Knowledge, Attitude And Practice On Smoking Among Students In Nigerian University

Project and Seminar Material for Sociology

Knowledge, Attitude And Practice On Smoking Among Students In Nigerian University


The purpose of this cross sectional study was to explore university students’ knowledge, attitude and practice towards smoking and to compare these factors between smokers and non-smokers. A sample of 300 students was randomly selected to complete a self-administered questionnaire about knowledge, attitude and practice of smoking in the University, Ojo. The Majority of the smoking students (69%) knew the adverse effects of smoking. Rates of non-smoking students who knew the adverse effects of smoking were significantly higher than that of students who smoke.

A high rate of students showed an opposing attitude towards the assumption that smoking females would have more friends (89%), have stronger personality (86%), and be more attractive (89%) than non-smoking females. Similar higher rates of negative attitude were also observed towards the smoking male. About 50% of smokers have a misguided belief that smoking helps them concentrate while studying and 20% believe that smoking helps in avoiding obesity. Students that started smoking before enrollment in a university had a significantly higher rate of heavy smoking as compared to those who started smoking after being enrolled. Students smoke not because they lack the knowledge about the risk of smoking but due to misguided beliefs and attitudes.

Keywords: Attitude, knowledge, practice, smoking, students, university.

Chapter One


1.1 Background of the Study

Smoking has become a complex global public health problem and a major health-risk factor linked with the development of cancer, heart disease, chronic respiratory diseases and diabetes (World Bank, 1999). It is responsible for the largest preventable cause of death in the world. Each day more than 13,000 people die prematurely because of tobacco use (CDC, 2000). This figure is expected to almost double by the year 2020. Countries at all levels of development are victims of the tobacco epidemic (WHO, 2003a).

According to the World Bank Reports in 2003 there were about 1.3 billion people smoking cigarettes or other products, and out of them, almost one billion were men and 250 million were women. About 80 percent of these people lived in low and middle-income countries (Guindon & Boisclair, 2003). Cigarette smoking has become not only a national social problem, but a global one also. Smoking is expected to kill 4 million people in the next 12 months, and by 2030, it will kill 10 million people a year, which is more than any other single cause of death. Seven million of these deaths will occur in low-income and middle-income countries (World Bank, 1999; CDC, 2000). Numerous studies reveal that smoking prevalence has remained stable in the United States of America (USA) at 23% since 1993 (Etter, 2004; Fiore, 2003; Giovino, 1994).

The World Health Organization (WHO) has estimated that five million deaths occur annually due to tobacco use and this number of deaths is expected to reach more than eight million by the year 2030 (Gajalakshmi et al., 2004; WHO, 2009). About 80% of this number will be in developing countries (WHO, 2009). However, the exact magnitude of the problem of smoking in developing countries is not well defined. There is little information to describe the characteristics of smoking patterns in these countries (Gajalakshmi et al., 2004). Smoking has a great economic burden by causing a decrease of economic productivity and high health care expenditures in addition to the cost of tobacco (Ruff et al., 2000).

Smoking also has an environmental impact due to second hand (passive) smoking (El-Ansari, 2002). The impact of smoking is not limited on the smokers, but it can spread to affect the non-smokers as well. Second hand smoking has an impact on birth outcomes represented in low birth weight (Abu-Baker et al., 2010), and contribute significantly to respiratory tract infections in infants (Jones et al., 2011).

It is well known that cessation of smoking is extremely difficult. This statement is supported by research that has proved beyond doubt that nicotine is highly addictive (Rugkasa et al., 2001). Smoking prevalence rises sharply during adulthood. This means that there is an induction of smoking even after high school (Torabi et al., 2002). Between 1991 and 1997, the rate of smoking had increased by 32% among 18 to 24 years old adults in the USA (Torabi et al., 2002). Studying smoking behavior and attitude among this sector of the population will add valuable information about the patterns of smoking among this age group (Vakeflliu et al., 2002). In addition, knowledge about previously identified socio-environmental factors associated with smoking among college students in developing countries is limited (Pickett et al., 2000; Moore, 2001).

1.2 Aim of the Study

The aim of this study is to investigate the knowledge, attitude and practice on smoking among University students in Nigeria.

1.3 Objectives of the Study

  1. To find out the knowledge about tobacco smoking among Nigerian University students
  2. To determine the smoking practice among Nigerian University students
  3. To investigate the gender difference of smoking among Nigerian University students
  4. To investigate effective methods to reduce prevalence of smoking in Nigerian University

1.4 Research Questions

  1. What is the prevalence smoking practice among Nigerian University students
  2. How are the knowledge, attitude, and practice students in Nigerian University related to smoking?
  3. Is there any gender difference as related to smoking among Nigerian University students
  4. What is the effective methods to reduce prevalence of smoking in Nigerian University

1.5 Research Hypotheses

  1. Smoking rate among Nigerian University is lower than among general population.
  2. How are the knowledge, attitude, and practice students in Nigerian University related to smoking?
  3. Smoking among Nigerian University students is gender related

1.6 Definition of Terms


Knowledge is a familiarity with someone or something, which can include facts, information, descriptions, or skills acquired through experience or education. It can refer to the theoretical or practical understanding of a subject. It can be implicit (as with practical skill or expertise) or explicit (as with the theoretical understanding of a subject); it can be more or less formal or systematic.


An attitude is an expression of favor or disfavor toward a person, place, thing, or event (the attitude object). Prominent psychologist Gordon Allport once described attitudes “the most distinctive and indispensable concept in contemporary social psychology.”.[1] Attitude can be formed from a person’s past and present.[2] Attitude is also measurable and changeable as well as influencing the person’s emotion and behavior.


Practice is the act of rehearsing a behavior over and over, or engaging in an activity again and again, for the purpose of improving or mastering it, as in the phrase “practice makes perfect”. Sports teams practice to prepare for actual games. Playing a musical instrument well takes a lot of practice. It is a method of learning and of acquiring experience.


Smoking is a practice in which a substance, most commonly tobacco, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them available for absorption through the lungs. It can also be done as a part of rituals, to induce trances and spiritual enlightenment.


Student is a learner, or someone who attends an educational institution. In some nations, the English term (or its cognate in another language) is reserved for those who attend university, while a schoolchild under the age of eighteen is called a pupil in English (or an equivalent in other languages), although in the United States a person enrolled in grades K–12 is often called a student. In its widest use, student is used for anyone who is learning, including mid-career adults who are taking vocational education or returning to university.


University is an institution of higher education and research which grants academic degrees in a variety of subjects and provides both undergraduate education and postgraduate education. The word “university” is derived from the Latinuniversitas magistrorum et scholarium, which roughly means “community of teachers and scholars

Chapter Five

Summary, Conclusion and Recommendations

5.1 Summary

The prevalence of smoking in university students (29.3%) is in accordance with other studies in Nigeria (Adekunle s. et al., 2011). Important factors related to knowledge, attitude and practice of university students towards smoking have been explored. Most of the university students, regardless of their smoking status, have good knowledge about the harmful effects of smoking. However, it showed that smoking students have a lesser extent of that knowledge than non-smoking students. This might be explained by the fact that smokers in part experience self-denial towards such information and/or seriously underestimate the rates of future complications and death associated with smoking as long as they are feeling healthy. Similar results are also found in university students in both developing and developed countries (Wechsler et al., 1998; Ruff et al., 2000; Seguire and Chalmers, 2000).

Most of the students believe that smoking females do not have more friends; a similar result was also found in other studies (Abdullah and Husten, 2004). The rate of smokers who believed that smoking females have more friends was more than that of non-smokers. This may be because smokers tend to gather together. One study (Seguire and Chalmers, 2000) said that smokers are perceived as friendly approachable people who had a common interest.

Some smokers thought that smoking helps them fit in with their peers; this was more pronounced among females. This may be because they feel that they are more accepted as smokers within their friends who are in most cases smokers as well. A study done by Seguire and Chalmers (2000) proposed that this may be due to the feeling of insecurity in social situations, and that one way to get rid of this feeling is to smoke so as to get an immediate connection with the group as everyone is smoking. Gaining peers acceptance and sense of identity can easily be acquired by smoking (Seguire and Chalmers, 2000).

Only 14% of the students believe that a smoking females has a strong personality, so smoking female who think the opposite are mistaken and misguided. It was also revealed that males are more likely to believe that a smoking female has a strong personality. This may be because they might think that she broke social barriers and common expectations by becoming a smoker. It is normal for smokers to support this attitude, because they are supporting themselves. It is worth mentioning, that the community in Nigeria traditionally looks down at the idea of a smoking female. On the other hand, there was no difference among males and females regarding the idea that a smoking male has a strong personality, because there is no social barrier to be broken; it is just accepted for males to smoke.

Prior studies reported that students in general see smokers as being unattractive (Biasco and Hartnett, 2002; Vakeflliu et al., 2002). The same attitude was also proved, since majority of these students do not see smokers, whether being females or males, as being attractive. However, the idea that smoking is attractive was found to be truer for the opposite gender. In other words, it was found out that more males than females see the smoking female as attractive and more females than males see the smoking male as attractive. This factor alone is enough for many students to justify smoking especially in communities where friendship between male and female is very strict and limited.

About half the smokers believe that smoking helps them concentrate while studying. Student’s grades and passing university examinations are some of the most important factors in building their future careers at this stage of a student’s life. In other words, the core of the student’s focus is to succeed and obtain high grades. They may take the risk of smoking for the sake of concentrating while studying. This negative attitude might be the most important factor to be considered in any smoking control program for university students. This wrong attitude and belief is contrary to the scientific fact that some of the substances included in cigarettes cause confusion and cognitive modifications (Lecacheux et al., 2009). In addition and in other studies, they found that smoking affects cognitive function and reduces mental performance in the long run, also the first direct biological evidence that smoking destroys brain cells has been proven (Richards et al., 2003). When the student smokes a cigarette, he will not be distracted by thinking of the next one, so a part of this belief may be psychological. Therefore, correcting this wrong attitude of “smoking helps me concentrate while studying” should be highly concentrated on in any smoking control program.

Smokers recorded the highest percentages in regards to the belief that smoking helps in avoiding obesity as compared to non-smokers. The relationship between smoking and body weight is complicated. Some studies revealed that smoking might cause irregularities in nutrient intake due to the enzymatic effects of smoking. Another suggestion was that smoking changes the taste in a smoker’s mouth, which in turn leads to difference in dietary intake (Dallongeville et al., 1998). One might ask, is smoking the right way to control obesity?

Smokers showed a negative attitude toward applying university laws that would ban smoking because they do not want to be restricted. On the other hand, non-smokers showed a positive attitude toward such laws. This is most likely because non-smokers are annoyed by the smell of burning cigarettes and smoke and/or they do not want to be exposed to the effects of second hand smoke. Prior studies found that although students view smoking as harmful, they do not want more restrictions Sharif et al. 35 by law (Biasco and Hartnett, 2002).

It was found out that the number of cigarettes smoked per day is associated with the time the student first started smoking. The students who start to smoke before enrollment in a university usually smoke more cigarettes than those who start after being enrolled. This can be explained by the fact that smokers are becoming more addicted to nicotine.

5.2 Conclusion

Despite the health impact of tobacco use, strong action to control smoking such as higher taxes, comprehensive bans on advertising and promotion, or restrictions on smoking in public places done by the Nigerian government,12 the number of cigarette smokers is still high, especially in academic settings. The findings in this study also raise a number of interesting issues about the extent to which students have knowledge about smoking and its effect on health, and present potential areas to institute smoking cessation interventions.

5.3 Recommendations

  1. The University authority has to develop interventions which directly target the smoking staff members. For example, there should be a structured support programme for those who are willing to stop smoking but are failing, and a health education programme which is needs-based should be developed, as some of the programmes are very generic.
  2. The University authority may even develop or reinforce its smoking policy as a way of controlling smoking practices within the University premises.
  3. Health education talk about smoking should be encouraged in university campus.
  4. Existing ban of smoking should be monitored and supervised in the campus to gain effective tobacco control. Perception would be change by health education methods using individual interview, group discussion and form anti-smoking campaign at University.
  5. To build network between Governmental Organization and Non-Governmental Organization to struggle against danger of smoking.
  6. To increase price of tobacco products, especially taxation.
  7. To conduct regular surveillance to monitor the effectiveness of tobacco control and prevention programs, campaigns, and policies.

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