KNOWLEDGE AND PRACTICE OF TOBACCO USE

AMONG MARRIED WOMEN’S OF KALIKA

MUNICIPALITY-6, CHITWAN

SUBMITTED BY

Sujata Sapkota

ELEVENTH SEMESTER, BATCH 2018

(BPH)

SUBMITTED TO:

ADVISOR LECT. Narayan Sapkota

DEPARTMENT OF PUBLIC HEALTH

OASIS MEDICAL AND TECHNICAL COLLEGE

PURBANCHAL UNIVERSITY

CHITWAN, NEPAL

DECLARATION

To the best of my knowledge and belief I declare that this

dissertation entitled “Knowledge and practice of tobacco use
among married women’s of kalika municipality-6, chitwan

1
” is the results of my own research and contains no material
previously published by any other person except where due
acknowledgement has been made. This dissertation report
contains no material, which has been accepted for the award of
any other degree or diploma in any university

___________________________

Sujata Sapkota

PU Registration no: 103-6-2-12739-2018

Date: ………………………

BACHELOR OF PUBLIC HEALTH,

ELEVENTH BATCH 2018

DEPARTMENT OF PUBLIC HEALTH

DECLARATION

To the best of my knowledge and belief I declare that this dissertation entitled “

Knowledge And Practice Of Tobacco Use Among Married Women’s of Kalika

Municipality-6 Chitwan” is the result of my own research and contains no material

previously published by any other person except where due acknowledgement has

been made. This proposal contains no material, which has been accepted for the

award of any other degree or diploma in any university.

___________________________

2
Sujata Sapkota

Date:

PU Registration No: 103-6-2-12739-2018

Exam Roll no: …………..

Date: ………………………

BACHELOR OF PUBLIC HEALTH

DEPARTMENT OF PUBLIC HEALTH

SUPERVISIOR CERTIFCATE

3
I Narayan Sapkota being the supervisor of Sujata Sapkota who is a BPH student

in the Department of Public Health, Oasis Medical College ,Chitwan, Nepal

certify that I have sighted the documentation supporting the dissertation report

entitled “ Knowledge And Practice Of Tobacco Use Among Married Women”s of

Kalika Municipality-6 Chitwan ” is the result of my own research and contains no

material and I am satisfied that the documentation is sufficient as the basis for

examination.

_________________________

Narayan Sapkota

Coordinator of Public Health department

Oasis Medical College

Date:………………….

Research Advisor

Date:……………….

Hem kumar Chaudhary

Principle of OASIS Medical Collage

APPROVAL SHEET

It is certify that Mr. Sujata Sapkota has prepared the dissertation proposal entitle

“Knowledge and Practice of Tobacco Use among Married Women’s of Kalika

4
Municipality-6 Chitwan” under my guidance and supervision. This proposal is

prepared for the partial fulfillment of the requirements for the degree of public health

(BPH). This proposal has been accepted and recommended for conducting research

Narayan Sapkota

Research supervisor

Signature …………...

Hem Kumar Chaudhary

Principal, Oasis Medical Collage

Bharatpur Chitwan

Signature………………….

Signature…………… Signature …………....

Internal Examiners External Examiners

1. ……………………………………… 1…………………………………
2. ……………………………………… ………………………………….
3. ……………………………………... 3…………………………………

ACKNOWLEDGEMENT

This proposal submitted to the faculty of public health department of

oasis Medical and Technical collage affiliated to purbanchal university
for the partial fulfillment of bachelors level in public health .

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 At first all of my sincere thanks belong to my Advisor Lect.
Narayan Sapkota for his continuous guidance and support during the
study .

I would also like to express sincere gratitude to BPH coordinator

Dipak Subedi for his support and cooperation .

I would also like to express sincere gratitude to Lect.Sunita Subedi

for her support and cooperation .

TABLE OF CONTENTS

DECLARATION 1

SUPERVISIOR CERTIFCATE 3

APPROVAL SHEET 4

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ACKNOWLEDGEMENT Error: Reference source not found

LIST OF ABBREVIATION 8

CHAPTER I 1

INTRODUCTION 1

1.1 Background of the study 1

1.2 Statement of the Problem 2

1.3 Rational of the study 3

1.4 Research Questions 4

1.5 Objectives of the Study 4

1.5.1General Objectives 4

1.5.2 Specific Objectives 4

1.6 Study Variables 4

General characteristics variables 5

1.6.1 Knowledge related variables 5

1.6.2 Practices related variables 5

1.7 Operational Definitions 6

CHAPTER II 7

LITERATURE REVIEW 82.1 Global Trend 8

2.2 In Nepal 8

CHAPTER III 10

METHODOLOGY 10

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 3.1 Study Design 10

3.2 Study Area 10

3.3 Study Population 10

3.4 Sampling Size 10

3.6 Research criteria 11

3.6.1 Inclusion criteria 11

3.6.1 Exclusion criteria 11

3.6 Data Collection Tools and Technique 11

3.7 Data Processing and Analysis 11

3.8 Validity and Reliability 12

3.9 Pretesting of the Tools 12

3.10 Ethical consideration 12

REFERENCES 13

ANNEX I Error: Reference source not found

INFORMED CONSENT 14

ANNEXES II 16

QUESTIONNAIRRES Error: Reference source not found

WORKPLAN 19

BUDGETING 21

LIST OF ABBREVIATION

COPD : Chronic Obstructive Pulmonary Disease

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NCD : Non-communicable Diseases

NSS : National Sample Survey

NDHS : Nepal Demographic Health Survey

WHO : World Health Organization

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 CHAPTER I

INTRODUCTION

1.1 Background of the study

Tobacco products are products made entirely or partly of leaf tobacco as raw material, which are
intended to be smoked, sucked, chewed or snuffed. All contain the highly addictive psychoactive
ingredient, nicotine [1].

Tobacco products can generally be divided into two types: smoked tobacco and smokeless
tobacco. Smoked tobacco products are Cigarettes, Cigars and Pipes, Hookahs, Bidis etc while
smokeless tobacco products are Chewing tobaccos, Dry snuff, Moist snuff, Gutkha,
Zarda,Toombak etc [2].

Tobacco use leads most commonly to diseases affecting the heart, liver and lungs. Smoking is a
major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD)
(including emphysema and bronchitis) and cancer (particularly lung cancer, pancreatic cancer,
cancer of larynx and mouth). It also causes peripheral vascular disease and hypertension [3].

Worldwide it is estimated that men smoke nearly five times as much as women but they are
projected to rise in many low and middle income countries [4].

Tobacco use is projected to kill 1 billion people during the 21 st century. While majority will
likely be killed by their use of cigarettes, tobacco use in other forms contribute to worldwide
morbidity and mortality [5].

Different varieties of tobacco products used in Nepal in both smoking and smokeless forms. The
smoking forms are Bidi, Hookah, Sulfa and Chillum or Kankad. The smokeless products include
Surti leaves, Khaini, Gutkha and Paan with tobacco ingredients. Among rural women tobacco
chewing is more social and acceptable than smoking [6].

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1.2 Statement of the Problem

Tobacco use is the six of eight leading preventable death globally [14]. As many as half of
people who use tobacco die from the results of this use. WHO estimates that each year 6 million
deaths are caused by tobacco where 10% of 6 million occurring in non-smokers due to second
hand smoke [15]. In the 20th century tobacco is estimated to have caused 100 million deaths [16].

Tobacco use leads most commonly to diseases affecting the heart, liver and lungs . Smoking is a
major risk factor heart attack, stroke, chronic obstructive pulmonary disease (COPD) and cancer
(particularly lung cancer, pancreatic cancer, cancer of larynx and mouth). It also causes vascular
disease and hypertension [3].

Tobacco use is a significant factor in miscarriages among pregnant women smokers and it
contributes to a number of health problems of the fetus such as premature birth, low birth weight
and increases by 1.4 to 3 times the chance of sudden infant death syndrome, erectile dysfunction
in male smokers [17].

Tobacco smoke contains 7000 chemicals in which more than fifty chemicals that cause cancer
[15]. Tobacco also contains nicotine which is highly addictive psychoactive drug, causes
physical and psychological dependency. Tobaccos sold in underdeveloped countries tend to have
higher for content, and are less likely to be filtered, potentially increasing vulnerability to
tobacco smoking related diseases in those regions [18].

The WHO states that “Much of the disease burden and premature mortality attribute to tobacco
use disproportionately affect the poor.” Of the 1.22 billion smokers, 1 billion of them live in
developing or transitional economies. In the developing world tobacco consumption is rising by
3.4% per year as of 2002 [3].

The WHO in 2004 projected 58.8 million deaths to occur globally, from which 5.4 million are
tobacco attributed and 4.9 million as of 2007. As of 2002, 70% of the deaths are in developing
countries. It is predicted that 1.5 to 1.9 billion people will be smokers in 2025 [19]

It is estimated that one third of the world’s adult population, of whom 250 million female are
smokers. Approximately 22% of women in developed countries and 9% of women in developing

2
countries smoke, but because women live in developing countries, there are numerically more
women tobacco user in developing countries [8].

In Nepal, Every year more than 15,700 of its people are killed by tobacco caused disease, while
more than 48, 18,000 adults continue to use tobacco each day. 10% of male and 9% of female
die in Nepal than on average in low income countries. Whereas 37.6% of male and 16.7% of
female adult smoke [20].

1.3 Rational of the study

There is a high epidemic of tobacco use in Nepal. Whereas using tobacco among women is also
higher in comparison to other countries, especially women of rural areas are more tobacco users.
But there are not enough research studies are conducted to assess the knowledge and practice of
tobacco use women, especially in rural areas. These gaps need to be filled in order to find out the
actual facts related to tobacco use and factors associated with it.

Annually around 15000 deaths are attributed to tobacco use in Nepal [7]. Despite having social
acceptability of tobacco in Nepalese society, little has been known about tobacco use in rural
women.

It is estimated that one third of the world’s adult population, of whom 250 million female are
smokers. Approximately 22% of women in developed countries and 9% of women in developing
countries smoke, but because women live in developing countries, there are numerically more
women tobacco user in developing countries [8].

Tobacco use by women results in adverse effects on the individual, family as well as maternal
and child health (fetal health) [9]. Chronic non-communicable diseases represent 42% of all the
deaths in Nepal [10]. This high rate may be attributed to current high tobacco use among men
and women [11].

Overall smoking and tobacco use is 56.5% in men and 19.5% in women which is higher in
comparison to other countries . According to study on tobacco economics of Nepal, the

3
prevalence of tobacco use is higher in rural areas (45.8%) than in urban areas (34.4%). In Nepal
71.7% of women smoked in high hills while only 14.2% of women did so in Kathmandu, the
urban area [31

1.4 Research Questions

What is the knowledge regarding tobacco use among the married women’s of Kalika
municipality, chitwan?

What is the practice of tobacco use among the married women’s of Kalika municipality,
chitwan?

1.5 Objectives of the Study

1.5.1General Objectives

To assess the knowledge and practice use among the married women’s
1.5.2 Specific Objectives

 To assess the knowledge of tobacco use and its health effects among married women’s
 To assess the practice of tobacco use among married women’s
 To identify the sources of knowledge of health hazard of tobacco use among married
women’s

1.6 Study Variables

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General characteristics variables

 Age
 Ethnicity,
 Religions , Education, Occupation

1.6.1 Knowledge related variables

Smoke and smokeless use of tobacco, Passive smoking tobacco, Health hazard of using tobacco,
Effective way to quit using tobacco

1.6. 2 Practices related variables

 Age group of smoking

 Frequency of smoking
 Reasons for starting smoking
 Smoking habits of family members.

5
 conceptual framework

Age

Sex

Cast Knowledge and practice of tobacco

use among married women
Religions

Economic Status

Education

Ethnicity

1.7 Operational Definitions

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 Tobacco: Nicotine rich leaves prepared by process of drying and fermentation for smoking
and chewing
 Smoking: Defined as the taking tobacco from smoking.
 Passive smoking: In my study it defines as the inhalation of tobacco (as form of another
cigarette) especially by non-smoker or breathing of cigarette smoke from people who are
smoking nearby.
 Good knowledge: Rural community women’s who could report at least three health hazard
illness of using tobacco among shortness of breath or asthma, heart problem, lung and other
cancer, chronic bronchitis or COPD.
 Some Knowledge: Women who could report at least two hazard/illness of tobacco use.
 Poor Knowledge: women who could report only one hazard of tobacco use.
 No Knowledge: Women who could not report any hazard/illness of tobacco use.
 Regular users: Those who use tobacco Everyday
 Occasional users: Use tobacco at least once a week but not every day.
 Ex-users: Those who were former daily tobacco users but currently do not use it at all.
 Never users: those who never used tobacco.
 Ever users: Includes all tobacco users (regular, occasional and ex users)

CHAPTER II

7
 LITERATURE REVIEW

2.1 Global Trend

Worldwide approximately 1.3 billion people smoke cigarettes or other tobacco related products,
almost 1 million men and 250 million women [21]. The WHO estimates that approximately 6
million people die each year worldwide from tobacco related illnesses. If current trend continues,
this figure will rise to about 10 million per year by 2030 [22].

It is estimated that men smoke nearly five times as much as women worldwide, with prevalence
varying across the countries [23]. However in the beginning of the 21 st century, prevalence of
smoking among women was 22.8%, signifying gradual increase of female smokers [24].

80% of tobacco related death occurs in low and middle income countries. Each year 600,000
non-smokers worldwide die from exposure to environmental tobacco smoke [25].

Tobacco use causes one in six non-communicable diseases [26]. Smoking is estimated to cause
about 71% of all lung cancer deaths, 42% of chronic respiratory diseases and nearly 10% of
cardiovascular disease [27].

Tobacco use costs the world hundreds of billions of dollars each year. Tobacco related diseases
results in high health care costs, which are borne by individual, families and government.

2.2 In Nepal

The survey revealed that prevalence of smoking and tobacco use in Nepal is 56.5% in men and
19.5% in women. Found to be higher tobacco use among the poor and illiterate section of the
population [12].

A study done in different ecological regions of Nepal indicated that prevalence of tobacco use in
adults was 68.4% in rural Kathmandu, 37% in urban Kathmandu, 54.7% in Terai region and
77.7% in mountain region.

It was interesting to note that in the mountain region, the female smoking rate was 71.6%, which
was one of the highest reported in the world [29].

8
The overall smoking prevalence in Nepal ranges from 25% to 73% in adult men and from 0.8%
to 60% in adult women across the different regions in the country. Prevalence of smoking in
Sunsari is 17% [30].

The overall prevalence for ‘any tobacco use’, ‘tobacco smoking’ and tobacco chewing were
30.3%, 20.7%, 14.6% respectively. Prevalence of men was significantly higher than women for
any tobacco use (56.5% versus 19.6%) [31]

Every year more than 15,700 people in Nepal are killed by tobacco caused diseases. Where
10.7% of men and 9% of women deaths are caused by tobacco [32].

The WHO surveillance in 2007 revealed that 15% of women smoked tobacco products and 4.6%
used smokeless tobacco in Nepal. The prevalence of smoking among adult females in Nepal is
one of the highest in the WHO South-East Asia region [33].

In study conducted on rural South-Eastern population of Nepal, pregnant women who smoke
were more likely to report symptoms of vaginal bleeding, edema, severe headache and
convulsions during pregnancy and the cases of infant mortality up to 6 months was
approximately 30% higher among smokers compared to non-smokers [34].

A National Sample Survey carried in 2000 in 10 out of 75 districts reported prevalence of ‘ever
smoker’ among females as 31.6% [35]. NDHS 2006 estimated prevalence of tobacco use among
women 20% whereas NDHS 2012 estimated 13% prevalence of female smokers [36]. The World
Bank report revealed 29% of prevalence of smoking among females in Nepal during 2009 [37]

A cross-sectional study in Dailekh district among women’s of rural area showed that more than
two in five were tobacco users and among them 4 in 5 used smoked form of tobacco [39].

Nepal has very high prevalence rate of chronic obstructive lung disease (COLD) varying from
20-40% in persons above the age of twenty years. This was found to be significantly associated
with tobacco smoking [7]. Tobacco smoking has also been found to be associated with coronary
artery disease in a hospital based study in Nepal [40].

9
 CHAPTER III

METHODOLOGY

3.1 Study Design

The study design will be descriptive cross-sectional

3.2 Study Area

The study was conducted at Kalika Municipality ward no. 6, Chitwan district

3.3 Study Population

The study population will be married women of Kalka Municipality ward no.6, Chitwan district.

3.4 Sampling Size

Sample will be calculated by using formula

N= Z²pq/e²

Where,

Z = 1.96 at 95% confidence interval,

Prevalence of risk factor (p)= 50% = 0.5

q = 1-p = 0.29

Allowable error (e) = 5% = 0.05

Sample size (n) = (1.96)2 (0.5) (0. 29)/ (0.05)2

=384

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3.5 Sampling Technique

Respondents will be selected by convening sampling method.

3.6 Research criteria

The females of Kalika municipality ward no.6 will be included in the study. The respondents age
will be married women which present on the day of data collection were included in the study.

3.6.1 Inclusion criteria

The females of Kalika municipality ward no.6 will be included in the study. The respondents will be
married women which present on the day of data collection were included in the study.

3.6.2 Exclusion criteria

The females of kalika municipality ward no. 6 who are not married are excluded in the study.

3.7 Data Collection Tools and Technique

Tools: Questionnaires were prepared to collect data. Instrument consists of three parts.

Part I: Socio-demographic data

Part II: Questions related to knowledge of tobacco use

Part III: Questions related to practice of tobacco use

Technique: Interview Schedule

3.8 Data Processing and Analysis

The collected data will be checked, reviewed and organized for their accuracy and completeness.
Editing, coding and categorization of the collected data will be done.

11
The information collected from field survey will be entered into the computer by using computer
software packages like SPSS (Statistic Package for Social Science) version 20 for its analysis
which would be transported to Microsoft Word for its interpretation.

The data will be analyzed and interpreted in terms of descriptive (frequency, percentage, etc.)
The finding of the study will be presented in various tables.

3.9 Validity and Reliability

To maintain validity, extensive literature review will be done and instrument will be prepared
consulting with research guide.

The reliability of the instrument will be maintained by pre-testing the instrument in 10% of total
sample at Kalika Municipality; Chitwan and instrument will revised and finalized on the basis of
feedback from the research guide.

3.10 Pretesting of the Tools

Pre-testing will be conducted prior to the research in a sample population with similar
characteristics. Pre-testing of schedule should be done in 10% population of total respondents in
same types of other community. Necessary modifications to the faults and errors in the tool will
be made after pretesting.

3.11 Ethical consideration

 Informed verbal consent will be taken from each participant before data collection.
 The respondents were explained clearly about purpose and objectives of the study.
 Privacy and confidentiality of each respondent will be maintained.

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 REFERENCES

1. World Health Organization; www.who.int/topics/tobacco/en/s

2. International Agency for Research on Cancer. Monograph; Lycon: 2007.
3. A Rivenson, D Hoffmann, B Prokopczyk, S Amin… - Cancer research, 1988 - AACR
4. H Vainio - Scandinavian journal of work, environment & health, 1987 - JSTOR
5. CW Warren, NR Jones, S Asma - 2008 - stacks.cdc.gov
6. Tobacco Free Initiative. Tobacco; Deadly in any form or disguise. WHO; Geneva 2006
7. S Dahal, RK Subedi, S Maharjan… - Nepal Journal of Medical …, 2014 - nepjol.info http://
www.biomedcentral.com/content/supplementary/1471- 2458-6-169-s1 … MoHP: Nepal
8. RB Khatri, SR Mishra, V Khanal - Indian journal of cancer, 2015 - indianjcancer.com
9. Gupta PC. The Public Health Impact of Tobacco. Curr Sci 2001;
10. Kallen K. The Impact of Maternal Smoking During Pregnancy on Delivery Outcome. Eur J
Public Health 2001
11. A Vaidya, S Shakya, A Krettek - International journal of environmental …, 2010 - mdpi.com
12. Ventura SJ, Hamilton BE, Mathews TJ, Chandra A. Trends and Variations in smoking during
pregnancy and low birth weight: Evidence from the birth certificate, 1990-2000
13. NDHS (2006) https://dhsprogram.com/pubs/pdf/FR191/FR191
14. Pandey S, Lin Y. Tobacco use among married women in Nepal: The role of women’s
empowerment. Maternal Child Health J 2013.
15. , Research for International Tobacco Control - 2008 - books.google.com
16. NB Johnson, LD Hayes, K Brown, EC Hoo, KA Ethier - 2014 - stacks.cdc.gov
17. US Department of Health and Human Services - 2014 - aahb.wildapricot.org
18. US Department of Health and Human Services - 2006 - gaspforair.org
19. Nichter M, Cartwright E, (1991). “Saving the children for tobacco industry”: Medical
Anthrology Quarterly
20. Doll R, Hill AB (Sep 1950). “Smoking and Carcinoma of the lung, preliminary report’.
British Medical Journal
21. J Mackay, M Eriksen, MP Eriksen - 2002 - books.google.com
22. O Shafey, S Dolwick, GE Guindon - Atlanta: American Cancer Society, 2003
23. World Health Organization - 2005 - cloudfront.escholarship.org
24. GE Guindon, D Boisclair - 2003 - escholarship.org
25. RM John, HY Sung, W Max - Tobacco control, 2009 - tobaccocontrol.bmj.com
26. B Aminian, V Renaudin, D Borio, G Lachapelle - Proceedings of ION GNSS10, 2010
27. CF Mountain - Chest, 1997 - Elsevier
28. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Priority Actions for the
NCD crisis. Lancet.2011

29. H Cena, ML Fonte, G Turconi - Nutrition reviews, 2011 - academic.oup.com

30. J Mackay, M Eriksen, O Shafey - Atlanta, GA: American Cancer Society, 2006
31. CT Sreeramareddy, PV Kishore… - BMC Public …, 2008 -
bmcpublichealth.biomedcentral.com
32. CT Sreeramareddy… - Substance …, 2011 - substanceabusepolicy …

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33. Chandrasekhar T Sreeram Reddy, N Ramakrishnar Reddy, HN Harsha Kumar, Brijesh
Sathian and John T Arokiasamy- Prevalence, distribution and Correlates of Tobacco
Smoking and Chewing in Nepal: A Secondary Data Analysis of NDHS-2006
34. M Hussain, RN Malik, A Taylor, M Puettmann - … Technology & Innovation, 2017 –
Elsevier
35. V Khanal, M Adhikari, R Karkee… - … health, 2014 - bmcwomenshealth.biomedcentral …
36. CJ DeFrances, MJ Hall, MN Podgornik - Adv Data, 2006 – Citeseer
37. V Khanal, M Adhikari, K Sauer… - International …, 2013 -
38. K Schwab, X Sala-i-Martin - 2010 - contexto.org
39. YB Karki, KD Pant, BR Pande - 2003 - openknowledge.worldbank.org
40. MR Pandey, RP Neupane, A Gautam… - Mountain Research and …, 1990 – JSTOR
cabdirect.org
41. MR Pandey, M Ghimire - Journal of the Nepal Medical Association, 1975 -

INFORMED CONSENT

Namaste,

I am Sujata Sapkota student of Bachelor of Public Health 11 th semester 4th year of Oasis Medical
& Technical College, Bharatpur Chitwan. I am here to get some information from you which you

14
are directly related to this questionnaire is requested to be filled up by you which will be useful
for me. The objective of this study is to assess the knowledge and practice of tobacco use among
married women’s of Kalika Municipality population. These questionnaires are set to fulfill the
research objective. All the information you provide will be confidential and will not be misused.
Participation in the survey is completely voluntary. I hope you will participate in the study and
make it succeed by providing correct answer of all the questions.

Agree to participant: Yes ( ) No ( )

………………………..

Signature of participants

Date of data collection:

Code number:

Data collector name:

15
 QUESTIONNAIRRES

Demographic information:

Age:

Caste/Ethnicity:

Religion:

Family type:

Marital status:

Educational status:

Occupation:

Knowledge related questions

1. Do you have knowledge about tobacco ?

a) Yes
b) No

2. What health effects does the tobacco use ?

a) Heart problem
b) Respiratory problem
c) Cancer
d) Headach

3. From what source do you know about health hazards of tobacco use?
a) School/Teachers
b) Family
c) Friends
d) Media
e) Health workers

16
4. Have you ever heard the health effects of tobacco use during pregnancy?
a) Yes
b) No

5. Do you know the hazards of tobacco use during pregnancy, if yes mention one?

a) Respiratory problem
b) Heart problem
c) Cancer
d) Premature birth
e) Sudden infant death syndrome
f) Don’t know

6. What do you think is hard to quiet tobacco or not

a) Yes
b) No

7. Why do you think it is difficult to quit tobacco use once it is started?

a) Addiction
b) Weakness
c) Don’t know

8. What do you think is the best way to quit tobacco smoking?

a) Willpower
b) Keeping your mind busy in other works
c) Avoiding the company of tobacco users
d) Don’t know
e) Family/friends motivation

17
Practice related questions

1. Have you ever used tobacco product?

a) Yes
b) No

2. Which type of tobacco product do you use?

a) Cigarette/Bidi
b) Surti/Khaini
c) Others

3. What was your age when you used tobacco first time?

a) 15-25
b) 25-35
c) 35-45
d) Above 45

4. Why do you use tobacco products?

a) Just for fun

b) Peer pressure
c) Addiction
d) Don’t know

5. How many times do you use tobacco product in a day?

a) Once a day
b) Twice a day
c) Three times a day
d) More than 3 times

6. Did you use tobacco during pregnancy?

18
a) Yes
b) No

7. Does any other member use tobacco product in your family?

a) Yes
b) No

8. Does any of your best friend use tobacco?

a) Yes
b) No

9. Have you ever tried to quit using tobacco?

a) Yes
b) No

10. What helped you to quit tobacco use? ( only for those who answered used to in Q.no.1)

a) Family
b) Friends
c) School/teachers
d) Self
e) Health worker

11. Is there any tobacco use related health problem occurred to you?

a) Yes
b) No

12. What health problem occurred to you due to tobacco use?

a) Respiratory problem
b) Heart problem
c) Cancer
d) Headache/ Anxiety

19
 WORKPLAN

S.N Activities January February March April May June

1 Literature review

2 Topic selection, presentation

and finalization

3 Proposal preparation,
presentation and submission

4 Developing tools for the study

5 Pretesting and tool finalization

6 Data collection

7 Analysis and interpretation of

data

8 completion of report

9 Report presentation

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10 Report submission

BUDGETING

S.N. Description Amount (Rs)

1 Stationery (pen, pencil, eraser, questionnaire) & anthropometric 3000

instruments cost

2. Pretesting cost 2000

3 Travel cost 2500

4 Enumerator cost 5000

5 Report print and binding cost 3000

Total 15,500.

21