|TOBACCO AND WOMEN
|Year : 2010 | Volume
| Issue : 5 | Page : 87-90
Less demand for tobacco smokers in the marriage market
J Sreedharan1, J Muttappallymyalil1, B Divakaran2
1 Research Division, Gulf Medical University, Ajman, United Arab Emirates
2 Department of Community Medicine, Academy of Medical Sciences, Pariyaram Medical College, P O Kannur, Kerala, India
|Date of Web Publication||9-Jul-2010|
Research Division, Gulf Medical University, Ajman
United Arab Emirates
Source of Support: None, Conflict of Interest: None
Background : In order to control the tobacco scourge, an array of measures is required. Aims : To determine the attitude of unmarried females toward tobacco smokers and ascertain their attitude toward marrying a smoker. Settings and Design : Female students from randomly selected colleges in Kannur district, Kerala state, India, were the participants for this cross-sectional study. Materials and Methods : Sample consisted of 1800 unmarried female students from two colleges. A self-administered, structured, close-ended pilot-tested questionnaire was used for data collection. Data were collected after obtaining verbal consent from them. Statistical Analysis : Data collected were entered into an excel spread sheet and analyzed using PASW 17 software. Results : The participants' age ranged between 17 and 25 years. About 59.6% revealed that their parents (father) used tobacco products. Of those with no family history of tobacco use, 96.5% had negative attitude toward tobacco smokers, whereas of the participants with family history of tobacco use among parents, 89% were with a negative attitude toward tobacco use or their parent's habit. This association was found to be statistically significant (P < 0.001); 79% expressed negative attitude toward their male co-students who use tobacco products. Of the total, 99.3% expressed their unwillingness to marry a person with the habit of tobacco use, whereas 0.7% were willing to marry a person with tobacco habit with the belief that they could bring about a change in their male partner's tobacco habit. Conclusion : More comprehensive tobacco control activities can be undertaken in the community and colleges by incorporating female students as facilitators.
Keywords: Female, marriage, tobacco control, youth
|How to cite this article:|
Sreedharan J, Muttappallymyalil J, Divakaran B. Less demand for tobacco smokers in the marriage market. Indian J Cancer 2010;47, Suppl S1:87-90
Publication of the supplement was supported by the funds from the 14th World Conference on Tobacco or Health, March 8-12, 2009, Mumbai. The Guest Editors, Editors, Authors and others involved with the journal did not get any financial or non-financial benefit from the sponsors.
| » Introduction|| |
India is the third largest tobacco producing country in the world, after China and Brazil.  Eighty percent of tobacco produced is consumed in the country.  The prevalence of tobacco use is rising among male youth.  According to World Health Organization estimates, there are around 1.3 billion smokers in the world, of whom almost one billion are men.  This corresponds to about one third of the global population aged 15 years and over  and the vast majority of these people, around 84%, live in the developing countries.  If there are no spectacular changes in cessation rates, no new interventions, and if children start smoking at the expected rates of 26.9%, then the current figure of 1.3 billion smokers worldwide is predicted to rise to 1.9 billion consuming more than 9 trillion cigarettes by 2025.  By 2030, tobacco is expected to be the single prime cause of death worldwide, with an estimated 10 million people worldwide dying of tobacco-related causes. Around 3 million of these will take place in the developed world and seven million in the developing countries. 
Studies in different countries, such as China, Vietnam, India, have observed that to bring about a reduction in smoking, an amalgamation of the following is needed: Mass media health education programs; a ban on all forms of tobacco advertising and promotion; vivid health warnings on tobacco products; regular increases in tobacco taxation; restrictions on smoking in public places and the workplaces; and better consumer information and help for smokers who wish to quit.  In addition, in countries such as India, where tobacco is grown, crop diversification should be introduced wherever possible.
Nations, such as India, Indonesia, and Thailand have introduced a wide range of measures and observed a decline in smoking prevalence and as a result also lowered cancers, heart disease, circulatory diseases and respiratory diseases.  In recognition of the global health impact of tobacco, the World Health Organization had launched the Tobacco Free Initiative in 1998 and has taken the lead in developing the world's first global tobacco control treaty-the Framework Convention on Tobacco Control.
Studies also reported that parental smoking has a large influence on whether or not kids smoke. Children who have a parent with smoking habit are more likely to smoke. , A study by Wilkinson et al. reported that current parental smoking influences children's smoking behavior. Also the study concluded that parental smoking influences their children's attitude toward smoking.  A study by Salaam Bombay Foundation observed that girls do not find a smoker attractive and 75% said that they would not marry a smoker.  The present study was conducted to determine the attitude of unmarried females toward tobacco smokers and to ascertain their attitude toward marrying a smoker.
| » Materials and Methods|| |
The present cross-sectional study was conducted over a period of 6 months from 2007 September to February 2008 among female college students in Kannur district, Kerala state, India. Kannur district is situated in the northern part of Kerala. This study was conducted in two randomly selected colleges in the district of Kannur. Simple random sampling procedure was adopted to select the study sample of 1800 students.
A detailed, structured, close-ended self-administered questionnaire was prepared and finalized after pilot study. The information on sociodemographics, tobacco users in the family, attitude toward male smokers, willingness to marry a smoker, and reasons for unwillingness/willingness were obtained in detail.
Before the data collection, female students were asked about their marital status and unmarried female students who were willing to participate in the study were interviewed using a self-administered questionnaire. Verbal consent was obtained from the participants before distributing the questionnaires. Anonymity was maintained by asking them not to write their names. Students who were present on the day of the study were given the questionnaire and the filled-in questionnaires were collected back on the same day.
The collected data were fed into an excel sheet and analyzed using PASW 17 software (IBM company, Illinois, Chicago). Chi-square test was performed to find the association between dependent and independent variables. P-value less than 0.05 was taken as statistically significant.
| » Results|| |
Eighteen hundred unmarried females participated in the study. The minimum and maximum age observed was 17 and 25 years with a mean age of 20.3 years. About 53% of the participants were 20 years old, 12.7% were 19 years old, and 11.3% were 21 years old. Of the students who participated in the study, 75% were undergraduate students and the remaining were postgraduate students. All were full-time undergraduate and postgraduate students. The distribution is given in [Table 1]. With regard to family history of tobacco use, 59.6% revealed that their parents (father) use tobacco products. The types of tobacco used by their parents are given in [Table 2]. It was revealed by 61.5% that their parents use smoke form of tobacco products, especially cigarette. Smokeless tobacco was used by 30.2% of the parents, whereas 7.2% opined that their parents had the habit of using both smokeless and smoke form of tobacco products; 1.1% of the participants were aware that their parents use tobacco but could not specify the type of tobacco product used. [Table 3] shows the participants' attitude toward their parents' tobacco use. About 60% of participant's parents used tobacco products. Among those participants whose parents used tobacco products, 89.4% had a negative attitude (unfavorable toward their parent's habit) toward their parents' tobacco use. About 8.9% were favorable toward their parent's tobacco habit and 1.7% of the participants did not have any opinion in this regard. Among the participants with no family history of tobacco use, 96.5% considered it as a bad habit and 2.5% did not have any opinion in this regard.
A Chi-square test was performed to find the association between the attitude of participants and use of tobacco products by their parents. There was a statistically significant association (P < 0.01) between the attitude of female participants and the use of tobacco product by their parents. Among those with no family history of tobacco use, 96.5% had a negative attitude, whereas 89% of the participants with a family history of tobacco use among parents had a negative attitude toward tobacco use or their parent's habit; 79% of the participants expressed negative attitude toward their male costudents who use tobacco products, whereas 21.0% had positive attitude toward their male co-students' tobacco habits. The response rate was 99.4%. [Table 4] shows the attitude of participants toward their male co-students who use tobacco products. Among the total participants, 28.3% mentioned that their male co-students use tobacco products. Among those participants with male co-students using tobacco products, 71% were favorable toward tobacco habit, but among those where the male co-students do not use tobacco, only 1.4% were favorable toward tobacco use. There was a statistically significant association (P < 0.001) between the presence of male co-students using tobacco and the attitude of the female students toward tobacco use. The female participants whose male co-students use tobacco showed a positive attitude toward smokers.
With regard to participant's response about the willingness to marry a man with habit of tobacco use, of the total, 1787 (99.3%) opined that they do not intend to marry a person with the habit of tobacco use, whereas of those who were willing to marry a person with tobacco habit, 13 (0.7%) opined that they could change their male partner's habit. It was interesting to note that 1039 (57.7%) opined that side stream smoke is injurious to their health and they did not prefer a smoker as their life partner; and 13.8% stated that they could not tolerate the disgusting smell coming from the smoker.
There was no statistically significant association between the attitude to marry a person who uses tobacco and those with a male co-student using tobacco. Detailed analysis of the year of study shows that as year of study increases, the willingness to marry a person with habit of tobacco use decreases. Irrespective of their attitude toward smokers, none of the female participants would talk to their male co-student if he was smoking at that time. Of the total, 97.8% participants were ready to participate in tobacco control activities.
| » Discussion|| |
The present study observed a negative attitude toward parent's tobacco use among participants. Also, there is a statistically significant association observed between the attitude of female participants and use of tobacco products by parents. A study by Oei et al. reported a similar finding that there is a significant association between the effects of parental smoking habits and the attitudes on the subject's decision to smoke.  Another study by Madan Kumar et al. observed that among tobacco users, the parental tobacco use was reported to be 2-3 times more.  Sinha et al. reported that tobacco use by parents and friends is strongly associated with student tobacco use. 
A study conducted among university students by Haddad and Malak shows that the nonsmokers had negative attitude toward smoking and were more aware of the adverse effects of smoking.  Even in the current study, three-fourths of the participants expressed negative attitude toward their male co-students who used tobacco products.
In a study conducted by Salaam Bombay Foundation, it was observed that Mumbai youth have a strong preference neither to "date" a smoker nor to marry a smoker. A significant number of youth are uncomfortable in the company of smokers.  Another study conducted among Sri Lankan immigrants living in Australia expressed strong negative attributes by females toward peers who smoked. Female participants did not have a positive attitude toward smoking and smokers in real life. Some female participants said they avoid peers who smoke due to cultural norms and community pressure. Female participants indicated that being a smoker or being with a smoker could affect their marriage prospects and their social standing.  Another study conducted by Frank Biasco and James observed that less than half of the people felt that they would not date or marry a smoker.  This study in Kerala observed that most of the unmarried females are not willing to marry a person with the habit of tobacco use. However, we could not find any study from Kerala to support our finding. Also this study observed that those with positive attitude toward smokers were also not willing to marry a person with the habit of tobacco use, which revealed that they do not want to get affected by this.
| » Conclusion|| |
Based on the study results, more comprehensive tobacco control activities can be undertaken in the community and colleges by utilizing the services of unmarried female students/workers. For ensuring the participation of female students in tobacco control programs, the National Service Scheme unit and Parent Teachers Association can actively participate and motivate female children and create a positive attitude among them toward the fight against tobacco use. Based on our finding, we are planning to implement school-/college-based anti tobacco campaigns with the help of female volunteers and also to involve the media to get maximum coverage.
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[Table 1], [Table 2], [Table 3], [Table 4]
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