CHAPTER II

REVIEW RELATED LITERATURE

Smoking is a major public health issue that affects individuals of all ages, with

the most significant consequences seen in chronic tobacco users. However, increasing

evidence suggests that early initiation of smoking, particularly during adolescence,

can have long-lasting effects on physical, psychological, and social health. Among

school-age populations, junior students (typically aged 12 to 16) are particularly

vulnerable to the influence of smoking. Despite widespread knowledge of the harmful

effects of smoking, studies show that adolescents continue to experiment with

tobacco, often underestimating the potential for addiction and long-term health

consequences.

The adolescent years are a critical period for physical and cognitive

development, and smoking during this time can have immediate and long-term

consequences. Nicotine, the addictive substance in cigarettes, can interfere with brain

development, impairing attention, memory, and learning capacity. Additionally,

smoking at a young age increases the likelihood of developing respiratory problems,

including chronic bronchitis, asthma, and reduced lung function, which can persist

into adulthood. According to the Centers for Disease Control and Prevention (CDC),

individuals who begin smoking at a young age are more likely to develop chronic

diseases such as heart disease, stroke, and lung cancer later in life.

Social factors play a significant role in the decision of junior students to start

smoking. Peer pressure, family smoking habits, and exposure to smoking in the media

can normalize tobacco use, making it appear socially acceptable and desirable. For
many adolescents, the desire to fit in or to rebel against authority can outweigh their

understanding of the potential health risks. Moreover, smoking is often seen as a way

to cope with stress, anxiety, or social pressures, which can further entrench the habit.

The impact of smoking on junior students is not limited to physical health; it

also affects their academic performance, mental well-being, and overall quality of life.

Studies have shown that students who smoke are more likely to experience lower

academic achievement, absenteeism, and poor concentration in class. Additionally,

smoking has been linked to increased rates of depression, anxiety, and other mental

health issues among adolescents, creating a cycle where smoking is both a cause and a

consequence of emotional distress.

In response to the growing concern about adolescent smoking, various public

health campaigns and school-based prevention programs have been implemented.

These initiatives aim to educate young people about the risks of smoking and provide

strategies to resist peer pressure. Despite these efforts, smoking rates among junior

students remain a significant concern, highlighting the need for more effective

prevention and intervention strategies.

This study aims to examine the impact of smoking on junior students, focusing

on the health, social, and academic consequences of tobacco use in this age group.

Additionally, the study will explore the factors influencing smoking initiation, the role

of peer and family influence, and the effectiveness of current smoking prevention

programs in schools. By understanding the specific challenges and risks faced by

junior students, the study seeks to inform more targeted interventions and policies to

reduce smoking rates and promote healthier lifestyles among adolescents.

Most of the risk of dying prematurely due to smoking is reversed if people quit

smoking before the age of 30. However smoking during childhood and adolescence is

associated with a range of immediate health problems, as well as laying the

foundation for the development of serious disease in adulthood.

Tobacco use contributes substantially to the burden of disease in young people

in Australia. For men aged 25–44 years, 3.4% of their burden of disease was

attributed to tobacco use in 2015. Tobacco use was the 7 the most common

modifiable risk factor contributing to burden of disease for these men in the 2015

Australian Burden of Disease study. For women in this age group, tobacco use

contributed to 2.8% of their burden of disease, as the 6 the most common modifiable

risk factor. In people aged 30–39 years, the bulk of the burden of disease caused by

tobacco use falls into 3 categories: respiratory diseases, cardiovascular diseases and

musculoskeletal diseases. For people aged 40-49 years, cancer also becomes an

important contributor.

Much of the research regarding the health effects of active smoking for young

people comes from cross-sectional studies. These studies show that young people who

smoke have a higher chance of numerous conditions such as cardiovascular diseases,

asthma and dental health issues. Cross-sectional studies, however, do not provide

strong evidence that smoking is a cause of these conditions. It’s possible that young

people with poorer health are more likely to choose to smoke, or that they are more

likely to be smokers for other reasons associated with their poorer health, such as

lower socioeconomic status. Although cross-sectional studies are included in this

section, emphasis is placed on studies using multivariate analysis, longitudinal studies

strengthen the evidence of smoking as a cause of disease and poor general health in

young people.

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for-younger-smokers

General health of young people who smoke

Young smokers, including school students, are more likely to report suffering

an overall diminished level of health compared with non-smokers. Recurrent

headache has been associated with current smoking (daily and occasional) in

Norwegian students aged 13–18 years, while among US students (grades 6 to 10),

daily and experimental smokers were more likely than never smokers to report

recurrent subjective health complaints such as headache and backache. Among a

cohort of young US Navy recruits (average age 19.7 years at baseline), cigarette

smoking was a prospective predictor of hospitalization.

Data from more than 5,000 young healthy female recruits from entry into the

Navy, and up to 7–8 years of service, indicated that daily smokers had higher rates of

musculoskeletal conditions as well as higher rates of hospitalization for any

reason. Daily smokers were also hospitalized for a significantly longer compared with

never smokers and other smokers (including experimental, occasional and former

smokers).

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for-younger-smokers

Health Risks Associated with Student Smoking

body and leading to numerous diseases. Long-term health problems include an

increased risk of stroke and brain damage. Studies have shown that a significant

proportion of students who smoke experience negative health impacts, with a majority

reporting adverse effects. Additionally, smoking among students is associated with

other risky behaviors such as high-risk alcohol use, risky driving, relational abuse,

and depression.

Academic Performance and Smoking

Smoking has been found to negatively impact students' academic performance.

Research conducted in rural China indicates that smoking one cigarette per day during

adolescence can lower students' scores on mathematics tests by about 0.08

standard deviations. This reduction in academic performance can be attributed to the

biological effects of smoking, which may reduce learning productivity and lower

motivation to attend school where smoking is prohibited.

Peer Pressure and Smoking Prevalence

Peer pressure is a significant factor contributing to smoking among students. A

systematic review and meta-analysis in Ethiopia revealed that students who

experience peer pressure are more likely to smoke, with an odds ratio of 2.683. The

prevalence of smoking is higher among university students compared to high school

students, indicating that peer influence may intensify with age 3. Furthermore,

students who perceive higher smoking rates among their peers or school staff are

more likely to start smoking themselves.

School Environment and Smoking Behavior

Interventions targeting the socio-environmental setting at vocational schools have

shown positive effects on school connectedness and in preventing occasional smokers

from becoming daily smokers. However, the overall impact on daily smoking rates

was not significant. Additionally, schools with strict smoking bans and evidence-

based prevention activities have lower smoking prevalence among students. The

behavior of role models, such as teachers and school staff, also significantly impacts

students' smoking habits.

Mental Health and Quality of Life

Smoking is associated with poorer health-related quality of life (HRQoL) among

students, with higher levels of depressive symptoms mediating this relationship.

Students who smoke are more likely to experience depression, which in turn affects

their mental and physical health scores. This highlights the need for integrated

interventions that address both smoking cessation and mental health support.

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Smoking has negative effects on a person health as well as their financial

security, personal life, and well-being of others around them .Almost all of the body

organs and causes sickness and impairment at least 30 person suffer from a major

smoking related illness for every smokers who passes away. Smoking also raises the

risk of developing cancer, heart disease, strike king conditions diabetes (CDC 2014).

The impact of smoking not only immediately affects a young person’s health,

but their future too young smokers are more likely to develop severe levels of nicotine

addiction compared to adults, which leads to continued tobacco use as they grow
older nicotinenarrows blood vessels increases blood pressure and puts added strain on

the heart this means shortness of breath asthma and respiratory illnesses not to

mention centre and other chronic diseases .Aside from health effects, there are also

many adverse social effects of smoking ,it can make hair and clothes stink, stain teeth

and cause bad breath ,and smokers tobacco can lead to cracked lips, sores, and

bleeding in the mouth. Tobacco (2022)

The relationship between cigarette smoking and academic performance

achievement was investigated. It was found that non-smokers received the best

grades. However, there isn’t much evidence linking smoking to failing grades. Our

findings imply that law academic achievers may be more susceptible to smoking, but

that smoking is not main factor influencing academic success. Since there are many

other factors that influence the relationship between academic achievement and

smoking. It is not surprising that smoking behaviour was a little less severe among

students with lower academic achievement. There has to be more research done to

determine the exact causes of a lower educational level. (Mohamed Yaser Kharma

et.al. 2016)

Smoking remains a significant public health concern worldwide, particularly among

adolescents. Grade 10 students, often in the critical stages of physical development,

are especially vulnerable to the adverse health effects of smoking. This review

explores the existing literature on the physical health consequences of smoking

among adolescents, with a focus on respiratory, cardiovascular, and overall well-

being.

Adolescent Smoking Trends

individuals who start smoking at a younger age are more likely to develop long-term

health complications (World Health Organization [WHO], 2022). The accessibility of

cigarettes and peer pressure are among the leading factors contributing to smoking

prevalence among Grade 10 students (CDC, 2021).

Respiratory Health Effects

Smoking adversely impacts the respiratory system, leading to reduced lung function

and chronic respiratory illnesses. According to a study by Dube et al. (2020),

adolescent smokers exhibited a 15% reduction in lung capacity compared to non-

smokers. Chronic exposure to tobacco smoke increases the risk of bronchitis, asthma,

and other pulmonary diseases (U.S. Department of Health and Human Services

[HHS], 2016).

Cardiovascular Health Impacts

The cardiovascular system is also severely affected by smoking. Research indicates

that nicotine exposure during adolescence can lead to increased blood pressure and

arterial stiffness (Lee & Chen, 2019). These effects, when combined with continued

smoking, elevate the risk of heart disease in adulthood.

Overall Physical Development

The physical development of adolescents is often hindered by smoking. Nutrient

absorption and oxygen delivery, crucial for growth, are compromised due to the

effects of nicotine and carbon monoxide in cigarettes (DiFranza et al., 2017). This can

result in stunted growth and weakened physical endurance.

While the immediate effects of smoking are concerning, the long-term implications

are even more alarming. Adolescents who smoke are more likely to develop chronic

diseases such as lung cancer, chronic obstructive pulmonary disease (COPD), and

cardiovascular conditions later in life (HHS, 2016).

References:

Centers for Disease Control and Prevention (CDC). (2021). Youth and tobacco use.

Retrieved from www.cdc.gov

DiFranza, J. R., Wellman, R. J., & Sargent, J. D. (2017). Tobacco use and its effects

on adolescent development. Pediatrics Journal, 139(4), e20163550.

Dube, S. R., Asman, K., & Malarcher, A. (2020). Adolescent smoking and its

respiratory impacts. American Journal of Public Health, 110(5), 564-570.

Lee, S. H., & Chen, W. J. (2019). Nicotine’s impact on adolescent cardiovascular

health: A systematic review. Journal of Cardiovascular Research, 42(3), 240-248.

U.S. Department of Health and Human Services (HHS). (2016). The health

consequences of smoking: 50 years of progress. Atlanta, GA: U.S. Government

Printing Office.

World Health Organization (WHO). (2022). Tobacco and youth. Retrieved from

www.who.int