Tobacco Education and the Role of Schools: Have Saudi Arabian Schools Done Their Job - Case Study Example

Running Head: TOBACCO EDUCATION IN SCHOOLS Tobacco education AND the role of schools: Have saudi arabian primary schools done their job? Name: Grade Course: Tutor’s Name: 6th, October, 2009 Abstract: There are no research articles that describe tobacco education efforts in specific countries across the globe. Most of the comprehensive research reports of smoking, tobacco use and tobacco education generally originate from the United States. When a string search for the keywords “tobacco education” and “Saudi Arabia” are submitted to the database, only 12 reports are listed and unfortunately, none of these are about tobacco education. The only reports available on the association of tobacco and Saudi Arabia include that of prevalence among these nationals, as well as gender differences and smoking behaviors (Saeed et al., 1996; Jarallah et al., 1999). There is therefore, a need to perform research regarding tobacco education in Saudi Arabian primary schools. Research Statement Tobacco smoking causes so many illnesses including bronchus, trachea, and lung cancer. It also causes oral cavity, pharynx and lip cancers. Treatment of such diseases requires a lot of money and expensive health care facilities especially cancers. Saudi Arabia is one of the kingdoms that have been adversely affected by tobacco smoking. In 2006, the government threatened to sue the Tobacco industry if it did not voluntarily pay for treating Saudi Arabians with tobacco related illnesses (BBC, 2006). In 2007, around May, news reports revealed that the government had sued the Tobacco industry and was seeking refund for the money ($2.7 billion) spent on treating Saudi Arabians with Tobacco related illnesses (NCASA, 2007). This is a clear indication that the level of Tobacco use in the country is very high. Efforts have been made by different governments to help reduce Tobacco in respective countries leading to the development of the association between Tobacco use and education. With education, several governments belief this problem can be contained. Despite the comprehensive description of this association in other countries such as the United States, Canada, Australia and New Zealand (Thomson et al., 2008; Walker and Darling, 2007), there are only a few reports that exist on this topic in developing and Eastern countries. Saudi Arabia is a country located in the Middle East which is known to engage in tobacco use. Aside from the simple cigarettes, the shahish or water pipe is a popular method of smoking in this country. Based on the cultural tradition of Saudi Arabians to use tobacco regularly, it is thus important to determine whether the younger citizens of this country are aware of the negative effects of tobacco use (Shiva and Padyab, 2008). One of the most effective methods of stimulating awareness is through tobacco education in primary schools. Unfortunately, there are not enough published research reports on tobacco, and more so on tobacco education, in Saudi Arabia. This research will aim to address the issue of tobacco education in Saudi Arabia, with primary focus on the extent of applying this approach in primary schools. In addition, this research would like to determine the influence of tobacco education in these schools. Justification Every body needs good health and one of the ways of achieving good health is through health promotion. A strategy that has been proven to be very effective in promoting health is health education. When people are educated about the effects of tobacco on their health, they will take precautions to ensure they either take very little of the product or eliminate it from their systems completely. According to Saudi Arabian culture, tobacco is part of the people’s life. Eliminating it completely would not be easy for the society. It is only by making them aware of the effects that they can decide on their own how to reduce its consumption. The reason why it is important to establish if there are Tobacco education programs in Saudi Arabian schools is because of the high prevalence of Tobacco smoking (19.1% in adult males, 8.3 in adult females and 20.2 in youth males) (TMA, 2002) and the dangerous effects it has on people’s health. According to the TMA, as at 2001, most youth involved in the use of tobacco and its product were of the age of 13-15 years old and were either in primary schools (class 7and 8) or forms I and II (2002). It is also important to acknowledge the role primary education plays on children and on influencing them about decision making. Kerr noted that children need to be empowered to take more responsibility for their own health (2000). If the children of Saudi Arabia are empowered to take responsibility for their health, chances of reduced Tobacco use or controlled Tobacco use would be very high. Additionally, despite the ban of tobacco smoking in public places, its consumption has not been hindered. It is noted in the Euromonitor International's Market Report that the government of Saudi Arabia imposed a ban in order to reduce cases of tobacco related illnesses but its consumption never went down. Tobacco smoking is still high irrespective of the increase in the number of illnesses related to its smoking in the country (2009). One important thing to consider is the role of health promotion in improving people’s health including prevention of occurrence of so many diseases. This could be a major break through to the government of Saudi Arabia. Research Objectives The following are the proposed research objectives. To find out if there are any kinds of Tobacco education in primary schools To find out the effect of such education in primary schools To determine if the young children of Saudi Arabia know about the negative effects of Tobacco To determine the level of knowledge about Tobacco use To determine the measures the Saudi Arabian government is taking in controlling the high prevalence of Tobacco smoking in Saudi Arabia To find out the effectiveness of such measures Methodology Section Research will be conducted in one of the cities (Ar-Riyād ) of Saudi Arabia as a representative sample involving 50 schools. It is not possible to conduct a research involving all primary schools and all class six to eight primary school teachers in the whole of Saudi Arabian Kingdom. This is the reason why it is important to select a representative region for all the primary schools in Saudi Arabia. It is not evident whether any education has been carried out in any primary school in Saudi Arabia. It is therefore very important to involve so many schools in the study as possible. Both private and public schools will be studied. The study will involve inquiring from the teachers about their special programs or about any involvement in Tobacco education. Information will therefore be obtained through questionnaires. It will also involve inquiring from students about their knowledge on Tobacco use and its effects as well as inquiring about strategies in place by the government to help reduce Tobacco use in the Kingdom. Determination of government strategies will help in making decisions about what recommendations the research should give. The participants of the study will be the class six to class eight teachers from various primary schools and senior teachers of the respective schools. Students of the respective schools of age 13-15 years will also be included in the study when determining the effect of Tobacco education if any. Data will also be collected from the Saudi Arabian ministry of education and reliable secondary sources. This region (Ar-Riyād) is one of the major Saudi Arabian cites and a study on various schools in it would represent so many other schools in different other cities and other regions in Saudi Arabia. Sampling Frame There are so many primary schools in Saudi Arabia and the best method to accomplish the mission of finding out if Tobacco education exists in the Saudi Arabian primary schools’ curriculum and their effects is to select representative samples. A representative sample of the whole region is Ar-Riyād City and the schools within it will act as representative samples for all the primary schools in Saudi Arabia. The schools will be selected through a systematic random sampling by selecting a number to use. A list of all the primary schools within the city will be made available and a random selection of a number done. This number will be used to select representative schools. A total number of 50 primary schools will be selected for the study. This kind of sampling will be done for both private and public schools separately. There will be no sampling of teachers since the ones to be involved in the study are already identified and they will be given questionnaires to complete. Method A cross sectional design will be used for the study. The study will obtain data through interviewing the teachers and filling in already prepared questionnaires designed to answer research questions and by going through the schools’ curriculums. Information from the education ministry will be obtained through two ways, by interviewing one or two of the relevant persons that can give required information and by collecting already laid out ministry of education’s framework/ strategy on how Tobacco smoking is being controlled in the country. Student participants will also be interviewed to determine the effect of Tobacco education in such schools. Based on the kind of information or data required for the study, it is very appropriate to conduct interviews or use questionnaires to obtain the kind of information. Interviewing or questionnaires will give a quicker way of determining if Tobacco education is included in the primary education or not. It is also cheap and the only way to achieve such kid of information. Going through the schools’ curriculum may be time consuming and a difficult way of determining if the schools offer Tobacco education as part of their curriculum, but is a sure way of getting the correct and reliable information. The impact of Tobacco education on the students cannot be obtained from any other source and it is from their teachers and the students that the right data can be obtained. Ethical Issues Tobacco smoking has been proven by scientists as a major cause of several cancerous diseases like the ones mentioned above. The society of Saudi Arabia has so many smokers which is a clear indication that most of them are addicted to the substance. The effect this substance has on the Saudi Arabian government also prompts for more research to be done on how smoking can be controlled. It is not unethical to smoke, but when smoking of Tobacco is done to an extent where the health budget is tampered with to care for those with Tobacco related illnesses, yet it can be controlled, it becomes unethical. Controlling Tobacco use in Saudi Arabia will be beneficial. So many interventions have seen used to control Tobacco use in Saudi Arabia, for example the use of religious leaders and religion to make the citizens believe that smoking is bad. This kind of strategy gives the citizens the idea that they suffer for their sins hence causing regrets during times of sickness. This is unethical. By use of education as an intervention, especially at the primary school levels, the culture of the country is being changed gradually so that when the children become adults, they may not have the same problems of tobacco smoking as the current generation. It is a long term solution. It is not unethical to create awareness about the dangers of a substance to the citizen’s health. Data Analysis Data analysis will have to determine the association between Tobacco education and positive effects variables such as reduced smoking, improved health and so many others. Determination of existence of Tobacco education in primary schools will be based on the response from the teachers and will require non time consuming data analysis. The number of primary schools offering such kind of education however has to be determined. This analysis will require statistical tests such as the Chi2, the Scheffe test, one way Analysis of variance and the student’s test depending on the variables (Novick, 2005). Timeline for the Research This research study requires preparation, which will include obtaining formal letters and permission to conduct research in various schools, and determination of required resources including human resource, the actual study period, data analysis and report writing. All these have to be allocated enough time. Below is a table indicating the average time required to complete the study. Duration Item Preparation 3 weeks Actual Study 2 months Data Analysis 3 weeks Report writing 2 weeks Total 4 months (16 weeks) The Type of Community Participation This research involves finding out the existence of Tobacco education in primary schools’ curriculum and therefore do not require active participation of the community. The type of data required and the method of research does not support the participation of the community as equal partners with the researcher. The community plays the role of providing the information and therefore no involvement in development of research ideas, interests, strategies, analysis or even methodologies (NHMRC, 2002). Provision of information is also not obtained from the whole community but a representative of the community. The communities that will participate in this research are the children of 13-15 years and the teachers. The children represent the whole community’s participation in solving the problem of tobacco smoking through proving answers to the research on the effectiveness of education in controlling Tobacco smoking. When a correct intervention is established, it benefits the whole community yet it is the representation community that participated. The teachers have the same role. They will act as sources of information to the research. The participants however will have to be informed of their role before undertaking their duties in the research project. Importance of the Research Saudi Arabian government has developed various infrastructure for the control of Tobacco use in the country (TMA, 2002) yet the consumption is still high (Euromonitor International's Market Report, 2009). According to Euromonitor International's Market Report, Tobacco consumption in the country still went high irrespective of the bans imposed. A smoking ban was imposed after government officials expressed concern over the growing number of people with Tobacco related illnesses and the much it was costing the Saudi Arabian government in 2004. This strategy is still operational yet it seems as if it is not. Other strategies for example advertisements, restriction of Tobacco sale to minors and restriction of sale by minors among others (TMA, 2002) also seem not to work. Based on the effectiveness of Tobacco education in primary schools in other countries such as Australia and New Zealand, it would be beneficial for the Saudi Arabian government and may also be a long term solution du to provision of knowledge. Since Tobacco has proven to be dangerous in the Saudi Arabian society with the medical bills going high on people with Tobacco smoking related diseases, it would be beneficial to find an appropriate strategy to deal with the long term problem. People’s health cannot improve by imposing smoking bans alone. A long term strategy is necessary. Health promotion has proven effective in improving people’s health in so many countries irrespective of the diseases. Health promotion can also help Saudi Arabia. Educating the young could develop a different culture hence reducing Tobacco related illnesses. Reference List BBC. News. (29 November 2006). Saudi Warning Over Tobacco Firms Cigarette. Retrieved on 4th, Oct, 2009 from: http://news.bbc.co.uk/2/hi/business/6194972.stm. Euromonitor International's Market Report. (2009). Tobacco Industry Report: Tobacco in Saudi Arabia. Jarallah, J.S., Al-Rubeaan, K.A., Al-Nuaim, A.R.A., Al-Ruhaily, A.A. and Kalantan, K.A. (1999). Prevalence and determinants of smoking in three regions of Saudi Arabia. Tobacco Control, 8, 53–56. Kerr, J. (2000). Community Health Promotion: Challenges for Practice. 26th Ed. New York, USA: Elsevier Health Sciences. National Center for Addiction and Substance Abuse (NCASA).(2007). Saudi Arabia Sues Tobacco Industry for Billions in Health Costs. Retrieved on 5th, Oct, 2009 from: http://www.jointogether.org/news/headlines/inthenews/2007/saudi-arabia-sues-tobacco.html. NHMRC. (2002). Summary Statement on Consumer and Community Participation in Health and Medical Research. Commonwealth of Australia. Retrieved on 5th, Oct, 2009 from: http://www.nhmrc.gov.au/publications/synopses/_files/r23.pdf. Novick, L. F. (2005). Public health administration: principles for population-based management. Sudbury, MA: Jones & Bartlett Publishers. Saeed, A.A.W., Khoja, T.A. and Khan, S.B. (1996). Smoking Behavior and Attitudes among Adult Saudi Nationals in Riyadh City, Saudi Arabia. Tobacco Control, 5, 215-219. Shiva, F. and Padyab, M. (2008). Smoking Practices and Risk Awareness in Parents Regarding Passive Smoke Exposure of their Preschool Children: A cross-sectional study in Tehran. Indian Journal of Medical Science, 62, 228-235. TMA. (2002). Tobacco Control in Saudi Arabia. Retrieved on 5th, Oct, 2009 from: http://docs.google.com/gview?a=v&q=cache:Smx_pWTy0I4J:www.who.int/tobacco/media/en/Saudi_Arabia.pdf+Tobaco+in+Saudi+Arabia&hl=en&gl=ke&sig=AFQjCNEVTuM5HSTIl9dfAGqM98wLP6R6Zg---justification 2 Thomson, G., Hoek, J., Edwards, R. and Gifford, H. (2008). Evidence and arguments on Tobacco Retail Displays: Marketing an Addictive Drug to Children? The New Zealand Medical Journal, 121, 87-98. Walker, J. and Darling, H. (2007). Tobacco education: Have New Zealand Primary Schools done their Homework? Australian and New Zealand Journal of Public Health, 31, 23-25. Read More