more effectively prevent youth smoking initiation. Despite its potential limitations, this
research offers significant insights for developing targeted tobacco control strategies.

Wiwin Haryati, Junaiti Sahar, Etty Rekawati, Besral (2021)

The understanding of the research on factors influencing smoking behaviours in adolescents effectively. It
outlines the study's objective, methodology, findings, and outcomes, presenting a comprehensive overview
of the research conducted. If more detailed information or a deeper analysis of certain aspects like the
specific roles of peers and parents, the impact of intentions and self-control on smoking initiation and
continuation, or the effectiveness of various smoking control strategies is needed, feel free to ask for further
elaboration.

Sreeramareddy, C.T., Acharya, K. & Manoharan, (2022)

The study analyzed the prevalence and factors associated with e-cigarette awareness and use among 13-15-
year-old students across 75 countries/territories, using data from the Global Youth Tobacco Surveys. Key
findings include high awareness of e-cigarettes in Europe, notably 95.8% in Poland, and the highest reported
ever use in Italy at 55.1%. Over 10% of youths in 30 countries reported current e-cigarette use, with Guam
at 35.1% being the highest. The study found that e-cigarette awareness and use were most prevalent in
European regions and High-Income Countries (HIC). Interestingly, youth from HIC and places with
restrictive e-cigarette regulations were more likely to be current users, while the most stringent regulations
were associated with lower usage rates. The research calls for ongoing global surveillance and suggests that
marketing restrictions and stringent policies could effectively reduce youth e-cigarette use.

Hamid Abasi and Zahra Pilevar (2022)

The study aimed to systematically review the factors influencing cigarette smoking in adolescents and
identified various influential factors at personal, familial, psychological, social, and environmental levels.
These factors encompassed personal demographics, family dynamics, psychological variables, sociocultural
influences, and educational and school-related variables. The study identified specific demographic features,
family-related variables, psychological variables, sociocultural influences, and educational and school-
related variables as influential factors in adolescent cigarette smoking. It also highlighted the importance of
addressing these influential factors to reduce smoking in adolescents, emphasizing the need for health
education and the promotion of positive social norms. In conclusion, the study provided comprehensive
insights into the multifaceted factors influencing adolescent cigarette smoking and recommended the design
and implementation of programs targeting different levels of influence to effectively prevent and reduce
smoking among this age group, while also acknowledging limitations in the aggregation and generalization
of results.

HJ Littlecott, GF Moore, RE Evans(2023)

The research shows how social influences and changing societal norms impact adolescent smoking,
highlighting the role of peer dynamics, stigma, and socioeconomic factors. Through a systematic review of
41 studies, it identifies key factors related to the socioecological influences on smoking behaviors among
youths. The findings emphasize the need for context-sensitive, tailored interventions in schools to address
health inequalities and adapt to the evolving landscape of tobacco use norms.

Jude Ball, Jane Zhang, James Stanley, Andrew Waa, Sue Crengle, Richard Edwards, (2024)
The study focused on identifying factors that could prevent smoking among Year 10 students in New
Zealand who live with at least one smoking caregiver. Analyzing data from the 2016 and 2018 Youth
Insights Survey, which included 2,205 students, the research found that 65% of students with a smoking
caregiver had never smoked. Factors associated with a higher likelihood of never smoking included
attending schools in low-deprivation areas, not being exposed to smoking inside homes or cars, having
parents who would be upset if they started smoking, and possessing high self-esteem. These modifiable
factors suggest pathways to reduce smoking uptake among New Zealand adolescents with smoking
caregivers, emphasizing the importance of a supportive and smoke-free environment and positive parental
attitudes towards non-smoking.
Sarah Bitar, Magali Collonnaz, Jennifer O’Loughlin, Yan Kestens, Laetitia Ricci, Hervé Martini,
Nelly Agrinier, Laetitia Minary, (2024)
The research aimed to summarize qualitative findings on factors associated with smoking cessation among
adolescents and young adults, aiming to provide insights not adequately addressed in quantitative reviews.
The study utilized an aggregative meta-synthesis approach, analyzing 39 articles retrieved from various
databases and targeting factors associated with smoking cessation or reduction in adolescents and young
adults. The findings identified 39 distinct factors categorized as environmental (i.e., tobacco control policies,
pro-smoking norms, influence of friends and family) and individual attributes (psychological characteristics,
pre-quitting smoking behavior, etc.), culminating in the development of a synthetic framework. The
outcomes emphasized that both environmental and individual factors significantly influence smoking
cessation among young individuals, stressing the importance of considering and addressing these factors
when designing cessation programs. Additionally, the study highlighted self-conscious emotions toward
cessation, such as embarrassment when using cessation services, which are often overlooked in quantitative
reviews. Overall, the research offers valuable insights, with important implications for the development of
effective smoking cessation interventions and policies for young individuals.

Chapter-3 Research Methodology

Research Objectives
1. To analyze the factor influencing tobacco among teenagers.
2. To examine the impact of family, peer on teenage smoking behavior.
3. To identify the psychological and emotional factors associated with teenage smoking.
4. To investigate use of alternative tobacco products among teenager such as, e-cigarette and
hookahs.
5. To assess the health risk associated with smoking among teenager.

Research Hypothesis
H0: There is a significant relation between gender and tendency to smoke.
H1: There is no significant relation between gender and tendency to smoke.
H0: There is a significant relation between age and tendency to smoke.
H1: There is no significant relation between age and tendency to smoke.
H0: There is a significant relation between the level of income and tendency to spend on cigarette.
H1: There is no significant relation between the level of income and tendency to spend on cigarette.

Research Design
Research Design It is basically a Descriptive Research. Descriptive research includes surveys and fact-
finding inquiries of different kinds. Purpose of descriptive research is a description of the state of affairs, as
it exists. It is more rigid than exploratory research and seeks to describe users of a product,

A Study on “Why does teen smoke? Analysis and factors affecting Tobacco consumption
among teenagers”

Case Processing Summary

N % Reliability Statistics
Valid 51
Cases 100.0
Excludeda 0 .0
Total 51 100.0 Cronbach's Alpha N of Items
a. Listwise deletion based on all variables in the .533 9
procedure.
 “Why do teen smoke? Analysis and factors affecting Tobacco consumption among
teenagers”

Basic Descriptive Analysis

Age

Frequency Percent Valid Percent Cumulative Percent

Valid 0-12 2 3.9 3.9 3.9
13-15 6 11.8 11.8 15.7
16-18 18 35.3 35.3 51.0
19-21 25 49.0 49.0 100.0
Total 51 100.0 100.0

The majority of participants in this study are between the ages of 16-21, with those in the 19-
21 age group comprising nearly half of the total (49%). The data indicates that the likelihood
of smoking increases with age among teenagers and young ad

Basic Descriptive Analysis

“Why do teen smoke? Analysis and factors affecting Tobacco consumption among
teenagers”
Chapter-4 Data Analysis
“Why do teen smoke? Analysis and factors affecting Tobacco consumption among
teenagers”

Age

Frequency Percent Valid Percent Cumulative Percent

Valid 0-12 2 3.9 3.9 3.9
13-15 6 11.8 11.8 15.7
16-18 18 35.3 35.3 51.0
19-21 25 49.0 49.0 100.0
Total 51 100.0 100.0

The majority of participants in this study are between the ages of 16-21, with those in the 19-21 age group
comprising nearly half of the total (49%). The data indicates that the likelihood of smoking increases with
age among teenagers and young adults.
 Gender

Frequency Percent Valid Percent Cumulative Percent

Valid Male 40 78.4 78.4 78.4
Female 10 19.6 19.6 98.0
Others 1 2.0 2.0 100.0
Total 51 100.0 100.0

Interpretation-
A significant gender disparity is observed, with males comprising 78.4% of the respondents. This suggests
that smoking is much more prevalent among male teenagers compared to females and others in this sample.

Q1
At what age did you first try cigarette smoking?
A large majority (80.4%) of the participants have never tried cigarette smoking, indicating a strong
inclination towards non-smoking behaviors among the teenagers surveyed. This could reflect effective anti-
smoking education or lack of access/inclination towards smoking.
Interpretation-

Cumulative
Frequency Percent Valid Percent Percent
Valid Never Tried 41 80.4 80.4 80.4
Under 13 years old 9 17.6 17.6 98.0
Between 13 to 15 years old 1 2.0 2.0 100.0
Total 51 100.0 100.0

Q2 If one of your best friend were to offer you a cigarette, would you smoke?
Cumulative
Frequency Percent Valid Percent Percent
Valid Strongly Disagree 29 56.9 56.9 56.9

Disagree 14 27.5 27.5 84.3

Neutral 4 7.8 7.8 92.2
Strongly Agree 4 7.8 7.8 100.0
Total 51 100.0 100.0
Interpretation-

A strong majority (84.4%) expressed disagreement (either disagree or strongly disagree) to smoking if
offered a cigarette by a best friend, suggesting a high resistance to peer pressure among the majority.

Q3
Do you feel smoking when you are stressed?
Cumulative
Frequency Percent Valid Percent Percent
Valid Strongly Disagree 34 66.7 66.7 66.7

Disagree 6 11.8 11.8 78.4

Neutral 7 13.7 13.7 92.2
Agree 2 3.9 3.9 96.1
Strongly Agree 2 3.9 3.9 100.0
Total 51 100.0 100.0

Interpretation-

The majority (66.7% strongly disagree and 11.8% disagree) do not turn to smoking when stressed, indicating
low reliance on tobacco as a stress relief tool among the surveyed group.
 What is your level of experience with different tobacco products?
Cumulative
Frequency Percent Valid Percent Percent
Valid Never Used 40 78.4 78.4 78.4
Limited Experience 5 9.8 9.8 88.2
Moderate Experience 2 3.9 3.9 92.2
Experienced 1 2.0 2.0 94.1
Very Experienced 3 5.9 5.9 100.0
Total 51 100.0 100.0

Q4

Interpretation-
The vast majority (78.4%) have never used tobacco products, which might indicate either effective anti-
tobacco use campaigns or personal disinterest/disapproval toward tobacco consumption.
Q5

How frequently you smoke in a day?

Cumulative
Frequency Percent Valid Percent Percent
Valid I do not smoke 46 90.2 90.2 90.2
Rarely (once a day or less) 2 3.9 3.9 94.1
Occasionally (2-5 times a 1 2.0 2.0 96.1
day)
Frequently (more than 10 2 3.9 3.9 100.0
times a day)
Total 51 100.0 100.0

Interpretation-

90.2% of the respondents claim they do not smoke at all, reinforcing the trend seen in previous answers that
the majority of the surveyed group does not engage in smoking
Q6

What is the approximate amount of money you spend on cigarettes per day?

Frequency Percent Valid Percent Cumulative Percent

Valid I do not Smoke 47 92.2 92.2 92.2
Less than Rs. 50 1 2.0 2.0 94.1
Rs.151 to Rs.250 3 5.9 5.9 100.0
Total 51 100.0 100.0

Interpretation-
Consistent with previous findings, 92.2% spend nothing on cigarettes, indicating either the respondents do
not smoke or it’s not a daily habit..

Q7-

On a scale of 1 to 5,please indicate your agreement with the following statement:

"Young people who smoke cigarettes have more friends"
Cumulative
Frequency Percent Valid Percent Percent
Valid Strongly Disagree 18 35.3 35.3 35.3

Disagree 9 17.6 17.6 52.9

Neutral 13 25.5 25.5 78.4
Agree 5 9.8 9.8 88.2
Strongly Agree 6 11.8 11.8 100.0
Total 51 100.0 100.0
Interpretation-

The response is mixed, with 35.3% strongly disagreeing and 25.5% remaining neutral, suggesting no clear
consensus on the social benefits of smoking among peers.

Q8

In the past, have you tried to quit smoking?

Cumulative
Frequency Percent Valid Percent Percent
Valid Never attempted to quit 25 49.0 49.0 49.0
Rarely attempted to quit 1 2.0 2.0 51.0
Neutral 15 29.4 29.4 80.4
Successfully quit Smoking 10 19.6 19.6 100.0
Total 51 100.0 100.0

Interpretation-

Nearly half of the smokers have never attempted to quit, while 19.6% have successfully quit. This shows a
varied range of commitment and success in quitting smoking among current or former smokers.
Q9

What is level of agreement with the statement: 'All tobacco products

are dangerous’?
Cumulative
Frequency Percent Valid Percent Percent
Valid Strongly Disagree 7 13.7 13.7 13.7
Disagree 1 2.0 2.0 15.7
Neutral 2 3.9 3.9 19.6
Agree 11 21.6 21.6 41.2
Strongly Agree 30 58.8 58.8 100.0
Total 51 100.0 100.0

Interpretation-

A substantial majority (80.4% agree or strongly agree) recognizes the dangers associated with tobacco
products, indicating high awareness of the health risks involved.
Q10

Rate your level of concern regarding the use of alternative tobacco products like
e-cigarettes and hookahs among teenagers?

Cumulative
Frequency Percent Valid Percent Percent
Valid Not concered at all 19 37.3 37.3 37.3
Sightly Agree 5 9.8 9.8 47.1
Moderately Concerned 7 13.7 13.7 60.8
Very Concerned 7 13.7 13.7 74.5
Extremely Concerned 13 25.5 25.5 100.0
Total 51 100.0 100.0

Interpretation-

A noticeable concern is evident, with 39.2% being very or extremely concerned about alternative tobacco
product use among teenagers, highlighting awareness and worry regarding emerging forms of tobacco use.
 Hypothesis testing

Hypothesis Analysis
If one of your best friend were to offer you a ciggarate would you smoke it?

Cumulative
H0≠There is a significant relation between gender
Frequency
and tendency
Percent
to smoke. Percent
Valid Percent
H1= ThereStrongly
Valid is no significant
Disagree relation between
34 gender66.7
and tendency to smoke.
66.7 66.7

Disagree 6 11.8 11.8 78.4

Neutral 7 13.7 13.7 92.2
Agree 2 3.9 3.9 96.1
Strongly Agree 2 3.9 3.9 100.0
Total 51 100.0 100.0

Statistics

If one of your best friends were

to offer you a ciggarate would How frequently you smoke in a
you smoke it? day?
N Valid 51 51
Missing 0 0
Mean 1.6667 1.2353
Median 1.0000 1.0000
Mode 1.00 1.00
Std. Deviation 1.10755 .83877
Variance 1.227 .704
Minimum 1.00 1.00
Maximum 5.00 5.00
 How frequently you smoke in a day?
Cumulative
Frequency Percent Valid Percent Percent
Valid I do not smoke 46 90.2 90.2 90.2
Rarely (once a day or less) 2 3.9 3.9 94.1
Occasionally (2-5 times a 1 2.0 2.0 96.1
day)
Frequently (more than 10 2 3.9 3.9 100.0
times a day)
Total 51 100.0 100.0

Descriptives
How frequently you smoke in a day?
95% Confidence Interval for
Std. Std. Mean
N Mean Deviation Error Lower Bound Upper Bound Minimum Maximum
Male 40 1.2000 .72324 .11435 .9687 1.4313 1.00 5.00
Female 10 1.0000 .00000 .00000 1.0000 1.0000 1.00 1.00

Others 1 5.0000 . . . . 5.00 5.00

Total 51 1.2353 .83877 .11745 .9994 1.4712 1.00 5.00

Tests of Homogeneity of Variances

Levene Statistic df1 df2 Sig.

Q5 Based on Mean 3.271 1 48 .077
Based on Median .753 1 48 .390
Based on Median and with .753 1 39.000 .391
adjusted df
Based on trimmed mean 1.218 1 48 .275
 ANOVA
Q5

Sum of Squares df Mean Square F Sig.

Between Groups 14.776 2 7.388 17.384 <.001

Within Groups 20.400 48 .425

Total 35.176 50

ANOVA Effect Sizesa

95% Confidence Interval

Point Estimate Lower Upper
Q5 Eta-squared .420 .191 .562
Epsilon-squared .396 .157 .544
Omega-squared Fixed-effect .391 .155 .539
Omega-squared Random-effect .243 .084 .369
a. Eta-squared and Epsilon-squared are estimated based on the fixed-effect model.

H0≠ There is a significant relation between age and tendency to smoke.

H1=There is no significant relation between age and tendency to smoke
 Descriptives
Q3
95% Confidence Interval for
Std. Mean
N Mean Deviation Std. Error Lower Bound Upper Bound Minimum Maximum
0-12 2 3.0000 2.82843 2.00000 -22.4124 28.4124 1.00 5.00
13-15 6 1.8333 .98319 .40139 .8015 2.8651 1.00 3.00
16-18 18 1.7222 1.01782 .23990 1.2161 2.2284 1.00 4.00
19-21 25 1.4800 1.04563 .20913 1.0484 1.9116 1.00 5.00
Total 51 1.6667 1.10755 .15509 1.3552 1.9782 1.00 5.00

Tests of Homogeneity of Variances

Levene Statistic df1 df2 Sig.

Q3 Based on Mean 2.760 3 47 .053
Based on Median 1.612 3 47 .199
Based on Median and with 1.612 3 43.174 .201
adjusted df
Based on trimmed mean 2.595 3 47 .0

NOVA
Q3

Sum of Squares df Mean Square F Sig.

Between Groups 4.649 3 1.550 1.285 .291

Within Groups 56.684 47 1.206

Total 61.333 50
 ANOVA Effect Sizesa,b

95% Confidence Interval

Point Estimate Lower Upper
Q3 Eta-squared .076 .000 .200
Epsilon-squared .017 -.064 .149
Omega-squared Fixed-effect .016 -.063 .147
Omega-squared Random-effect .006 -.020 .054
a. Eta-squared and Epsilon-squared are estimated based on the fixed-effect model.

b. Negative but less biased estimates are retained, not rounded to zero.

Multiple Comparisons
Dependent Variable: Q3
Tukey HSD
Mean Difference 95% Confidence Interval
(I) Age (J) Age (I-J) Std. Error Sig. Lower Bound Upper Bound
0-12 13-15 1.16667 .89668 .567 -1.2215 3.5549
16-18 1.27778 .81855 .410 -.9023 3.4579
19-21 1.52000 .80701 .249 -.6294 3.6694
13-15 0-12 -1.16667 .89668 .567 -3.5549 1.2215
16-18 .11111 .51770 .996 -1.2677 1.4899
19-21 .35333 .49925 .894 -.9764 1.6830
16-18 0-12 -1.27778 .81855 .410 -3.4579 .9023
13-15 -.11111 .51770 .996 -1.4899 1.2677
19-21 .24222 .33948 .891 -.6619 1.1464
19-21 0-12 -1.52000 .80701 .249 -3.6694 .6294
13-15 -.35333 .49925 .894 -1.6830 .9764
16-18 -.24222 .33948 .891 -1.1464 .6619
 Q3
a,b
Tukey HSD

Subset for alpha = 0.05

Age N 1
19-21 25 1.4800
16-18 18 1.7222
13-15 6 1.8333
0-12 2 3.0000
Sig. .127

H0≠There is a significant relation between the level of income and tendency to spend on
cigarette.
H1= There is no significant relation between the level of income and tendency to spend on
cigarette.

Descriptive Statistics

Mean Std. Deviation N

Q8 2.3922 1.56305 51

Q9 4.0980 1.40364 51

Correlations
Q8 Q9
Pearson Correlation Q8 1.000 .256
Q9 .256 1.000
Sig. (1-tailed) Q8 . .035
Q9 .035 .
N Q8 51 51
Q9 51 51
 Change Statistics

Adjusted R Std. Error of the R Square Sig. F

R R Square Square Estimate Change F Change df1 df2 Change
.256a .065 .046 1.52647 .065 3.425 1 49 .070

ANOVAa

Model Sum of Squares df Mean Square F Sig.

1 Regression 7.981 1 7.981 3.425 .070b
Residual 114.176 49 2.330
Total 122.157 50
a. Dependent Variable: Q8
b. Predictors: (Constant), Q9

Coefficientsa
Standardized
Unstandardized Coefficients Coefficients
Model B Std. Error Beta T Sig.
1 (Constant) 1.226 .666 1.842 .072
Q9 .285 .154 .256 1.851 .070
a. Dependent Variable: Q8
 Chapter 5: Findings

The entire study is on the topic why do teen smoke? Analysis and factors affecting
Tobacco consumption among teenagers”
Key Findings from the Analysis on Teen Smoking are as follows-

Age-The majority of study participants are aged 16-21, with the 19-21 age group making up nearly half
(49%) of the total respondents. This suggests an increased likelihood of smoking as teenagers grow older.

Gender-There is a significant gender disparity in smoking behaviors, with males representing 78.4% of the
respondents. This indicates a higher prevalence of smoking among male teenagers.

Initial Smoking Experience-A significant majority (80.4%) of the participants report never having
tried cigarette smoking, reflecting a strong inclination towards non-smoking behaviors.

Influence of Peers on Smoking-A vast majority (84.4%) would refuse a cigarette if offered by a best
friend, indicating strong resistance to peer pressure regarding smoking.

Smoking as Stress Response-Most respondents (78.5%) do not turn to smoking when stressed,
showing low reliance on tobacco for stress relief.

Experience with Tobacco Products-A large majority (78.4%) of teenagers have never used any
tobacco products, indicating effective anti-tobacco influences or personal disinterest.

Daily Smoking Frequency-A significant portion (90.2%) of the teenagers do not smoke at all,
supporting the trend of non-smoking behaviors.

Daily Spending on Cigarettes-The vast majority (92.2%) spend nothing on cigarettes daily,
suggesting that either they do not smoke or do not do so regularly.

Social Benefits of Smoking-Responses are mixed regarding the social benefits of smoking, with 35.3%
strongly disagreeing that smokers have more friends, and 25.5% remaining neutral.

Attempts to Quit Smoking-Among smokers, nearly half have never tried to quit, while 19.6% have
successfully quit, indicating varied commitment and success in quitting efforts.

Perception of Tobacco Danger-Most respondents (80.4%) recognize the dangers associated with
tobacco use, showing a high level of awareness of health risks.

Concern about Alternative Tobacco Products-There is noticeable concern (39.2%) about the use
of alternative tobacco products like e-cigarettes and hookahs among teenagers, highlighting awareness and
apprehension about these emerging forms of tobacco use.

These findings reveal general trends towards non-smoking behaviors among teenagers and a high awareness
of tobacco-related risks
 Conclusion
This comprehensive analysis was designed to explore the various factors that influence tobacco consumption
among teenagers and provided critical insights into these behavioral patterns. The findings from this study
show a significant correlation between age and gender and smoking habits, with older teenagers (ages 19-
21) and males exhibiting a higher propensity to smoke. This suggests that specific demographic groups may
require more focused intervention strategies.

Interestingly, the influence of peer pressure on initiating smoking was less pronounced than anticipated. This
finding diverges from the common perception that peer influences are a primary driver of teenage smoking
behaviors, suggesting instead that other factors—possibly including family dynamics or socio-economic
background—could be more influential, though this warrants deeper investigation in future studies.

The analysis also revealed that the majority of teenagers do not turn to smoking as a method of stress relief.
This observation indicates a lower psychological or emotional dependency on tobacco among the surveyed
group, which might be attributed to effective public health messaging and education on healthier coping
mechanisms for stress.

Furthermore, the study raised concerns regarding the popularity of alternative tobacco products, such as e-
cigarettes and hookahs, especially among the youth. This shift in tobacco product preferences underscores
the necessity for targeted educational campaigns and stringent regulatory measures to address the specific
appeal and perceived harmlessness of these products.

Another positive outcome from the study was the high level of awareness among teenagers about the health
risks associated with tobacco use. This reflects the success of ongoing public health communications and
suggests that continuing these efforts could further reinforce these perceptions.

However, despite the effectiveness of current anti-smoking strategies, the study indicates the need for
ongoing adaptations in public health approaches to keep pace with the evolving landscape of tobacco use.
This includes a particular focus on interventions that address the differences in smoking behaviors between
genders and the growing popularity of alternative tobacco products.

Overall, this research highlights the importance of sustained and dynamic public health initiatives aimed at
reducing the prevalence of smoking and mitigating its health impacts among teenagers. The insights
gathered call for a nuanced understanding of the factors that lead to tobacco use among youth and the
development of tailored strategies that effectively address these elements.
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Annexe: Questionnaire
1. Name
2. Age
a) Under 13
b) 13-15
c) 16-18
d) 19-21
3. Gender
a) Male
b) Female
c) Others
4. At what age did you first try cigarette smoking?"
a) Never Tried
b) Under 13 years old
c) Between 13 and 15 years old
d) Between 16 and 18 years old
e) Over 18 years old
5. If one of your best friends were to offer you a cigarette, would you smoke it?
a) Strongly disagree
b) Disagree
c) Neutral
d) Agree
e) Strongly Agree
6. Do you feel smoking when you are stressed?
a) Strongly disagree
b) Disagree
c) Neutral
d) Agree
e) Strongly Agree
7. What is your level of experience with different tobacco products?
a) Never Used
b) Limited Experience
 c) Moderate Experience
d) Experienced
e) Very Experienced

8. How frequently you smoke in a day?

a) I do not smoke
b) Rarely (once a day or less)
c) Occasionally (2-5 times a day)
d) Moderately (6-10 times a day)
e) Frequently (more than 10 times a day)

9. What is the approximate amount of money you spend on cigarettes per day?
a) I do not smoke
b) Less than 50
c) 51-150
d) 151- 250
e) More than 250

10. On a scale of 1 to 5, please indicate your agreement with the following statement:
"Young people who smoke cigarettes have more friends."
a) Strongly Disagree
b) Disagree
c) Neutral
d) Agree
e) Strongly Agree

11. In the past, have you tried to quit smoking?

Never attempted to quit
a) Rarely attempted to quit
b) Neutral
c) Attempted to quit once or twice
d) Successfully quit smoking

12. What is level of agreement with the statement: 'All tobacco products are dangerous.'"
a) Strongly Disagree
b) Disagree
 c) Neutral
d) Agree
e) Strongly Agree
13. Rate your level of concern regarding the use of alternative tobacco products like e-
cigarettes and hookahs among teenagers,
a) 1 - Not Concerned at All
b) 2 - Slightly Concerned
c) 3 - Moderately Concerned
d) 4 - Very Concerned
e) 5 - Extremely Concerned"

Plagiarism Report