Prevalence of Tobacco Use among School Teachers and Effect of Training on Tobacco Use in Western Turkey.

INTRODUCTIONTobacco use is one of the biggest public health issues. Roughly, there are 1.3 billion smokers worldwide, including a third of the world population aged over 15. It is indicated if the current smoking behaviours remain unchanged, this rate will reach two billion by the year 2030. Nearly 80% of the more than one billion smokers worldwide live in low and middle income countries where the burden of tobacco related illness and death is substantial ( 1 ). Turkey ranks 1 Oth in the list of countries with the highest rate of tobacco use (2). Tobacco endemic is a leading cause of death, illness, cancer, and impoverishment, resulting in nearly six million fatalities annually. Over 90% of these deaths are caused directly by tobacco use whilst about 10% are the results of non-smokers being exposed to second-hand smoke. If the current smoking behaviours remain unchanged, there will be worldwide increase in deaths up to more than eight million per year by 2030 (1). Smokers have a greater risk of cancer than nonsmokers (3). Smoking causes many serious diseases including cancer and strokes, and it shortens the life expectancy (4).Most smokers began smoking before the age of 18. Thus, smoking prevention should be aimed at young people (5, 6). Children and adolescents learn smoking from their role models (7). Given that teachers are respected people, they have a great responsibility for tobacco control (8). The relevant literature suggests that teachers are also role models for students and key figures in tobacco prevention programmes (8, 9). Since teachers have regular interactions with students, they have a great opportunity to prevent them from smoking.Particularly in developing countries, nurses have worked in smoking cessation and prevention programmes during the past ten years. Nursing interventions were performed in a planned manner, and smokers were informed and consulted. These programmes had successful results. The purpose of nursing intervention is to change smoking behaviour (10). The intervention plan is based on valid and reliable theoretical models. The Transtheoretical Model (TTM) concerns the stages of behaviour change. Stages are defined as "qualitatively distinct states in a behaviour change process." The Transtheoretical Model increases people's efforts to change and their levels of awareness (11, 12).The literature suggests that teachers do not quit smoking because they do not know any method for quitting smoking (13). There are very few studies on tobacco smoking behaviours among teachers, and they were only cross-sectional. The effects of smoking prevention training on the levels of quitting smoking have not been examined in Turkey. Also, there are very few studies on tobacco smoking among teachers in Turkey (14-17). The aim of this study was to find out the prevalence of tobacco smoking among teachers in Turkey, determine the perception related to pros and cons of smoking among teachers, and evaluate effectiveness of smoking prevention training by nurses.MATERIALS AND METHODDesignThis quasi-experimental study determines the frequency of tobacco use. Pre-test and post-test were used first with a crosssectional group, and then with a single group.Study PopulationThe research sample comprised teachers (N = 530) working at primary and high schools (N= 17) between May 16, 2013 and August 7,2014 in Izmir. The research included teachers who were physically present in the schools (who were not on career leave or sick leave, or based in another region) and agreed to participate in the research (N = 530).Between January 13 and March 4, 2014, 466 teachers were interviewed to determine the frequency of tobacco use among teachers. Due to a lack of data, 16 surveyed participants were eliminated. The remaining 450 were analyzed (participation rate: 84.9%). A pre-test was also conducted and a training session was held. It was found that 179 teachers were smokers. …