Fariz

School Effort to Reduce Number of High School Aged Smokers

Chronic non-communicable diseases slowly becoming a more dangerous threat of human health problems compared to communicable diseases. Out of the 56 million global deaths in 2012, as many as 38 million, or 68%, were due to non-communicable diseases (WHO, 2013). The distribution of non-communicable diseases deaths worldwide is highly concentrated on low and middle income countries by around 80% (29 million deaths) (WHO, 2015), and unfortunately Indonesia still presently categorized as lower-middle income country (WHO, 2014).

Non-communicable diseases (abbreviated NCD) –as stated by the name- is a medical condition or disease which defined as non-infectious and non-transmissible between humans. Four main type of NCDs are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes (WHO, 2015). Tobacco smoking proven to be risk factors to all four types of NCDs (Pyrgakis, 2009; Gandini, et al., 2008; Vineis, et al., 2005; Will, et al., 2001) thus concluding that smoking direct or indirectly the main risk factor for human deaths (WHO, 2014). Aside from being the risk factors for non-communicable diseases, there is also unequivocal scientific evidence that tobacco directly causes death, disease, and disability (Hughes, et al., 2011). Due to the danger of tobacco smoking, World Health Organization negotiated a treaty under auspices of WHO on 2003 which deemed effective in 2005 named Framework Convention on Tobacco Control (WHO, 2015). World Health Organization Framework Convention on Tobacco Control (abbreviated WHO FCTC) was developed in response to the outbreak of tobacco epidemic, as evidence based guidance to control the spreading of the outbreak and support the right of people to receive highest standard of health (WHO, 2015).

The overwhelming majority of smokers begin tobacco use before they reach adulthood. Among those young people who smoke, nearly one-quarter smoked their first cigarette before they reached the age of ten (WHO, 2002). WHO identifies age phase before adulthood and after childhood as adolescence (from ages 10 to 19) (WHO, 2015). Indonesia has 12 years education school grades which started from six years old that divided into primary school (age 6-12), middle school (age 12-15), and high school (age 15-18). This concludes Indonesia’s educational grade covers adolescent period. 

Paul Slovic (1998) stated that adolescent tends to see smoking as non-hazardous and/or perceive short term risks of smoking as trivial, and thinks that they can stop smoking by the time they wanted to stop. This clearly stated that most adolescent doesn’t know the level of risk that smoking tobacco holds.

Public Health Department of Gadjah Mada University asks his clinical rotation students to make a project, which helps to address common health problems in Indonesia. The project that I aspire to implement have the sole purpose to decrease the number of smokers of high school students. Because, according to Prabandari, et al., 2004, the prevalence of students in senior high school are 0.3, this means at most 3 from 10 students are smokers started by senior high school.

The program details is as follow:

*picture*

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and can be downloaded as project libre file format below:

*link*

To better implement my project, I've done several researches to several journals. These journal helps the application of the program, by measuring and searching which promotional method best suited for school's smoking cessation class and which policy should be considered in a school to support smoking cessation program. My assessment of these journals, and my comments on whether it's effective or not, it's applicable or not, is posted on my following blogposts.

Journal about smoking cessation class promotion:

1. School-based smoking cessation programs: Do youth smokers want to participate in these programs?
2. Facebook recruitment of young adult smokers for a cessation trial: Methods, metrics, and lessons learned
3. Text Message Delivered Peer Network Counseling for Adolescent Smokers: A Randomized Controlled Trial.The Journal of Primary Prevention.

Journal about smoke free school policy:

1. Changes in teachers' smoking behaviour following enforcement of a total smoke-free school policy
2. School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews