The document describes a study that aims to evaluate the effectiveness of a structured teaching program on knowledge of nicotine consumption and prevention among pre-university students in Bengaluru, India. The study will use a pre-experimental pre-test post-test design with 60 students. The structured teaching program will be delivered and knowledge assessed using a questionnaire before and after the intervention. The study aims to increase knowledge and identify factors associated with baseline knowledge. Findings could help design interventions to educate youth on risks of nicotine use.

1. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BENGALURU, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
''A STUDY TO EVALUATE THE EFFECTIVENESS OF
STRUCTURED TEACHING PROGRAM ON KNOWLEDGE
REGARDING NICOTINE CONSUMPTION AND ITS
PREVENTION, AMONG STUDENTS AT SELECTED PRE
UNIVERSITY COLLEGES , BENGALURU''
Mr.SHASHIKANTHRADDY.PATIL
1ST
YEAR M.Sc. NURSING
MEDICAL SURGICAL NURSING
BRITE COLLEGE OF NURSING
CHIKKARGOLLARHATTI, BENGALURU-560091

2. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BENGALURU, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF
SUBJECTS FOR DISSERTATION
1. Name of the candidate and
address
Mr. SHASHIKANTHRADDY.PATIL
1ST
YEAR M.Sc. NURSING,
BRITE COLLEGE OF NURSING,
BENGALURU-91
2. Name of the Constitution BRITE COLLEGE OF NURSING,
CHIKKARGOLLARHATTI,
BENGALURU-91
3. Course of study and subject 1ST
YEAR M.Sc. NURSING
MEDICAL SURGICAL NURSING
4.
Date of admission to course
30/06/2012
5. Title of the topic “A STUDY TO EVALUATE THE
EFFECTIVENESS OFSTRUCTURED
TEACHING PROGRAM ON
KNOWLEDGE REGARDING NICOTINE
CONSUMPTION AND ITS
PREVENTION, AMONG STUDENTS AT
SELECTED PRE UNIVERSITY
COLLEGES, BENGALURU”.

3. 6. Brief resume of the intended work.
INTRODUCTION
Prevention is better than cure.
K .Park
Nicotine is an alkaloid which is named after the tobacco plant ''Nicotiana
tabacum'' found in the family of plants which constitutes approximately 0.6–3.0% of
dry weight of tobacco. In low concentrations an average cigarette yields about 1 mg of
absorbed nicotine), the substance acts as a stimulant in mammals and is the main factor
responsible for the dependence-forming properties of tobacco smoking. German
chemists Posselt & Reimann, who considered it a poison.
According to the American
Heart Association, the "nicotine addiction has historically been one of the hardest
addictions to break." 1
There are various forms in the consumption of nicotine and one of the
reasons tobacco became so popular in the 1600s, along with tea & coffee, was that
nicotine is a powerful stimulant the infamous deadliness of smoking would seem to be
almost solely from the smoke, not the nicotine. All of the harm seems to stem from
tobacco, and tobacco smoking in particular. The amount of nicotine absorbed by the
body from smoking depends on many factors, including the types of tobacco, whether
the smoke is inhaled, and whether a filter is used. For chewing tobacco, dipping
tobacco, snus and snuff, which are held in the mouth between the lip and gum, or taken
in the nose, the amount released into the body tends to be much greater than smoked
tobacco. Nicotine content in cigarettes has slowly increased over the years, and one
study found that there was an average increase of 1.6% per year between the years of
2005 and 2012.2
Nicotine produces numerous effects on the individuals. It produces both
physical symptoms involving almost all the systems of our body and psychological
symptoms; most predominantly including psychological withdrawal symptoms which
includes intense craving for nicotine containing drugs, food, anxiety, short temper,
depression, head ache, irritability, drowziness and sleeplessness.3
Some of journals pediatric psychology have given some of the terrifying report
that there is an significant increase in the nicotine consumption rate among adolescent.
There were multivariate causes have been implicated to explain the causation of
nicotine consumption like peer group influences, familial influences, stress, academic
pressure, influences from the media etc.4

4. Prevention of nicotine consumption is one of the major public priority. There
are several strategies both at hospital and at community level for treating nicotine
withdrawal. Nicotine supplementation in the form of gum or patch can be helpful. A
variety of other agents have also been used with some success in maintaining
abstinence and reducing withdrawal symptoms. These agents include clonidine,
antidepressants such as fluoxetine, and buspirone. Bupropion was approved in 1996 by
the Food and Drug Administration as a treatment for nicotine dependence screening for
depression may also be helpful to ensure proper treatment and increase the odds of
maintaining abstinence. There are so many counselling de-addiction centers, hypnosis
smoking cession programme and psychotherapies have been propped up in order to
treat withdrawal state. People trying to quit smoking often become discouraged when
they don't succeed at first. Research shows that the more times you try, the more likely
you are to succeed - so don't give
6.1 Need for study
Teenagers abuse a variety of drugs, legal and illegal which includes ,Alcohol,
Tobacco, Prescribed medications, various Inhalants, Stimulants, Depressants, Steroids,
etc.. The World Bank has reported that nearly 82,000–99,000 children and adolescents
all over the world begin smoking every day.[6]
Tobacco is used in a wide variety of ways in India including smoking and
smokeless use. Tobacco is smoked in the forms of beedis and cigarettes or by using
devices like hooka, hookli, chhutta, dhumti, or chillum . Smoking of cigars and pipes
are not common in India, as they are in most western countries. Tobacco is used in a
number of smokeless forms in India, which include betel quid chewing, mishri, khaini,
gutka, snuff, and as an ingredient of pan masala.[7]
Adolescence is a time for trying new things. Teens use drugs for many reasons,
including curiosity, because it feels good, to reduce stress, to feel grown up or to fit in.
It is difficult to know which teens will experiment and stop and which will develop
serious problems. Teenagers at risk for developing drug addiction include those,with a
family history of substance abuse,who are depressed, who have low self-esteem, who
feel like they don’t fit in or are out of the mainstream.[6]
India is the third largest producer and consumer of tobacco in the world. The
country has a long history of tobacco use. Tobacco is used in a variety of ways in India;

5. its use has unfortunately been well recognized among the adolescents . Tobacco
addiction of a large number of adults has been initiated during the adolescence[7]
Facts on nicotine are undisputed proven truths about the drug nicotine. Nicotine
is a substance similar to heroin and cocaine in terms of its ability and power to cause
dependency in the user. It is found in several plant leaves. It is harvested on a mass
scale for commercial purposes like tobacco cigarettes from dried tobacco plants.[8]
Many diseases are linked to tobacco and nicotine: cardiovascular disease,
stroke, lung cancer, cancer of the kidney, cancer of the larynx and neck, mouth cancer
and breast cancer.On average, smokers die 13 to 14 years earlier than non-
smokers.Approximately 70% of smokers want to quit. About 40% try to quit every
year.Of those who try to quit, about 7% stay off nicotine for more than a year. The vast
majority do not make it even a week without cigarettes.The highest rate of smoking is
found in the Native American ethnic group at 36.4% and the lowest in the Asian
community (9.6%).About one in five high school students smoke, although this number
is falling.About half of those who start smoking as an adolescent will continue to
smoke for the next 15 to 20 years.The cigarette industry spends about 34 million dollars
a day on advertising and promotion.[9]
Nicotine is thousand times more potent than alcohol and 5-10 times more
powerful than cocaine or morphine. It is one of the most addictive of all drugs. One
may become an addict after enjoying only one pack of cigarettes or after smoking just
5-6 cigarettes. It acts as a stimulant and it plays the role of a tranquilizer too. It inhibits
the release of insulin from the pancreas which results in high blood sugar leading to
loss of appetite. Nicotine is responsible for release of adrenaline, the 'fight or flight'
hormone which leads to rapid, shallow breathing and racing heartbeats. Adrenaline also
plays an important role in instructing the body to dump excess glucose into the
bloodstream[9]
.
At this stage, it becomes difficult to quit smoking, even though the person wants
to. This type of addiction needs to be treated with nicotine replacement therapy (proper
use of nicotine supplements that are available in the form of gum, nasal sprays, inhalers
and skin patch) and non-nicotine / smoking cessation medication. Use of nicotine gum
is an effective method to quit smoking, but one should know about the side effects of
the gum,beforeuse.[10]

6. The various therapies that are used for the prevention of addiction that includes
behavioral therapy,nicotine relacement therapy,nicotine chewingum therapy are widely
used now a days. It is the need of hour to educate and prevent the young generation
from getting addicted to nicotine.
In reference to the above mentioned literature, the investigator realized that the
severity of impact of nicotine among young children is drastic. Based on this, the
investigator felt the need to explore the nicotine hazards and its prevention on high
school children and educate them.
6.2 Review of literature.
In the study the review various literatures was organized and presented under
the following headings.
1. Literature related to the knowledge regarding prevalace of nicotine use.
2. Literature related to nicotine consumption.
3. Literature related to the prevention of nicotine consumption
1.Literature related to the knowledge regarding prevalace of nicotine use.
A cross sectional survey was conducted to estimate the prevalence and
determinance of tobacco use and nicotine dependency. Samples of 18018 individuals in
the age group of greater than 16 years was selected in the union territory of Andaman
and Nicobar Island. Data was collected using a structured questionnaire method.
Results revealed that tobacco chewing alone was prevalent in population where 10% of
males were nicotine dependent and females were only 3%. In the conclusion of the
study the high prevalence of tobacco use especially the chewing form are high [11]
A study was conducted to identify the breaking of smoking habit with nicotine
chewing gum in health personnel. Among 221 health professionals which includes 71%
physicians & nurses, 29% from the other professionals without sanitary responsibility.
The programme combines group therapy, nicotine chewing gum and behavioral
assistance through the evaluation of carbon monoxide contained in expired breath.
Results revealed that 30% were not smoking after one year of follow up. Study
concluded that nicotine chewing gum and behavioral assistance were effective.[12]
2.Literature related to nicotine consumption
A study was conducted to evaluate the level of physical activity in pre university
students and to investigate its potential association with smoking. Sample comprises of
871 students from Gurupi, Central West Brazil. Inferential statistics were used for

7. analysis which revealed that prevalence of physical activity was 29.9% and smoking of
72%. Study concluded that physical inactivity was seen more in smokers than non
smokers.[12]
A pre experimental design study was conducted to analyze the underlying
factors related to smoking and cessation compliance in patients following coronary
artery bypass graft. Pre experimental research design was used. Results revealed that
there is a good cognition in non smokers than smokers and relationship between
smoking and ischemic heart disease (61.7%) Vs 40.3% and relation between smoking
and COPD was 80.6% Vs 60.5%. Study concluded that cognition on relationship
between smoking and coronary artery disease should be improved in patients going
CABG.[13]
A study was conducted to find out the role of pan masala chewing induce
deterioration in oral health and its implications in carcinogenesis based on experiment
as well as clinical studies. It was found that pan masala is at high risk in causing
various oral diseases, oral submucosis fibrosis and leucoplakia which leads to cancer.
This study concluded that it is needed more research to find out early population which
could be reversed. [14]
3.Literature related to the prevention of nicotine consumption
An international peer-review journal for health professionals and in tobacco
control, The study was conducted on interventions for tobacco use prevention in
indigenous youth Among young indigenous population of Australia who has reached
the age of 18 as nonsmokers then unlikely to become smokers thereafter. Quantitative
narrative synthesis approach was used and results revealed that a significant health
disparity exists in indigenous population having the burden of smoking related
morbidity and mortality. The interventions that were implemented for the prevention
was having less significance. Study concluded that indigenous youth is twice
prevalence when we compare non- indigenous population.[15]
A study was conducted to identify the effectiveness of a motivational
interviewing smoking cessation program on cessation changes in adolescents. Samples
were 39 pre university students from G city Korea. The students were assigned to
experimental group and participated in motivational interviewing cessation programme
and in control group who did not participate. Results revealed that experimental group
had significantly less daily smoking, nicotine dependence smoking temptation in

8. comparisons to control group. Study concluded that the motivational interviewing
cessational programme delivered to adolescent can be utilized as an effective nursing
intervention for adolescents who smoke.[16]
A study was conducted to analyze the public attitudes regarding the banning of
cigarettes and regulation of nicotine by Food and Drug Administration in US adult
population. It was revealed that 43% supports for the banning of cigarettes’ where 65%
for reducing nicotine. The study recommended removing all addictive cigarettes from
market place. [17]
PROBLEM STATEMENT
“A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED
TEACHING PROGRAM ON KNOWLEDGE REGARDING NICOTINE
CONSUMPTION AND ITS PREVENTION, AMONG STUDENTS AT SELECTED
PRE UNIIVERSITY COLLEGES , BENGALURU”.
6.3 Objectives
1. To assess the existing knowledge of pre university students regarding nicotine
consumption and its prevention,
2.To evaluate the effectiveness of structured teaching program regarding nicotine
consumption and its prevention, among pre university students at selected colleges
Bengaluru”.
3. To find association between pre test knowledge scores of pre university students
regarding nicotine consumption & its preventions and selected demographic variables.
6.3. 1 Hypotheses
H1:There will be statistically significant difference between mean pre – test and post –
test knowledge scores regarding nicotine consumption and its prevention among pre
university students in seleted colleges
H2:There will be significant association between pre – test knowledge scores and
demographic variables of pre university students in selected colleges.
6.3.2 Variables
• Independent variable: Structured Teaching Program.
• Dependent variable: Knowledge regarding nicotine consumption and its
prevention .

9. • Demographicvariable:age, gender, class, socio-economic status ,area of
residence, history of nicotine consumption in family, source of information.
6.4Operational definition
a)Effectiveness: In this study effectiveness refers to desired significant gain in
knowledge scores of students after structured teaching program as measured by
structured questionnaire.
b)Structured Teaching Program: In this study, it refers to the systematically
organized teaching learning process prepared on nicotine consumption and its
prevention for pre university students developed by researcher and validated by
experts.
c)Knowledge: It refers to the correct responses of students to structured
questionnaire regarding knowledge regarding nicotine consumption and its prevention.
d)Nicotine consumption:In this study it refers to the act of ingestion or inhalation of
highly addictive compound present in tobacco by pre university students.
e)Prevention: In this study it refers to act of staying away from the addictive
substances.
f)Pre University students: In this study refers to students who are in the age group of
15 to17 and studying in selected P U colleges Bengaluru.
6.6 Delimitation
Study is limited to pre university students studying at selected collegesBengaluru.
7. Material and method:
7.1 Sources Of Data : Pre university students at selected colleges,
Bengaluru.
7.2 method of data collection:
7.2.1 Research Approach : Evaluative approach
7.2.2 Research design : Pre experimental one group pre-test post-test design
7.2.3 Setting : Selected PU colleges, Bengaluru.
7.2.4 Sample size : 60 college students.
7.2.5 criteria for data collection
7.2.5.1 Inclusion criteria:
• College Students who are available during the period of collection data.

10. • College students between 15-17 years of age.
• College Students who are able to read and write English.
7.2.5.2 Exclusion criteria:
• College Students who are sick at the time of study.
• College Students who are not willing to participate in the study.
7.2.6 Sampling technique: Non – Probability convenience Sampling Technique.
7.2.7 Tool of research:
Structured questionnaire will be constructed in two parts:
• Part I - Demographic data
• Part II- Knowledge based structured questionnaire regarding nicotine
consumption and its prevention .
7.2.8 Collection of data
• The formal permission will be obtained from the colleges.
• Informed consent will be taken from students.
• The investigator collects data from students using stuctured questionnaire
followed by Structured Teaching Program for experimental group.
• Post test will be conducted after 7 days for both the groups.
7.2.9 Duration of collection of data : 30 days.
7.2.10 METHOD OF DATAANALYSIS AND PRESENTATION:
The data obtained from the sample will be organized and analysed with the use of both
descriptive and inferential statistics.
a) statistics Descriptive
1) Frequency and percentage distribution will be used to describe the demographic
variable of college students
2) Mean, median, mean percentage, range and standard deviation will be used to
describe the knowledge regarding nicotine consumption and its prevention
b) Inferential statistics

11. 1) Paired ‘t’ test will be used to evaluate the effectiveness of structured teaching
program regarding nicotine consumption and its prevention.
2) Chi square test will be used to find the association between knowledge regarding
nicotine consumption & its prevention and selected demographic variables
The analysed data will be presented in the form of tables, diagrams and graphs
based on findings
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION
TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN BEINGS OR
ANIMALS? IF SO, DESCRIBE BRIEFLY.
YES, the study includes an intervention in the form of structured teaching program.
However, there will be no other invasive or non invasive investigation on participants
in the study.
7.4 HAS ETHICAL CLEARANCE HAS BEEN OBTAINED FROM YOUR
INSTITUTION?
 Yes, consent will be obtained from concerned subjects and authority of the
institution.
 Privacy, Confidentiality and Anonymity will be garded.
 Scientific objectivity of the study will be maintained with honesty and
impartiality

12. 8.LIST OF REFERENCES.
1) News medical: general health care [serial online]. 2012 Dec [cited on 2012 Dec
24] Available from: URL:http://www.news medical.net.
2) Home site me:the benefit and lack of demerits of nicotine [serial online]. 09
May 2011[cited on 2012 Dec 24].Available from: URL:http:// www.gwern.net.
3) Wikipedia, the free encyclopedia. [serial online] [cited on2012 Dec 22].
Available from: URL:http://en.wikipedia.org/wiki/nicotine.
4) Deinise Knadel. Journal of paediatric psychology :measurement of nicotine
dependence among adolescent [serial online] June 2005[cited on 2012 Dec 24]
Available from: Available from: URL:http://www.journal of paed psych.net.
5) Nicotine withdrawal symptoms and recovery: nicotine is a very powerful drug.
[serial online]2012 Nov 12[cited on2012 Dec 22]. Available from:
URL:http://quitsmokingsupport.com.
6) Effectiveness of motivational interviewing smoking cessation program on
cessation change in adolescents[internet]. 2012 Feb[cited on 2011 nov22]
Available from: http://www.ncbi.nlm.nih.gov.
7) Brinn MP. Labiszewski NA. Interventions for tobacco use prevention in
Indigenous youth[internet]. 2012 Aug[cited on 2011 nov22] Available from
http://www.ncbi.nlm.nih.gov
8) Cahill K. Hatsukami DNicotine vaccines for smoking cessation
[internet]2002[cited on 2011 nov22]Availablefromhttp://www.ncbi.nlm.nih.gov
9) Kumar S Panmasala chewing induces deterioration in oral health and its
implications in carcinogenesis.[internet] 2008 Jan[cited on 2011 nov22]
Available from http://www.ncbi.nlm.nih.gov.
10) survey of influencing factors on smoking and cessation complianceinpatients aft
er coronary artery bypass graft surgery[internet] 2011 Feb[cited on 2011 nov22]
Available from http://www.ncbi.nlm.nih.gov.
11) Estopá R. González JA multicenter study of the breaking of the smoking habit
with nicotine chewing gum in health personnel [internet]1991 Oct 26[cited on
2011 nov 22] Available from http://www.ncbi.nlm.nih.gov.
12) Physical activity and smoking in undergraduate students.[internet]2008
aug[cited on 2011 nov22] Available from http://www.ncbi.nlm.nih.gov.

13. 13) Samir Chaukar. Addiction and Teenagers.[internet]2007 oct[cited on2011
nov22] Available from http://hpathy.com/homeopathy-papers/addiction-and-
teenagers.
14) SN Sengupta. Tobacco use by Indian adolescents[internet].2002 june [cited on
2011 nov 22]. Available from http://www.ncbi.nlm.nih.gov/pmc/articles.
15) An international peer-review journal for health professionals and in tobacco
control. Tobacco. Control nov 2012[cited 0n 2011 no 22] .Available from
http://tobaccocontrol.bmj.com.
16) An international peer-review journal for health professionals and in tobacco
control. Tobacco. Control nov 2012[cited 0n 2011 no 22] .Available from
http://tobaccocontrol.bmj.com.
17) Public attitudes regarding banning of cigarettes and regulationof nicotine. 2012
Apr cited 0n 2011 no 22] .Available from: http://tobaccocontrol.bmj.com.
9. Signature of the candidate
10.
Remarks of the guide
The study is feasible and of genuine interest of
the student.

14. 11. Name and designation of
11.1. Guide MRS.VIJI.C.
Asst.Professor.
HOD, Medical surgical nursing
Brite College Of Nursing
Bengalaru-60.
11.2. Signature
11.3. Co-guide Mrs.Rajashree.S.S
Lecturer
Brite College Of Nursing
Bengalaru-60.
11.4. Signature
11.5. Head of the department MRS. VIJI.C.
Asst. Professor,
HOD, medical surgical nursing
Brite College Of Nursing
Bengalaru-60.
11.6. Signature
12 12.1. Remarks of the principal The topic for the study is relevant and
forwarded for needful action.
12.2. Name & Signature PROF.H.H. DASEGOWDA.SS