Tobacco use patterns, knowledge, attitudes towards tobacco and availability of tobacco control training among school personnel from a rural area in Poland

Dorota Kaleta, Kinga Polańska, Adam Rzeźnicki, Włodzimierz Stelmach, Piotr Wojtysiak, Dorota Kaleta, Kinga Polańska, Adam Rzeźnicki, Włodzimierz Stelmach, Piotr Wojtysiak

Abstract

Background: Tobacco-free school environment as well as non-smoking teachers and school personnel provide positive role models for children and young people. In Poland, smoking should be banned in colleges, schools, educational establishments and educational care facilities. However, for the existing law to be effective, awareness of all people in school curriculum and enforcement of the law are crucial. The aim of the study was to evaluate tobacco use patterns, knowledge and attitudes towards tobacco as well as availability of tobacco control training among school personnel in a rural area in Poland. Moreover, compliance with tobacco control policies and their enforcement were assessed.

Methods: The study was carried out in Piotrkowski district between November 2014 and May 2015 in accordance with the Global School Personnel Survey (GSPS) methodology. Sixty schools participated in the survey (92% of the schools from the region) with involvement of 1044 teachers and 500 non-teaching staff (the response rate - 83.1%). The multivariate linear regression analyses were applied to study factors linked to the need for anti-tobacco training dedicated to the youth and teachers' knowledge as well as activities to educate the students about tobacco use and its prevention.

Results: About 24% of the school personnel were current and 9% were ex-smokers. Significantly more teachers than the non-teaching staff indicated that the schools had a policy prohibiting tobacco use among students. In addition, 6% of the study participants indicated everyday violations of the tobacco control policy by the school personnel. More than 80% of the teaching personnel indicated the need for training dedicated to the youth to prevent their tobacco use. In the multivariate linear regression model, longer duration of working experience predicted higher levels of knowledge and more activities performed to teach the youth about tobacco use and its prevention. The smokers comparing to the non-smokers perceived the need for anti- tobacco training among the youth less strongly.

Conclusions: In order to make it possible for the inhabitants of Piotrkowski district to work and learn in tobacco smoke free environment there is an urgent need for taking actions aiming at increasing effectiveness of enforcing applicable tobacco control regulations in educational units. The necessity for systematic training dedicated to the youth to prevent their tobacco use, including accurate preparation of teachers, also needs to be highlighted.

Keywords: Health policy; School personnel; Smoking; Tobacco control training.

References

    1. The Health Consequences of Smoking-50 Years of Progress A Report of the Surgeon General 2014. U.S. Department of Health and Human Services. Accessed 16 Oct 2015.
    1. WHO report on the global tobacco epidemic 2013 Enforcing bans on tobacco advertising, promotion and sponsorship. Accessed 16 Oct 2015.
    1. Surgeon General’s Report-Preventing Tobacco Use Among Youth and Young Adults Surgeon General 2012. U.S. Department of Health and Human Services. Accessed 16 Oct 2015.
    1. Kaleta D, Usidame B, Biliński P, Raciborski F, Samoliński A, Wojtyła A, Fronczak A. Global adult tobacco survey (GATS) in Poland 2009–2010 – study strengths, limitations and lessons learned. Ann Agric Environ Med. 2012;19(4):658–63.
    1. Kaleta D, Usidame B, Dziankowska-Zaborszczyk E, Makowiec-Dąbrowska T, Leinsalu M. Prevalence and factors associated with hardcore smoking in Poland: findings from the Global Adult Tobacco Survey (2009–2010) BMC Public Health. 2014;14:583. doi: 10.1186/1471-2458-14-583.
    1. Kaleta D, Makowiec-Dąbrowska T, Dziankowska-Zaborszczyk E, Fronczak A. Prevalence and socio-demographic correlates of daily cigarette smoking in Poland: results from the Global Adult Tobacco Survey (2009–2010) Int J Occup Med Environ Health. 2012;25(2):126–36. doi: 10.2478/s13382-012-0016-8.
    1. Kaleta D, Makowiec-Dąbrowska T, Dziankowska-Zaborszczyk E, Fronczak A. Determinants of heavy smoking: results from the global adult tobacco survey in Poland (2009–2010) Int J Occup Med Environ Health. 2012;25(1):66–79. doi: 10.2478/s13382-012-0009-7.
    1. Włodarczyk A, Raciborski F, Opoczyńska D, Samoliński B, GATS PWG. Daily tobacco smoking patterns in rural and urban areas of Poland--the results of the GATS study. Ann Agric Environ Med. 2013;20(3):588–94.
    1. Currie C et al., eds. Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the 2009/2010 survey. Copenhagen, WHO Regional Office for Europe, 2012 (Health Policy for Children and Adolescents, No. 6) Accessed 16 Oct 2015.
    1. Poulsen LH, Osler M, Roberts C, Due P, Damsgaard MT, Holstein BE. Exposure to teachers smoking and adolescent smoking behaviour: analysis of cross sectional data from Denmark. Tob Control. 2002;11(3):246–51. doi: 10.1136/tc.11.3.246.
    1. Conrad KM, Flay BR, Hill D. Why children start smoking cigarettes: predictors of onset. Br J Addict. 1992;87:1711–24. doi: 10.1111/j.1360-0443.1992.tb02684.x.
    1. Kaleta D, Makowiec-Dąbrowska T, Dziankowska-Zaborszczyk E, Fronczak A. Predictors of smoking initiation - results from the Global Adult Tobacco Survey (GATS) in Poland 2009–2010. Ann Agric Environ Med. 2013;20(4):756–66.
    1. Fronczak A, Polańska K, Dziankowska-Zaborszczyk E, Bąk-Romaniszyn L, Korytkowski P, Wojtyła A, Kaleta D. Changes in smoking prevalence and exposure to environmental tobacco smoke among adults in Łódź, Poland. Ann Agric Environ Med. 2012;19(4):754–61.
    1. Pierce JP, White VM, Emery SL. What public health strategies are needed to reduce smoking initiation? Tob Control. 2012;21:258–64. doi: 10.1136/tobaccocontrol-2011-050359.
    1. Aslam SK, Zaheer S, Rao S, Shafique K. Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of Global Youth Tobacco Survey. Subst Abuse Treat Prev Policy. 2014;9:1–10. doi: 10.1186/1747-597X-9-1.
    1. GTSS Collaborative Group The global school personnel survey: a cross-country overview. Tob Control. 2006;15(Suppl 2):ii20–30.
    1. Wakefield M, Giovino G. Teen penalties for tobacco possession, use, and purchase: evidence and issues. Tob Control. 2003;12(Suppl 1):i6–13. doi: 10.1136/tc.12.suppl_1.i6.
    1. Darling H, Reeder AI, Williams S, McGee R. Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors? Health Educ Res. 2006;21(1):108–15. doi: 10.1093/her/cyh047.
    1. Wold B, Currie C, Roberts C, Aaroe LE. National legislation on school smoking restrictions in eight European countries. Health Promot Int. 2004;19(4):482–8. doi: 10.1093/heapro/dah410.
    1. Lovato CY, Sabiston CM, Hadd V, Nykiforuk CI, Campbell HS. The impact of school smoking policies and student perceptions of enforcement on school smoking prevalence and location of smoking. Health Educ Res. 2007;22(6):782–93. doi: 10.1093/her/cyl102.
    1. Hamilton B, Torsheim T, Currie C, Roberts C. National and school policies on restrictions of teacher smoking: a multilevel analysis of student exposure to teacher smoking in seven European countries. Health Educ Res. 2004;19(3):217–26. doi: 10.1093/her/cyg029.
    1. Barnett TA, Gauvin L, Lambert M, O’Loughlin J, Paradis G, McGrath JJ. The influence of school smoking policies on student tobacco use. Arch Pediatr Adolesc Med. 2007;161(9):842–8. doi: 10.1001/archpedi.161.9.842.
    1. Moore L, Roberts C, Tudor-Smith C. School smoking policies and smoking prevalence among adolescents: multilevel analysis of cross-sectional data from Wales. Tob Control. 2001;10(2):117–23. doi: 10.1136/tc.10.2.117.
    1. Farshad AA, Vesali S, Azaripour H, Rahimi Z, Akbari F, Asadi-Lari M. School personnel tobacco use in Iran: results of the global school personnel survey. Prim Health Care. 2012;2:119.
    1. Sorensen G, Gupta PC, Sinha DN, Shastri S, Kamat M, Pednekar MS, Ramakrishnan S. Teacher tobacco use and tobacco use prevention in two regions in India: results of the Global School Personnel Survey. Prev Med. 2005;41(2):417–23. doi: 10.1016/j.ypmed.2004.09.048.
    1. Huang HL, Hsu CC, Magnus JH Chen FL, Rice J, Lee CH, Yen YY, Chen T. Perceived smoking prevalence at school-level and children’s smoking initiation: a multi-level analysis of a cross-sectional data in Taiwan. Health Policy (Amsterdam, Netherlands) 2008;86:213–21. doi: 10.1016/j.healthpol.2007.10.012.
    1. Leatherdale ST, Manske S. The relationship between student smoking in the school environment and smoking onset in elementary school students. Cancer Epidemiol Biomarkers Prev. 2005;14:1762–5. doi: 10.1158/1055-9965.EPI-05-0065.
    1. Hamilton G, Cross D, Lower T, Resnicow K, Williams P. School policy: what helps to reduce teenage smoking? Nicotine Tob Res. 2003;5:507–13. doi: 10.1080/1462220031000118559.
    1. Huang HL, Chen FL, Hsu CC, Yen YY, Chen T, Huang CM, Shi HY, Hu CY, Lee CH. A multilevel-based study of school policy for tobacco control in relation to cigarette smoking among children in elementary schools: gender differences. Health Educ Res. 2010;25(3):451–63. doi: 10.1093/her/cyq014.
    1. Griesbach D, Inchley J, Currie C. More than words? The status and impact of smoking policies in Scottish schools. Health Promot Int. 2002;7:31–41. doi: 10.1093/heapro/17.1.31.
    1. Amendment of the Act on Protection of Health against Consequences of Consumption of Tobacco and Tobacco Products and the Act on National Sanitary Inspectorate (of 8 April 2010) J Laws. 2010, No. 81, item 529.
    1. Balwicki Ł, Stokłosa M, Balwicka-Szczyrba M, Tomczak W. Tobacco industry interference with tobacco control policies in Poland: Legal aspects and industry practices. Tob Control. 2015; 28, doi:10.1136/tobaccocontrol-2015-052582.
    1. Manko Association. PR and CSR Practices of the Tobacco Industry in Poland. Available online: . Accessed 04 Aug 2016.
    1. Wojtyniak B, Goryński P, Moskalewicz B. Sytuacja zdrowotna ludności Polski i jej uwarunkowania [The health situation of the Polish population and its determinants] Warszawa: Narodowy Instytut Zdrowia Publicznego – Państwowy Zakład Higieny; 2012.
    1. Charzyńska-Gula M, Sygit K, Sygit M, Goździewska M, Dobrowolska B, Gałęziowska E. Problems of health education in rural areas in Poland. Ann Agric Environ Med. 2013;20(3):515–22.
    1. Balwicki Ł, Zarzeczna-Baran M, Wierucki Ł, Jędrzejczyk T, Strahl M, Wrotkowska M, Goniewicz ML, Zdrojewski T. Smoking among pregnant women in small towns in Poland. Int J Public Health. 2016;61(1):111–8. doi: 10.1007/s00038-015-0735-2.
    1. Giza-Poleszczuk A. Informacja o sytuacji młodzieży na wsi; w: Warunki życia na wsi. Szanse edukacyjne na obszarach wiejskich. [Information copncerning situation of adolescents in rural areas. In: Life conditions in rural areas: Educational opportunities in rural areas]. Biuletyn Forum Debaty Publicznej; ISSN 2083-5868; 2011; vol. 6; Kancelaria Prezydenta Rzeczpospolitej Polskiej, Warsaw, June 2011:33–38 (in Polish).
    1. Jodkowska M, Oblacińska A, Tabak I, Radiukiewicz K. Nierówności w dostępie uczniów do profilaktycznej opieki zdrowotnej w Polsce w ostatnim roku wdrażania Rządowego Programu “profilaktyczna opieka zdrowotna nad dziećmi i młodzieżą w środowisku nauczania i wychowania”. [Inequalities in access of Polish schoolchildren to prophylactic health care in the last year of implementation of government project ‘Prophylactic health care of children and adolescents in the environment of education]. Instytut Matki i Dziecka, Warszawa (in Polish). Medycyna Wieku Rozwojowego, 2010, XIV, 2: 179-188 .
    1. The Global School Personnel Survey (GSPS). Accessed 16 Oct 2015.
    1. Assessment of health needs of the residents of Piotrkowski district 2014. [citation date: 05 May 2016]. Available from: .
    1. United Nations Development Programme. National Human Development Report. Poland: Regional and local development; 2012. Available at .
    1. Lipperman-Kreda S, Paschall MJ, Grube JW. Perceived enforcement of school tobacco policy and adolescents’ cigarette smoking. Prev Med. 2009;48(6):562–6. doi: 10.1016/j.ypmed.2009.03.008.
    1. Nikaj S, Frank Chaloupka F. School personnel smoking, school-level policies, and adolescent smoking in low- and middle-income countries. Tob Control. 2015. doi:10.1136/tobaccocontrol-2015-052531.
    1. Wakefield MA, Chaloupka FJ, Kaufman NJ, Orleans CT, Barker DC, Ruel EE. Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study. Br Med J. 2000;321:333–7. doi: 10.1136/bmj.321.7257.333.
    1. Reid DJ, McNeill AD, Glynn TJ. Reducing the prevalence of smoking in youth in western countries: an international review. Tob Control. 1995;4:266–77. doi: 10.1136/tc.4.3.266.
    1. Pentz MA, Brannon BR, Charlin VL, Barrett EJ, MacKinnon DP, Flay BR. The power of policy: the relationship of smoking policy to adolescent smoking. Am J Public Health. 1989;79:857–62. doi: 10.2105/AJPH.79.7.857.
    1. de Vries H, Engels R, Kremers S, Wetzels J, Mudde A. Parents’ and friends’ smoking status as predictors of smoking onset: findings from six European countries. Health Educ Res. 2003;18:627–36. doi: 10.1093/her/cyg032.
    1. Wen CP, Tsai SP, Cheng TY, Hsu CC, Chen T, Lin HS. Role of parents and peers in influencing the smoking status of high school students in Taiwan. Tob Control. 2005;14(Suppl. 1):i10–5. doi: 10.1136/tc.2003.005637.
    1. Lantz P, Jacobson P, Warner K, Wasserman J, Pollack H, Berson J, Ahlstrom A. Investing in youth tobacco control: a review of smoking prevention and control strategies. Tob Control. 2000;9:47–63. doi: 10.1136/tc.9.1.47.
    1. Thomas RE, Perera R. School-based programmes for preventing smoking. Cochrane Database Syst Rev. 2006;3:CD001293.
    1. Dobbins M, DeCorby K, Manske S, Goldblatt E. Effective practices for school-based tobacco use prevention. Prev Med. 2008;46:289–97. doi: 10.1016/j.ypmed.2007.10.003.
    1. Peterson AV, Jr, Kealey KA, Mann SL, Marek PM, Sarason IG. Hutchinson smoking prevention project: long-term randomized trial in school-based tobacco use prevention–results on smoking. J Natl Cancer Inst. 2000;92:1979–91. doi: 10.1093/jnci/92.24.1979.
    1. Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. Cochrane Database Syst Rev. 2013;4:CD001293.
    1. NHES . National health education standards: achieving excellence. Atlanta: National health education standards; 2007.
    1. Gajalakshmi V, Kanimozhi CV, Sinha DN, Rahman K, Warren CW, Asma S. Global school personnel survey among 5200 school personnel in India: comparison of the results for the years 2009 and 2006. Asian Pac J Cancer Prev. 2012;13(2):539–43. doi: 10.7314/APJCP.2012.13.2.539.
    1. Sinha DN, Gupta PC. Tobacco use among school personnel in Orissa. Indian J Public Health. 2004;48(3):123–7.
    1. Sinha DN, Roychowdhury S. Tobacco control practices in 25 schools of West Bengal. Indian J Public Health. 2004;48(3):128–31.
    1. Zhang L, Wang W, Zhao Q, Vartiainen E. Psychosocial predictors of smoking among secondary school students in Henan, China. Health Educ Res. 2000;15(4):415–22. doi: 10.1093/her/15.4.415.

Source: PubMed

3
Tilaa