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CHAPTER ONE
INTRODUCTION
1.1 Background of the study
Smoking is a practice in which a substances such as, tobacco, marijuana or cannabis is
burned and the smoke tasted or inhaled Akintaro (2015). It is primarily practiced as a route of
administration for recreation of drug use, as combustion release the active substances in drugs such
as nicotine and makes them available for absorption through the lungs. It can be done as a part of
rituals to induce trances and spiritual enlightenment, (Lock, Reyndds and Tansey, 1998). Smoking
is one of the most common forms of recreational drug use. In recent times, tobacco smoking is by
far the most popular form of smoking ahead of pipes, cigars and chewing tobacco and is practiced
by over one billion people in the majority of all human societies resulting in nearly 2 billion people,
that is a third of the world’s population being exposed to pulmonary tuberculosis pathogen (Philips
2010; World Health Organization, 2002).
Smoking is one of the most common addictions of modern times. It has been implicated as
an etiological agent for various chronic diseases, including a variety of infection, cancer, heart
disease, and respiratory illness such as chronic obstacle pulmonary disease, that have impairment
in the balance between cells growth and cells death, which, put together, are leading the cause of
morbidity and mortality in today society (Zhonget al, 2008; Mehta et al, 2008). Unless smoking
cigarette patterns are reserve, the world health organization estimated that by 2020-2030, cigarette
smoking will be responsible for 10million death per year, with 70percent of them occurring in the
developing counties like Nigeria, Ghana, Cameroon, Egypt, Senegal and many other countries in
Asia, Latin America (WHO 2001; Suriyaproum et al.; 2007).
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Smoking has been shown to be a leading cause of premature mortality and morbidity
resulting in several millions of deaths globally. It has been predicted that if the pattern currently
seen among youth continues, a lifetime of tobacco use would result in the deaths of 250 million
children and young people alive today, most of them in developing countries (WHO, 2012).
National Population Commission (2009) submitted that Nigeria is one of the most populous
countries in Africa, with an estimated population of 162 million people of which youth are
estimated to be more than 30%. In Nigeria, the prevalence of tobacco use among adults(12.3%
males < 1% in females) is generally lower than in more developed countries, however, prevalence
among youth tends to be higher than among adults, a mean lifetime smoking prevalence of 26.4%
was reported among secondary school students with values ranging from 7.2% to 42.9%
(Odukoya, Odeyemi, Oyeyemi and Updhyay, 2013).
Cigarette smoking has been associated with an extensive list of health disorders as well as
reduction of life expectancy (Detels 2002; Doll et al 2004). On the average, cigarette smokers lose
about 15 years of their life (WHO 2008) and an estimated 4 million. Smoking is associated with
several failures such as negative externalities and imperfect information of the smoker. The health
consequences of smoking result in huge health care expenses partly paid from public funds. In
addition, the cost of medical treatment for smokers inflates health insurance premiums for
everyone regardless of smoking participation. Lower labor market productivity is another result of
engagement in tobacco consumption. These market failures can justify government interventions
in the market for tobacco products. Youth is of particular interest for public policy makers and
economists because it is the most effective group to target for smoking prevention programs and
because there are some additional externalities associated with youth smoking. Almost all first use
of cigarettes occurs during the high school years. At that age, consumers are either not well
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informed or they do not consciously process information on the health hazards of smoking. At the
time, the young people are making a decision about smoking, they may not be fully aware of the
health consequences of smoking. Youth typically underestimates the risk of addiction to cigarettes
and mistakenly assumes that they can quit easily in a few years. In recent times, tobacco smoking
is by far the most popular form of smoking ahead of pipes, cigars and chewing tobacco and is
practiced by over one billion people in the majority of all human societies resulting in nearly 2
billion people, that is a third of the world’s population being exposed to pulmonary tuberculosis
pathogen (Philips, 2010; World Health Organization, 2002).
Smoking has been shown to be a leading cause of premature mortality and morbidity
resulting in several millions of deaths globally. It has been predicted that if the pattern currently
seen among youth continues, a lifetime of tobacco use would result in the deaths of 250 million
children and young people alive today, most of them in developing countries (WHO, 2012).
National Population Commission (2009) submitted that Nigeria is one of the most populous
countries in Africa, with an estimated population of 162 million people of which youth are
estimated to be more than 30%. In Nigeria, the prevalence of tobacco use among adults (12.3%
males<1% in female). American cancer society (2005) stated that tobacco smoking among the
youth is a public health concern because of the immediate and long-term health risks associated
with tobacco use such as asthma, chronic cough, chronic obstructive airways disease, cancers and
cardiovascular diseases. Adolescent tobacco use has also been linked to other risky health-related
behaviours, mental health problems, suicide, motor vehicle accidents, violent crime and even
dental problems (US Department of Health and Human Services, 2004). Furthermore, research on
the sequence of drug use suggests that cigarette smoking may serve as a gateway to illicit drugs
(Mackay and Eriksen, 2002). Tobacco use in any form is dangerous and addictive and every effort
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should be made to discourage its use. According to Greaves (2002); Philips (2010), substances that
are smoked include: Marijuana (cannabis), Tobacco, Clarified butter (ghee), Fish offal, Dried
snake skin, Pastes molded around incence sticks, Ayurveda (for medical purposes), Dhumrapana
(drinking smoke). Similarly, USDHHS (2010) hinted that smoked tobacco products which may be
cigarettes, pipes, cigars or hand-rolled tobacco are particularly harmful because the burning
process releases a dangerous cocktail of about 7,000 chemicals of which about 70 are known
carcinogens
1.2 STATEMENT OF THE PROBLEM
Studies have shown that the smoker does not only harm him or herself but also puts the life
of others at risk (Greaves 2002, Philips, 2010). Research has firmly established that an
environment devoid of smoke is the only effective way to protect the population from the
detrimental effects of secondhand smoke exposure. (WHO 2007, 2.) The burning and smoking of
tobacco produces a complex mixture of chemicals which are harmful to the health of people who
inhale the smoke. Children are at great risk from adults smoking and smoking around a pregnant
woman poses a health risk to a foetus. (Mackay & Eriskon 2002, 36.)
Tobacco has also been found to cause many chronic disease, acute respiratory diseases
such as pneumonia and influenza, and a number of persistent respiratory symptoms such as
wheezing and cough (Colditz & Hunter 2000, 3.) Research suggests that the risk of death from
lung cancer may rise with amount of cigarettes smoked and duration of smoking. (Report on
carcinogens 2011, 408). Many are of the belief that young people are picking up the habit of
smoking due to ignorance about risks associated with smoking and also that it is part of adolescent
rebelliousness. (Dawn 2006, 71-72.)
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It is against this background that the study really wants to find out the extent to which the
various implications of cigarette smoking among youths, as highlighted in the literature are real in
the lives of the youths in Ankpa. The study is also concerned about the immediate and remote
causes of cigarette smoking among the youths in Ankpa LGA.
1.3 Research Questions
For the successful completion of the study, the following research questions were formulated by
the researcher:
i) What are the factors that influence Ankpa youths in cigarette smoking?
ii) What are the causes and consequences of cigarette smoking among youths in Ankpa
LGA?
iii) What is the effect of cigarette smoking among youths in Ankpa LGA?
iv) What other alternatives can be used to curb the menace of cigarette smoking among
youths in Ankpa LGA?
1.4 Objective of the Study
The main objective of the study is to investigate the causes and consequence of cigarette smoking
among youths in Ankpa L.G.A. But for the purposed of the study the researcher set the following
objective:
i) To determine the factors that influence Ankpa youths on cigarette smoking.
ii) To ascertain the relationship between tobacco smoking and health implication.
iii) To examine the effect of Cigarette smoking among youths in Ankpa L.G.A.
iv) To develop other alternatives that can be used to curb the menace of cigarette
smoking among youths in Ankpa L.G.A.
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1.5 Research Hypothesis
For the successful completion of the study, the following research hypotheses were formulated by
the researcher
H
0
: there is no significant relationship between smoking and crime
H
1
: there is a significant relationship between smoking and crime
H
0
2
: smoking does not have any negative impact on the mental well-being of the youth
H
2
: smoking does have a negative impact on the mental well-being of the youth
1.6 Significance of the Study
It is perceived that at the completion of the study, the findings will be of importance to the
federal ministry of health as the findings will encourage them on embarking on more awareness
programs on the dangers of smoking. The study will also be of importance to religious bodies who
will also benefit on the findings of the study to educate their congregation or followers on the
dangers of smoking. The study will also be of great importance to researchers who intend to
embark on study on a similar topic. Finally the study will be of great importance to the general
public especially the youths who engage in smoking and drug addicition.
1.7 Scope and limitation of the Study
The scope of the study covers the dangers of tobacco smoking among Ankpa LGA youths in Kogi
State. However the study has some limitation to its scope below were some of the limitation to the
scope of the study:
a) Availability of Research Material: The research material available to the researcher is
insufficient, thereby limiting the study
b) Time: The time frame allocated to the study does not enhance wider coverage as the
researcher have to combine other academic activities and examinations with the study.
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c) Organizational privacy: Limited Access to the selected auditing firm makes it difficult
to get all the necessary and required information concerning the activities
1.7 Definition of Terms
Tobacco
Tobacco is a product prepared from the leaves of the tobacco plant by curing them. The plant is
part of the genus Nicotiana and of the Solanaceae (nightshade) family. While more than 70
species of tobacco are known, the chief commercial crop is N. tabacum. The more potent
variant N. rustica is also used around the world.
Nicotine
Nicotine is a potent parasympathomimetic stimulant and an alkaloid found in
the nightshade family of plants. Nicotine acts as a receptor agonist at most nicotinic acetylcholine
receptors (nAChRs), except at two nicotinic receptor subunits (nAChRα9 and nAChRα10) where
it acts as an receptor antagonist. Nicotine is found in the leaves of Nicotiana rustica in amounts of
214%, the tobacco plant Nicotiana tabacum, Duboisia hopwoodii and Asclepias syriaca
Smoking
Smoking is a practice in which a substance is burned and the resulting smoke breathed in to be
tasted and absorbed into the bloodstream. Most commonly the substance is the dried leaves of
the tobacco plant which have been rolled into a small square of rice paper to create a small, round
cylinder called a "cigarette". Smoking is primarily practiced as a route of
administration for recreational drug use because the combustion of the dried plant leaves
vaporizes and delivers active substances into the lungs where they are rapidly absorbed into the
bloodstream and reach bodily tissue. In the case of cigarette smoking these substances are
contained in a mixture of aerosol particles and gasses and include the pharmacologically active
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alkaloid nicotine; the vaporization creates heated aerosol and gas to form that allows inhalation
and deep penetration into the lungs where absorption into the bloodstream of the active substances
occurs.
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CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1 Introduction
Cigarette smoking is the inhalation of smoke from burned dried leaves of the tobacco plant.
People may smoke casually for pleasure, habitually to satisfy an addiction to the nicotine present
in tobacco and to the act of smoking, or in response to social pressure. Tobacco smoke contains
nicotine and harmane, which when combined gives rise to the addictive stimulant and euphoriant
properties. The effects of nicotine in beginners or irregular users are increase in alertness and
memory, and mild euphoria. Nicotine, however, disturbs metabolism and suppresses appetite.
Adolescence here refers to the stage of maturation between childhood and adulthood. The term
denotes the period from the beginning of puberty to maturity. It usually starts at about age 11 till
19 yr. The transition to adulthood varies among cultures, but it is generally defined as the time
when individuals begin to function independently of their parents. Smoking epidemic has been on
the decline in most industrialized countries but in the developing countries data suggests that
cigarette smoking is increasing by 3% per year.
It is estimated that the total number of deaths attributable to smoking worldwide will
increase from 2.5 million in 1995 to 12 million by the year 2050. Most of these deaths will occur
in the developing countries. Part of the reason is that there are poor public health institutions and
there is expansion of tobacco companies into the African markets. The health consequences of
cigarette smoking are slow, gradual, and cumulative. Cigarette smoke is mild enough to be inhaled
in overdose quantities. Its addiction has historically been one of the hardest addictions to break.
Although the hazards of smoking are well-known, the number of smokers among adolescent
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students is still high. There are many factors influencing these students to smoking for example
socio-economic status, having parents, siblings and friends who smoke, also the social
environment around the person. The long-term consequence of cigarette use may be easier for
young people to ignore because they feel inherently invulnerable to these far-off risks, and many
young smokers believe they can quit smoking before the long-term health “bill” comes due for
their smoking behavior.
However, evidence suggests that most people who begin smoking regularly in adolescence
will continue to do so, regardless of their intentions to quit. Smoking prevalence in Nigerian adults
(15 years & older) 1990 National Demographic Health Survey showed that the prevalence rate of
smoking in males is much greater when compared to that of females. Males have prevalence rate
of 15.4, while that of females was 1.7. Overall: 8.9. A survey conducted by the United States
Centre for Disease Control in Cross River State in Nigeria, found that as many as 45% of the young
people surveyed think boys who smoke and 28% think girls who smoke have more friends. Again,
17% think boys who smoke and 16% think girls who smoke look more attractive. Little wonder,
therefore, that as many as 22% of the sample population currently use tobacco with as many as
20% of those who had never smoked likely to start smoking in the next year. Young people see
their role models like film stars, musicians, and celebrities smoking and portraying smoking as
something glamorous. Many also see it as a status symbol, a way of telling your peers and
contemporaries that you have come of age.
In Nigeria, there is no age restriction on buying cigarettes. People sell anything to anybody
without batting an eyelid. It is interesting to note that most adults prefer to send children to buy
cigarettes and alcohol for them. Reference reported a finding of a survey of smoking habits among
secondary school children and medical students in Lagos, Nigeria. 40% of the boys and 8.4% of
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girls at secondary school, and 72.4% and 22.2% of women at medical school were found to smoke
while the habit of smoking of the secondary school boys was influenced by the smoking habits of
their parents and friends, the smoking habits of their secondary school girls and female medical
students were mainly influenced by that of their friends. Reducing adolescence smoking rate is
essential, since smoking often begins in adolescence. About 90% of adult smokers start smoking
before the age of 20years. A good number of these adolescents’ are found in the senior secondary
school classes and this prompted this study on the prevalence of cigarette smoking among in-
school adolescents in Owerri, South-Eastern Nigeria. This study explores the present status of
cigarette smoking behaviour among in-school adolescents and their knowledge about health risks
associated with smoking.
Adolescence is a stage of significant growth and potential but it is also considered to be a
time of great risk. A lot of adolescents are facing pressures to use alcohol, cigarettes, or drugs and
to start sexual relationships, thereby putting themselves at high risk for intentional injuries and
infection from sexual transmitted diseases. (Kipke 1999, 2.) According to the World Health Report
1999 a considerable number of deaths would be prevented and tobacco related deaths would be
halved if most of the adult smokers quit smoking over the next 20 years. People who begin smoking
early have a greater risk of lung cancer compared to those who begin smoking at a later age as a
result of the cumulative exposure. (Colditz & Hunter 2000, 7.) Tobacco is known to be the only
legal consumer product that can cause harm to everyone exposed to it and kills most of those who
use it as intended. Tobacco is also considered as the single most preventable cause of death in the
world. The use of tobacco is widespread due to low prices, strong marketing, lack of education
about its negative effects, and poor public policies against its use. (WHO 2008, 8.) Tobacco
contains many chemicals which are known to cause cancers. (Report on Carcinogens 2005, 408).
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Tobacco kills more than the combination of AIDS, legal drugs, illegal drugs, road accidents,
murder and suicide. (Mackay & Eriksen 2002, 36). The easiest way to stop the effect of tobacco
is to prevent its initiation. (Robin & Sugarman 2001, 143). The purpose of this study is identify
factors contributing to adolescent smoking initiation and the aim of the thesis is to produce an
evidence based information that will be published on Turku University of Applied Sciences’
Hoitonetti Adolescence is a time when young people undergo physical, psychological,
sociocultural and cognitive development (DiClemente et al 2009, 4). It is a time when many
physical, psychological and behavioural transformations happen and when adolescents develop a
lot of the habits, behavioural patterns and relationships they will take into their adulthood
(Committee on Adolescent Health Care Services and Models of Care for Treatment 2008, 17).
Studies on humans and nonhumnan primates show that adolescence is a period for undertaking
important development tasks like maturing physically and sexually; acquiring skills necessary to
perform adult roles; gaining more independence from parents, and establishing social ties with
members of the same and opposite gender (Kipke 1999, 2). During this period, the adolescent
establish their emotional and psychological independence, learn to understand and takes charge of
their sexuality and think about their future in society. This process is gradual, emotional and at
times unsettling. The adolescent may feel sad, disillusioned and hurt one moment; happy,
optimistic and in love the next moment. (UNICEF 2002, 4.)
Adolescence is a period the young person is trying to achieve a personal identity so it is a
time he or she may experiment with different behaviours (Haven 1996, 14). The adolescent period
is a stage when the adolescent takes on new roles and experiment with independence. They seek
for identity, learn to apply values gained in early childhood and build skills that will help them in
adulthood.
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2.2 Adolescent Risk Behaviour
Risk taking behaviours are behaviours in which the results are unknown and from which
there is a possibility of identifiable and possibly fatal, injury. These are behaviours that can cause
physical harm to the participant or others. Risk behavious include driving at high speed, alcohol
use and driving, using illicit drugs, exhibiting aggressive behaviour towards others and engaging
in unprotected sexual activity. They also include behaviours that are socially unacceptable and
could lead to serious legal consequences such as shoplifting, vandalism, assault, theft and drug
dealing. (Sofronoff 2004, 60-61.) According to Sarkar & Andreas (2004, 699), adolescent drivers
are more dangerous than other drivers but their perceived risk of being caught engaging in
dangerous driving may not be enough to deter them from such behaviour.
Wang et al (2010, 320) found that early adolescents who were male and who did not come
from two-parent families had more risk behaviours than others. According to Wang et al (2010,
320), although adolescents may pressured into identifying with peers’ risk behaviours, adolescents
who have good emotional regulation may deal with stress better and be less affected by peers’ risk
behaviours. Giannakopoules et al (2008, 168) found time spent on studying to be strongly
associated with decreased risk of smoking. They found adolescent smokers to spend more time
watching TV and playing videogames, other than sports activities, playtime or walks. Also they
found that sport activities outside school were inversely associated with smoking. Giannokopoules
et al (2008, 168) found that smoking adolescent smokers were less likely to be involved in health-
promoting dietary and physical activity habits. According to Sabbah et al (2008, 47), students who
were not happy with their weight were more likely to be involved in risky behaviours such as
bullying others at school, being bullied and smoking nargila, than adolescents who were more
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satisfied with their weight. They also found that girls who were dissatisfied with their weight
engaged in more risky behaviours such as fighting or fighting that resulted in an injury than with
girls who were satisfied with their weight.
In the study by Robert & Ryan (2002, 1061), adolescents who had tattoos reported greater
involvement in sexual intercourse, higher levels of substance use by their peers and by themselves,
higher levels of violence perpetration and have more school problems than their nontattooed
counterparts (Robert & Ryan 2002, 1061). According Ryan & Robert (2002, 1062), tattoo may be
permanent, easily noticed indicator for identifying an adolescent who is at risk for involvement in
premature sexual intercourse, substance use, violence and school problems. Observation of a tattoo
during physical examination of an adolescent should prompt a more intensive assessment for high
risk behaviours and subsequent counselling during clinical office visits (Ryan & Robert 2002,
1062). Violence is found to a higher extent in male adolescents males with tattoos and female
adolescents with body piercing (Carroll et al. 2002, 1027). A study by Felton & Bartoces (2002,
63) found low problem solving skills, fewer health enhancing behaviours and less education to be
risk factors for early sex. Since adolescent smokers are also more bound to be involved in other
risky behaviours, the observation of tattoos should be a way of identifying adolescent who may be
involved in risk behaviours. (Dearden et al. 2007, 160.)
2.3 Addiction to Tobacco
Addiction may be described as continued uncontrollable use of a substance regardless of
harmful consequences. Many smokers do not acknowledge that they are addicted to tobacco. Most
people think they can quit whenever they want to. Many youth are of the opinion that they have a
lot of time to work on quitting. The first step in recovery is acknowledging that there is a problem.
(MacDonald 2004, 26-27.) Addicted smokers experience a strong irresistible or uncontrolled
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desire to smoke. These irresistible desires to smoke can be aroused by smoking cues, abstinence
and stressful situations in the environment. (DiFranza 2010, 381.) Nicotine is like heroine and
cocaine addiction in some ways because it is a psychoactive drug. It is also considered as a
reinforcing drug, which is the reason why the smoker finds it hard to quit. Due to the reinforcing
effect, most smokers may find it difficult to stop smoking. Cigarette smoking can be described as
a physical and psychological addiction. (Becket 2004, 12.) Withdrawal symptoms of nicotine
include anxiety, sleep disturbances, depression, increased appetite, irritability, cognitive and
attention deficits Although withdrawal is associated with the pharmacological effects of nicotine,
many behavioural factors can also contribute to the intensity of withdrawal symptoms. Some
smokers claim that the smell, and the meer sight of a cigarette and the ritual of obtaining, lighting,
handling and smoking the cigarette are all linked to the pleasurable effects of smoking and may
worsen withdrawal or cravings. (National Institute on Drug Abuse 2009, 3.) Nicotine causes
reliance by providing centrally mediated reinforcing effects, by controlling elements such as body
weight and mood in a manner that is considered useful or pleasing by the tobacco user and by
causing a physical reliance such that abstinence may result in unpleasant symptoms (Jiloha 2008,
129).
2.4 Health Effects of Smoking
Smoking prevalence is estimated at around 28.6% (40% among males and 18.2% among
females) in the WHO European Region. Smoking rates in men and women has stabilized or is
reducing in most western European countries. The rate of smoking in some eastern European
countries is declining although in general it is rising in women and stabilizing in men. The rates
of weekly smoking in fifteen-year old girls in many western European countries surpasses that of
boys of the same age. The rates of weekly smoking in boys in eastern European countries is higher
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than that of girls. (European Tobacco Control Report 2007, 12.) Studies have shown that the
smoker does not only harm him or herself but also puts the life of others at risk. Research has
firmly established that an environment devoid of smoke is the only effective way to protect the
population from the detrimental effects of secondhand smoke exposure. (WHO 2007, 2.)
The burning and smoking of tobacco produces a complex mixture of chemicals which are
harmful to the health of people who inhale the smoke. Children are at great risk from adults
smoking and smoking around a pregnant woman poses a health risk to a foetus. (Mackay & Erikson
2002, 36.) Tobacco has been found to cause many chronic diseases, acute respiratory diseases such
as pneumonia and influenza, and a number of persistent respiratory symptoms such as wheezing
and cough (Colditz & Hunter 2000, 3.) Research suggest that the risk of death from lung cancer
may rise with amount of cigarettes smoked and duration of smoking. (Report on Carcinogens 2011,
408). Many are of the belief that young people are picking up the habit of smoking due to ignorance
about risks associated with smoking and also that it is a part of adolescent rebelliousness. (Dawn
2006, 71-72.)
Cigarrete smokers been found to have lower level of lung function compared to
nonsmokers. The rate of lung growth can also be reduced by smoking. Smoking is known to affect
the athletic capabilities of young people. Regular smoking may lead to coughs and worsen
respiratory diseases among young people. Adolescent smokers experience shortness of breath at
higher rates compared to nonsmoking adolescents and produce phlegm more often than those who
do not smoke. (Page & Page 2011, 271.) Smoking causes damage to different parts of the body
such as mouth, teeth, skin, fingernails and hair. Tobacco products contains elements and
compounds such as arsenic, carbon monoxide, nicotine and formaldehyde which may cause
wrinkles, discolouration of skin complexion and yellowing of fingernails when they enter the
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bloodstream. Secondhand smoke may also result in cosmetic damage when it gets in contact with
the body.
The harm caused by smoking on a person’s appearance may be cummulative and may take
several years of smoking to create observable effects. Smokers who give up the habit can prevent
further damage to their physical features but in most cases the years of damage may require
cosmetic surgery. Damage caused internally and externally by smoking leads to many changes in
a person’s appearance. Smoking makes people seem older than they actually are. (McCay et al.
2009, 70-71.) Women who are smokers or who stay with a smoker are prone to health effects
associated with reproductive health such as problems associated with pregnancy, use of oral
contraceptive, menstrual function, and cancers of the cervix and bladder. Smoking may also lead
to irregular menstrual cycles and increased menstrual discomfort. Women who are smokers may
also have earlier menopause, which increases chances of getting osteoporosis, heart disease and
other conditions for which estrogen provides a protective effect. The risk of sudden infant death
syndrome may also increase when a pregnant woman smokes. (Page & Page 2011, 273.) Tobacco
smoking can have negative effects on the oral cavity such as bad breath, stained teeth and life
threatening conditions such as oral cancer. Also tobacco users often develop gum disease. (Alters
& Schiff 2009, 211-212.)
2.5 The Economic Cost of Smoking and Benefits of Quitting
According to McCay et al (2009, 76-77), smoking costs the smoker in many ways and the
cost of smoking goes beyond purchasing tobacco products. A smoker spends a considerable
amount of money on medical bills, lost wages, higher insurance costs, and spends a lot of money
on cosmetics and clothing. Studies have found that people in the lower socioeconomic classes
smoke more than people in the upper socioeconomic classes. (McCay et al 2009, 76- 77.) Tobacco
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use compromises the health of both the smoker and nonsmokers exposed to tobacco smoke.
Treating of tobacco-related diseases requires a number of medical services, such as hospital stays,
physician services, other health practitioners’ services, prescription drugs, home care, and nursing
home care.
Healthcare in many advanced countries is catered for by private insurance and socialized
health care systems whereas patients in many developing countries pay for medical care costs
themselves. (Research for International Tobacco Control 2003, 21.) Economically, the costs of
smoking to smokers and their families include money spent on buying tobacco, which could have
been used on food, clothing and shelter, and other important things. As smoking causes the death
of many in their working years, a lot families are deprived of many years of income. Smokers also
lose a lot of their income through illness. In the event of a smoker’s premature death, a partner,
children or elderly parents can be left without a means of sustainance.
A considerable amount of money is lost by family members of smokers through time spent
looking after them when they are sick, and time lost taking them to health centers or hospital.
(MacCay & Eriksen 2002, 40-42.) Smoking does not only have harmful health effects, but smoking
cessation has been found to result in improvements in health. Quitting smoking leads to almost
instant improvements in general health and benefits both persons with smoking-related illnesses
as well as those with other ailments. People who stop smoking increase their life expectancy. Also
smoking cessation has been found to be related to reductions in the risk of developing lung and
other types of cancers. It has also been found to reduce the risk of heart disease. Pregnant women
who quit smoking have reduced risks of smoking-related complications such as low birth weight.
(Sloan et al 2004, 78.)
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According to Britton (2004, 34), smoking quitting results in improvements in life
expectancy and prevention of disease. Quitting smoking also improves individuals’quality of life
as smokers tend to have less health problems compared to non-smokers. Individuals and society
also benefits from smoking cessation due to reductions in the effects of secondhand smoke.
(Britton 2004, 34.) According to Alters & Schiff (2009, 214), since cigarette smoking has negative
effects on the respiratory system, a smoker who quits may notice that it is easier to breathe.
Smoking cessation reduces the occurrence of symptoms such as cough, mucus production, and
wheezing. Smoking Cessation may also reduce the occurrence of respiratory infections such as
bronchitis and pneumonia. (Alters & Schiff 2009, 214.)
2.6 Marketing of Tobacco Products
Information explicitly revealed in tobacco industry documents makes clear the industry’s
interest in and efforts to entice young people to use their products. Tobacco companies have long
argued that their marketing efforts do not increase the overall demand for tobacco products and
have no impact on the initiation of tobacco use among young people; rather, they argue, they are
competing with other companies for market share. In contrast, the weight of the evidence from
extensive and increasingly sophisticated research conducted over the past few decades Tobacco
Marketing at Retail Stores shows that the industry’s marketing activities have been a key factor in
leading young people to take up tobacco, keeping some users from quitting, and achieving greater
consumption among users. In her landmark 2006 ruling that the tobacco industry violated the
Racketeer Influenced and Corrupt Organizations (RICO) Act, Judge Gladys Kessler concluded
that cigarette marketing recruits youth to smoke and that the major cigarette companies know it.
Tobacco companies are very interested in initial brand preference because they know it is highly
associated with subsequent brand selection. The tobacco companies know that youth are very
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brand loyal, and once they have chosen a brand, most will continue with it. For example, a
previously confidential Philip Morris document states as its “underlying premise” that “[t]he
smokers you have are the smokers you are most likely to keep.” Tobacco companies have
consistently stated that the purpose of spending billions of dollars on cigarette marketing is to
attract and hold current adult smokers to their brands of cigarettes.
In addition, the companies deny that marketing campaigns are intended to increase demand
for cigarettes among existing smokers or to encourage young people to initiate smoking. The
economic value of the amount of brand switching that occurs, however, does not justify the
magnitude of marketing expenditures. Despite the industry’s arguments about brand loyalty and
inducing existing smokers to switch brands, there are times when cigarette company executives
themselves have acknowledged that marketing reaches and influences underage adolescents. For
example, in 1997, Bennett S. LeBow, CEO of the holding company that owns Liggett, stated:
“Liggett acknowledges that the tobacco industry markets to ‘youth’, which means those under 18
years of age, and not just those 18–24 years of age.” Tobacco companies have always claimed that
they do not want adolescents to use their products. However, for a tobacco company to be
profitable over the long term, it must compete successfully for a share of the youth market. As
stated succinctly in one of RJR’s marketing research documents, “Young adult smokers have been
the critical factor in the growth and decline of every major brand and company over the last 50
years.”
2.7 Reasons for Smoking Among the Youth
There are many reasons young people begin using tobacco. Teenagers, and even preteens,
are developing behaviors, social connections, and attitudes. They often experiment with different
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behaviors because they see these behaviors in peers they admire, in adults they hope to be like
someday, or in media or entertainment idols.
Social Influences
Adolescents and young adults are very susceptible to social influences. If they see tobacco
use as a normal behavior because their friends or family members use tobacco, young people are
more likely to try tobacco themselves. Teens and young adults highly value their friendships and
want to fit in with their group. What their peers doand especially what the leaders of their social
groups docan have a strong influence on what they do. Young people whose friends smoke are
much more likely to smoke as well.
Physical Influences
Nicotine is just as addictive as heroin and cocaine. Because they are sensitive to nicotine,
teens can feel dependent on tobacco sooner than adults. There is also evidence that genetics might
make it more difficult for some young people to quit smoking once they have started.
Environmental Influences
Teens and young adults are sensitive to what they see and hear in the world around them.
If they are exposed to images that portray smokers as cool, attractive, rebellious, funloving, risk-
taking, or other characteristics they