CHAPTER ONEINTRODUCTIONBackground of the StudyAlmost every one grows up in a world that is inundated with the mass media, for instance, television, radio, billboards, magazines, newspapers, and the Internet (Latif & Abideen, 2011). Of all marketing weapons, advertising is renowned for its long lasting impact on a consumer’s mind, as its exposure is much broader (Katke, 2007). Advertising is a subset of promotion mix which is one of the 4P’s in the marketing mix i.
e. product, price, place and promotion. As a promotional strategy, advertising serves as a major tool in creating product awareness in the mind of a potential consumer to take eventual purchase decision. Advertising, sales promotion and public relations are mass-communication tools available to marketers. Advertising through all media influence audiences, but television is one of the strongest medium of advertising and due to its mass reach; it can influence the individual’s attitude, behaviour, life style, exposure and in the long run, even the culture of the country (Latif and Abideen, 2011). As a promotional strategy, advertising provides a major tool in creating product awareness and condition the mind of a potential consumer. Advertiser’s primary mission is to reach potential customers and influence their awareness, attitudes and buying behaviour (Ayanwale, Alimi, and Ayanbimipe, 2005).
Wakefield, Flay, Nichter and Giovino (2003) note that tobacco advertising imbues the product with an image that is sufficiently attractive to make people want to use it. There are a number of pathways through which advertising can increase cigarette consumption. The four pathways include (a) encouraging the youths to experiment with cigarettes and initiate regular use; (b) increasing smoker’s level of daily consumption by acting as a cue to smoke; (c) reducing smoker’s motivation to quit; and (d) encouraging former smokers to resume smoking. In addition, an indirect pathway which might lead to change in cigarette consumption is through the ubiquity and familiarity of tobacco advertising contributing to an environment where tobacco use is perceived to be more socially acceptable, more normative and less hazardous than it in fact is. The tobacco industry has been extremely adept at creating images for cigarette brands over a long period of time, targeting advertising for different brands to the youths. In addition, it has used the concern about the health risks of smoking to its advantage by promoting ‘light’ and ‘low tar’ cigarettes, leading consumers to believe they are smoking a ‘safer’ cigarette, whereas, in fact, there is no evidence that these types of cigarettes deliver less tar when smoked.Tobacco advertising means any form of commercial communication aimed at promoting, directly or indirectly, tobacco products.
It is a form of communication through mass media such radio, television, newspaper, magazine billboard and Internet about tobacco products paid for by an identifiable sponsor and aimed at persuading the consumers to make a purchase. Tobacco products are one of the most advertised products in the world. The aim of cigarette advertisement is to entice people to start cigarette smoking and deter smokers from quitting or switching brands. As a result, tobacco companies continuously analyse market and develop new marketing strategies, including a combination of effective advertisements and strategies to recruit new users of tobacco products. These marketing strategies take women and young girls into consideration. Cigarette advertisements have always associated smoking with gender equality, glamour, slimness, weight control, luxury, style, sophistication, class and women emancipation all in a bid to recruit women and young girls. Besides, tobacco industries employ covert means such as fashion shows, to recruit young girls and women into the world of cigarette smoking.
Tobacco industries use overt and direct advertisements or covert and indirect advertisements to recruit and retain users of tobacco products. Overt and direct cigarette advertisements make use of conventional media of mass communication such as radio, television, newspaper etc to entice people to take up cigarette smoking and reduce the motivation of the smokers to quit smoking. Covert and indirect cigarette advertisements employ sponsorship of individuals, institutions and events; promotion through the ambient media such as hospitality venues; packaging and direct marketing; so-called social responsibility initiatives which are far from being charitable in their intention, but aim to create a favourable image of tobacco companies in the minds of consumers and spread their influence.
Cigarette advertisements have been so pervasive that both smokers and non-smokers can name a brand of cigarette product whose advertisements capture their attention in the media. United States Health and Human Services (2010) notes that a number of mechanisms have been hypothesized to account for the impact of tobacco advertising on youths. The pervasiveness of cigarette smoking gives youths a false impression that most people are cigarette smokers.
Cigarette advertisements undercut the fact that tobacco use is unhealthy because people pictured in the cigarette advertisements appear very young, vibrant and healthy. Messages conveyed by cigarette advertising images are precisely those that would effectively appeal to young people – that smokers are adventurous, independent, popular, risk-taking and attractive to the opposite sex. In other words, cigarette advertisements increase the perceived social values of smoking, and by doing so, increase the rate of cigarette smoking among youths.Smoking remains a huge public health problem and one of the preventable causes of morbidity and mortality worldwide (Mpabulungi and Muula, 2004, Salawu, Danburam, Desalo, Olokoba, Agbo and Midalla, 2009). It is a very widespread activity. The consumption of cigarette has today reached the level of global epidemic (Can, Tobpas, Oztuna, Ozgun and Yavuzyilmaz, 2009).
American Cancer Society (2005) states that tobacco smoking among the youths is a public health concern because of the immediate and long-term health risks associated with tobacco use such as asthma, chronic cough, chronic obstructive airways disease, cancers and cardiovascular diseases. Youths’ tobacco use has also been linked to other risky health-related behaviours – mental health problems, suicide, motor vehicle accidents, violent crime and even dental problems (US Department of Health and Human Services, 2004). Tobacco is estimated to kill up to one of every two users. No other risk factor carries such a high mortality rate and costs more than half a trillion dollars in economic damages annually (WHO, 2013b). As the use of tobacco has declined in high-income countries, the tobacco industry has increasingly turned to low- and middle-income countries, particularly in Africa, Asia, and Eastern Europe, to recruit new users. Without comprehensive tobacco prevention and control policies, it is estimated that smoking prevalence in the Africa sub-region will increase by nearly 39 percent by 2030, from 15.
8 percent in 2010 to 21.9 percent – the largest expected regional increase globally (Blecher and Ross, 2013; Mendez, Alshanqeety and Warmer, 2013). Increasing prevalence, combined with sustained economic growth and population dynamics, could drive tobacco consumption in Africa to double within the next 10 years (Baleta, 2010). The morbidity and mortality caused by such an increase in tobacco use and exposure could have devastating effects on health, development efforts, and economic growth in African countries.
Empirical research suggests that the mass media can potentially influence behaviours. For example, research indicates that the more the youths are exposed to movies with smoking the more likely they are to start smoking (Dalton, Sargent, Beach, Titus-Ernstoff, Gibson and Ahrens, 2003). The youths emulate the actions and inactions of movie and television role models, and this relates to the decision to take up the smoking behaviour.Smoking cigarette has been associated with an extensive list of health disorders as well as reduction of life expectancy (Detels, 2002; Dolls, Peto, Boreham, and Sutherland, 2004). On the average smokers lose about 15 years of their lives (WHO, 2008) and an estimated 4 million cigarette smokers die worldwide annually (Global Youth Tobacco Survey Action Group, 2002).
Several researchers have reported that cigarette may be the first drug used by adolescents in a sequel that may involve alcohol, marijuana and hard drug, individuals who are not smoking by the age of 20 are unlikely to become smokers (Mayhew, Flay and Mot, 2000, Siziya, Rudatsikirat, Milla and Ntata, 2007). Prevalence of cigarette smoking varies from one part of Nigeria to the other and it appears that the prevalence is higher in the Northern part of Nigeria compared to the South (Omokhodion and Faseru, 2008; Salawu, Danburam, Desalo, Olokoba, Agbo and Midalla, 2009; Adeyeye, 2011). Many factors have been put forward for youths’ engagement in smoking. These include normal developmental challenges, psychological factors and social environment. Under normal developmental challenges, influence of peers, the need to conform and direct craving for cigarette use have been found as responsible for smoking behaviour. For psychological factors, emotional problems such as low self-esteem, dissatisfaction with life, less social confidence, need for approval, anxiety, restlessness, and anti-social factors have been identified. Considering social environment, family influences (having parents who are unstable and engage in cigarette smoking), role of the media (advertisement for cigarette, portraying people who smoke cigarette as sophisticated, sexy, manly in movies) have also been identified as responsible for the youths’ smoking behaviour (Ojo, Lawani, Adedigba and Nwhator, 2008).
It is against this background that this study was conducted to determine the magnitude of cigarette smoking among the youths in Oyo State as well as factors that determined their cigarette smoking behaviour. This would enable the appropriate intervention to be instituted to arrest the social menace.Statement of the Research ProblemThe World Health Organisation (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, Asma, and Warren, 2004; WHO, 2009). About 80% of this number will be in developing countries (WHO, 2009). Youths engage in different habits among which cigarette smoking stands out. Several studies have reported the harmful health effects of cigarette smoking among youths such as bronchitis, lung cancer, cough, etc (Oyewo ; Oyediran, 2006; Lafinhan and Arowolo, 2009). Aside these side effects, cigarette smoking is an expensive hobby for youths as a result of advertising.
Both government and non-governmental organisations have employed multiple approaches to reduce smoking prevalence. These include mandatory packet warnings, price increases, a ban on tobacco advertising, smoke-free environment legislation, health education, the provision of quit programmes, and litigation against the tobacco industry (Crane, Blakely and Hill, 2004). Despite an increase in resources being committed to tobacco control and, in particular, to smoking cessation programmes since 1996 (Price and Allen, 2003), cigarette smoking prevalence has not markedly declined among youths in Nigeria in recent years. This is because adults who quit smoking are being replaced by younger people taking up the habit. Involving in cigarette smoking usually occurs during adolescence, while the vast majority of smoking-related deaths occur in middle-aged and elderly people.In spite of these efforts, however, the last decade has witnessed tremendous increase in cigarette smoking among youths in Nigeria. In fact, the warning on cigarette packets: “The Federal Ministry of Health warns that smokers are liable to die young” seems to go unnoticed since the prevalence of cigarette smoking among youths in Oyo State is still on the increase.
The question is: does tobacco advertising play any role in influencing the attitude of youths in Oyo State towards cigarette smoking?1.3 Objectives of the Study The objectives of this study therefore are to:identify the different kinds of cigarette advertisements disseminated in the media in Oyo State;ascertain the level of the youths’ exposure to radio and television cigarette advertisements in Oyo State;determine the extent to which cigarette advertisements affect the youths’ attitude to smoking in Oyo State;(iv) determine if the warning by the Ministry of Health on cigarette packets has any influence on youths’ smoking habit;investigate the extent to which peer pressure and parental influence affect the youths’ attitude to smoking in Oyo State.Research QuestionsThe research questions that guide the study are as follows:what are the different kinds of cigarette advertisements disseminated in the media in Oyo State?what is the level of the youths’ exposure to radio and television cigarette advertisements in Oyo State?to what extent do cigarette advertisements affect youths’ attitude to smoking in Oyo State?what influence does warning on cigarette packets by the Ministry of Health have on the youths’ smoking habit in Oyo State?what effects do peer pressure and parental influences have on the youths’ attitude to smoking in Oyo State?Research HypothesesYouths’ exposure to cigarette advertisement leads to more positive attitude to cigarette smoking.Youths will be influenced more by peer pressure to take up cigarette smoking than by their parents.Youths will tend to pay more attention to cigarette advertisements than to the warnings on cigarette packets.
1.6 Significance of the StudySmoking poses a very serious threat to the health of tobacco consumers worldwide. The evidence is clear in terms of sicknesses, diseases, and deaths related to cigarette usage.
Cigarette smoking and other tobacco consumption behaviours have proved to be a major economic strain on developing countries like Nigeria. The health hazard associated with smoking and other negative attributes of smoking such as loss of productivity due to poor health, and increased consumption of societal resources, especially in the health-care sector, and sometime death, affects the Nigerian society negatively. This study enlightened the youths about the health effects of cigarette smoking and guided the relevant health stakeholders and policymakers towards making relevant policies to arrest the high incidence of cigarette smoking. The study was useful to the policy makers and health professionals concerned with health implications and effects of cigarette smoking because it provided enough literature in the studies. It was also of help to professionals like teachers, counselors, nurses among others who are interested in treatment of addicts or dependent smokers.It re-echoed dangers inherent in the cigarette smoking behaviour, and suggested ways to prevent initiating the non-smokers as well as stimulated the smokers to quit. It promoted public health and guided the relevant policy makers in the health sector to further strengthen the anti-smoking campaigns aimed at curbing high mortality and morbidity rate arising from cigarette smoking by the youths in Oyo State and by extension, Nigeria.
The study extended the frontiers of knowledge in health communication and, it guided other researchers who might wish to study the tobacco advertising on media and youths smoking behaviour. The study was beneficial to Federal Ministries of Health, State Ministries of Health, Agencies, Departments as well as Non-Governmental Organisations championing the anti-smoking activities in Nigeria. The study also benefitted scholars and students of development communication because it provided sufficient literature for similar studies in the field.Scope/Limitations of the StudyThe study investigated tobacco advertising, media and youths’ attitude to cigarette smoking.
In dealing with the media, this study focused on the traditional mass media such as the television, newspaper, internet, billboard, magazine and radio.The study focused on the tobacco advertising on media and youths’ attitude to cigarette smoking in Oyo State. In evaluating the tobacco advertising and youths’ smoking attitude, the study focused on identifying the different kinds of cigarette advertisements disseminated in the media in Oyo State, ascertain the level of the youths’ exposure to radio and television cigarette advertisements, determine the extent to which cigarette advertisements affect the youths’ attitude to smoking, determine if the warning by the Ministry of Health on cigarette packets has any influence on youths’ smoking habit and investigate the extent to which peer pressure and parental influence affect the youths’ attitude to smoking.In view of the fact that the study sought the subjects’ opinions on tobacco advertising and youths’ attitude to smoking, the possibility of bias, or prejudice in respondents’ opinions or views might not be completely ruled out. The researcher, however, tried as much as possible to explain the objectives of the study to some respondents aimed at making them understand the rationale behind the study better.Besides, other limitations in this study stemmed from the fact that the researcher did not collect some information directly from the stated population. The researcher visited the Operations Headquarters of British-America Tobacco Nigeria located in Ibadan many times, but was directed to the Head Office of the company in Lagos.
The researcher’s frantic effort to have an interview with the Director of Marketing in the BATN Head of Office in Lagos was rebuffed. The company’s operations were enshrouded in secrecy. The security personnel confided in the researcher that the members of staff of the company do not know the department or unit in which others work. They know only those who work in the same unit or department as they do. The researcher wrote a letter to the Director of Marketing of the company, but it was never replied.
Both junior and senior staff of the company displayed a high level of hostility to the researcher. After weeks of continuous visit to the company’s Head Office in Lagos, the researcher decided to interview a senior staff of the Oyo State Signage and Advertising Agency in the Ministry of Environment, and the needed information about subject-matter of investigation was yielded.1.8 Operational Definition of Terms1.
8.1Tobacco Advertising: This encapsulates a paid message in the media such as television, newspaper, magazine, internet, radio, billboard, and transit advertising intended to create awareness about cigarettes with the aim of stimulating a purchase.1.8.2 Media: Media represent the means by which information about cigarette advertisement is conveyed to the youthful smokers and non-smokers of cigarette.
These include television, newspaper, movies, magazine and radio, poster, banners and other below-the-line media.1.8.3Youths: Youths represent the adolescents.
It refers to the period between the childhood and adulthood. Youths are taken to represent the persons between 15-35 years of age in this study.1.8.
4Attitude: This is largely agreed to be a blend of beliefs, values and feelings that exerts an influence on a person’s response to people, objects and situations. Some scholars have suggested that two other components that are part of attitudes are: expectations about the object and intentions to act towards the object.1.
8.5Parental Influence: This involves the children or the young adults positively or negatively affected by the behaviour and attitude of their parents.1.
8.6Peer Pressure: This suggests the direct influence on people by peers, or an individual who gets encouraged to follow their peers by changing their attitudes, values, or behaviour to conform to those of the influencing group or individual. This represents the persuasion or instigation to take up the attitude or behaviour of one’s mates or friends in an environment.1.8.
7Peer influence: Peer influence is a process in which adolescents become more similar to their peers by interacting with them. It is the process whereby youths are influenced negatively or positively by their peers, especially in the process of developing a value system.1.8.
8Cigarette: This suggests a small roll of paper that is filled with cut tobacco and smoked. It is the commonest and most widely smoked of all the tobacco products. It is the tobacco product commonly marketed and advertised in the media by tobacco companies.1.8.9Smoking: This involves the process of inhaling and exhaling the smoke from a stick of cigarette, cigar or pipe.
CHAPTER TWOREVIEW OF RELEVANT LITERATURE2.1 Review of ConceptThis chapter is structured in three parts – review of conceptual frames, review of related studies and theoretical framework. The conceptual frames include advertising and consumer behaviour, consumer socialisation, tobacco use and health implications, media influence and smoking behaviour, gender and cigarette smoking, among other.
These conceptual frames are needed to help provide better understanding of the objectives and research focus. Six related studies in advertising, health, marketing, cigarette smoking and tobacco consumption were reviewed to provide recent leaning for the study. The chapter rounded off with the analysis of three relevant theories that provided explanations for the study. The theories are the social cognitive theory, observational learning and imitation behaviour theory and social learning theory.2.
1.1 The Concept of AdvertisingAdeolu, Taiwo and Mathew (2005) citing Dunn and Barban (1978) view advertising from its functional perspectives, hence they define it as a paid, non-personal communication through various media by business firms, non-profit organisations, and individuals who are in some way identified in the advertising message and who hope to inform or persuade members of a particular audience. Morden (1991) is of the opinion that advertising is used to establish a basic awareness of the product or service in the mind of the potential customers and to build up knowledge about it. Kotler (1988) as cited by Adeolu, Taiwo and Mathew (2005) see advertising as one of the four major tools companies use to direct persuasive communications to target buyers and public noting that “it consists of non-personal forms of communication conducted through paid media under clear sponsorship”. According to him, the purpose of advertising is to enhance potential buyers’ responses to the organisation and its offering, emphasizing that “it seeks to do this providing information, by channelling desire, and by supplying reasons for preferring a particular organisation’s offer”. While writing on advertising nature and scope, Etzel, Walker and Stanton (1997) as cited by Adeolu, Taiwo and Mathew (2005) succinctly capture all advertising as having four features:(i) A verbal and or visual message(ii) A sponsor who is identified(iii) Delivery through one or more media(iv) Payment by the sponsor to the media carrying the message.
Summarising the above, they conclude that “advertising then consists of all the activities involved in presenting to an audience a non-personal, sponsor-identified, paid-for message about a product or organisation”. Those views of Etzel, Walker and Stanton (1997) as cited by Adeolu, Taiwo and Mathew (2005) coincide with the simple but all-embracing definitions by Richards and Curran (2002). For instance, while Richards and Curran state that “advertising is a paid, mediated form of communication from an identifiable source, designed to persuade the receivers to take some actions, now or in the future, Osunbiyi (2001) expressing almost the same view describes advertising as “a controlled persuasive communication, paid for by identifiable sponsors, about products, services or ideas and disseminated through the mass media to a target group”.
From the foregoing, it could be concluded that the purpose of advertising is to create awareness about the advertised product and provide information that will assist the consumer to make purchase decision. The relevance of advertising as a promotional strategy, therefore, depends on its ability to influence consumer not only to purchase but to continue to repurchase and eventually develop-brand loyalty. Consequently, many organisations expend a huge amount of money on advertising and brand management.2.1.2 Advertising and Consumer BehaviourAdeolu, Taiwo and Mathew (2005) note that advertiser’s primary mission is to reach prospective customers and influence their awareness, attitudes and buying behaviour. Advertisers spend a lot of money to keep individuals (markets) interested in their products.
To succeed, they need to understand what makes potential customers behave the way they do. The advertisers’ goals are to get enough relevant market data to develop accurate profiles of buyers to find the common group (and symbols) for communication. This involves the study of consumers’ behaviour: the mental and emotional processes and the physical activities of people who purchase and use goods and services to satisfy particular needs and wants (Arens, 2008).
Proctor and Stone (2006) as cited by Zain-UI and Salman (2013) note that the principal aim of consumers’ behaviour analysis is to explain why consumers act in particular ways under certain circumstances. It tries to determine the factors that influence consumers’ behaviour, especially the economic, social and psychological aspects which can indicate the most favoured marketing mix that management should select. Zain-UI and Salman (2013) observe that Consumers’ behaviour analysis helps to determine the direction that consumer behaviour is likely to make and to give preferred trends in product development and attributes of the alternative communication method. Consumers’ behaviours analysis views the consumer as another variable in the marketing sequence, a variable that cannot be controlled and that will interpret the product or service not only in terms of the physical characteristics, but in the context of this image according to the social and psychological make-up of that individual consumer (or group of consumers)2.1.3 Consumer Socialisation In consumer research, the concept of consumer socialisation was first used by Ward (1974) to describe the process of forming purchasing and consumption attitudes, habits, and knowledge. Based on social learning theory, consumer socialisation research suggests that consumer behaviours are learned during early childhood and pre-adult years through the influence of socialisation agents such as parents, media sources, peers, and educational institutions (Churchill and Moschis 1979; Moschis and Moore, 1984) as cited by Phylis, Charisse, and Peg (2006).
Consumer socialisation, first addressed in the 1970s, was defined as a lifelong process through which individuals acquire skills, knowledge, habits, attitudes, and values that affect their “present” and “eventual” behaviour as consumers in the marketplace (Baumrind, 1978; Ward, 1974; Ward, Wackman, and Wartrella, 1977). Based on the social learning model in which children learn to be consumers as they interact with socialisation agents (Moschis and Moore, 1984), the primary influencers are parents, peers, schools, and mass media (Bush, Smith, and Martin, 1999). Research identifies the most significant influence on children’s consumer behaviour as their parents (Caruana and Vassallo, 2003; Mascarenhas and Higby, 1993). Three of the methods used by parents to influence their children’s consumer behaviour include (1) modelling, (2) parental styles of interaction, and (3) providing them with information about consumption-related activities (Grossbart, Carlson, and Walsh, 1991). Parental modelling occurs when children emulate the behaviours, both positive and negative, of their parents.
The parental style of interaction refers to the degree of leniency or authoritative control a parent exhibits over the child’s behaviour (Moschis 1985; Ward, 1974). The level of communication within the family also has an impact on consumer socialisation when parents provide their children with information about consumption-related activities (Grossbart, Carlson, and Walsh 1991; Moschis, 1985) as cited by Phylis, Charisse, and Peg (2006). 2.
1.4 Tobacco Use and Health ImplicationsTobacco product is defined as any manufactured product made of tobacco leaf used for smoking, sucking, chewing, or snuffing (WHO FCTC, 2005). There are three types of tobacco preparations. The first is the hand-rolled tobacco, which is smoked. This is called cigar, usually longer and thicker than cigarette. The second is cigarette, which is a small roll of paper that is filled with cut tobacco and smoked. Cigarette is the commonest and most smoked of the tobacco products.
The third type is cut and smoke in pipes (WHO, 2006). Tobacco contains nicotine and many carcinogens. Hence, it is an addictive plant (WHO, 2006).Scientific evidences show that the consumption and exposure to tobacco smoke cause these three: (1) Death, (2) Disease, and (3) Disability. Aside, it has been found out that there is a time interval between the exposure to smoking and the start of tobacco-related diseases (WHO FCTC, 2005).Smoking indeed causes pre-mature deaths. About half of the 650 million cigarette smokers, who are still alive, will sooner or later die from tobacco-related disease if they continue to smoke (WHO, 2006).
Right now, the higher burden of tobacco-related diseases and deaths is fast shifting to developing countries (WHO, 2006). Cigarettes are considered to be among the most deadly and addictive products made by man. If users will smoke cigarettes according to the intention of cigarettes manufacturers, cigarette smoking can kill half of its users (WHO, 2006). On the other hand, it is not only tobacco consumers who are susceptible to its negative effects.
The second-hand tobacco smoking, which is also known as passive smoking has exposed millions of people including half of the world’s children to the negative effects of tobacco consumption. Evidence links second-hand smoking to the increased risk of cardiovascular diseases, lung cancer and other cancer, asthma and other respiratory diseases, ear infection and sudden infant death syndrome in children. The above mentioned diseases are but a few of second-hand smoking’s harmful effects (WHO, 2006).The tobacco epidemic is rising rapidly hence the regulation of tobacco products is critical. All tobacco products can cause disease and death aside from the fact that they are harmful and addictive (WHO, 2006). Tobacco consumption has harmful effects to smokers and non-smokers. It is harmful to children causing them to have respiratory problems and other health problems (USDHHS, 2000).
Annually, second-hand smoking causes an estimated 3000 lung cancer deaths and 62,000 coronary heart disease deaths in California (NCI, 1999). All tobacco products are dangerous and addictive. Government effort should be made to discourage the use of tobacco in any forms as well as to raise awareness about its harmful and deadly effects (WHO, 2006). However, in order to maintain profit, tobacco companies continue to develop new products.
These companies cover the tobacco products’ harmful effects by portraying tobacco products as attractive and less harmful (WHO, 2006).Tobacco-related diseases have been widely reviewed. According to WHO (2006) it is now also known that tobacco use contributes to cataracts, pneumonia, acute myeloid leukemia, abdominal aortic aneurysm, stomach cancer, pancreatic cancer, cervical cancer, kidney cancer, periodontitis and other diseases.These diseases join the familiar list of tobacco-related diseases, including cancer of the lung, vesicle, esophagus, larynx, mouth and throat; chronic pulmonary disease, emphysema and bronchitis; stroke, heart attacks and other cardiovascular diseases.
In fact, we know today that tobacco causes 90% of all lung cancers. Tobacco seriously damages the reproductive system too, contributing to miscarriage, premature delivery, low birth weight, sudden infant death and pediatric diseases, such as attention hyperactivity deficit disorders. Babies born to women who smoke are, on average, 200 grams lighter than babies born to comparable mothers who do not smoke. Nowadays, the prevalence of smoking is very high among adolescents in many countries.
It is said that people start smoking with median age of less than 15 years old (GYTS, 2007). The risk of death from smoking-related diseases increases when people started smoking at younger ages. Young people who start smoking early will be likely to die at lower age, and they will often find it difficult to quit smoking. It is said that half of them will die from their tobacco consumption (GYTS, 2007).2.1.5 Media Influence and Smoking BehaviourEmpirical research suggests that the mass media can potentially influence behaviour.
For example, research indicates that the more adolescents are exposed to movies with smoking the more likely they are to start smoking (Dalton, Sargent, Beach, Titus-Ernstoff, Gibson and Ahens, 2003). Furthermore, research has shown that the likeability of film actors and actresses who smoke (both on-screen and off-screen) relates to their adolescent fans’ decisions to smoke (Distefan, Gilpin, Sargent and Pierce, 1999). Films tend to stigmatise drinking and smoking less than other forms of drug taking (Cape, 2003). However, the media transmit numerous positive messages about drug use and other potentially risky behaviours, and it is plausible that such favourable portrayals lead to more use by those that watch them (Will, Porter, Geller, ; DePasquale, 2005) as cited by Mark (2010). Some things may be changing.
For instance, there appears to be more emphasis on the media’s portrayal of alcohol as socially desirable and positive as opposed to smoking that is increasingly being regarded as anti-social and dangerous (Griffiths, 2009).It is a fact that adolescents spend a lot of their free time watching movies, TV and reading magazines. The exposure of adolescents to icons, or scenes with smoking-related items appears to have a positive influence on the development of smoking habits. Stockwell showed in 1997 that adolescents are influenced 3 times more strongly than adults towards developing smoking habits by their exposure to tobacco products in films and movies.
In the USA a study showed that in a total of 20 best seller movies the watchers were exposed to smoking images at an average of 5 minutes per film, while anti-smoking messages were limited to 43 seconds per film. TV programmes also devote a small percentage to showing tobacco products or regular smokers. A study by Dukan, in 1997, demonstrated the strong contribution in promoting smoking habits of song lyrics and musical video clips. In the world renowned musical channel, MTV, 26% of the broadcast musical video clips highlight smoking habits. Magazines addressed at adolescents also have a serious role in the formation of adolescents’ character and in promoting idols. Magazines with fashion and life style content promote smoking habits by illustrating model and VIPs who smoke.In recent years the rapid development of technology has introduced great changes in the life style of adolescents.
The ease of having a computer and internet access has created a different range of factors in the psycho-social development and education of children and adolescents. According to a study by Lenhart and Madenn, conducted in 2006, 91% of children aged 12-17 years used internet services, of whom 61% used them on a daily basis. The most popular reported sites were those of social networks, at a rate of 55%. In 2004, according to a research project published by Centre for Disease Control, 34% of junior high school and 39% of senior high school students reported that they were exposed to tobacco advertisement and had the opportunity to order cigarettes via internet.
In 2009, Jenssen carried out a study recording exposure to tobacco via the internet, which showed that of the 1.2 million sites that were visited by the 346 participants, 8,702 (0.72%) had items regarding smoking, of which 4612 (53%) were social network sites. The items on smoking in these sites were mainly in the form of reports or text, while 3% was in the form of images.
2.1.6 Interaction Effects of Parental and Peer Smoking on Adolescents Source: Australian Journal of Basic and Applied Sciences: 2011 Peer smoking is considered to have a major impact on adolescent smoking, with research providing a lot of evidence that peer smoking is tied more strongly to adolescent smoking than does parental smoking. For example, Avenevoli and Merikangas (2003) as cited by Lianne (2010) notes that parental smoking influences are very small in magnitude, especially when compared to other risk factors, such as peer smoking. In contrast however, Bricker, Peterson, Andersen, Leroux, Rajan ; Sarason (2006) and De Vries, Candel, Engels and Mercken (2006) as cited by Lianne (2010) shows that the influence of parental smoking and peer smoking was of comparable importance to adolescent smoking. Thus, it is not entirely clear yet what the relative influences of both peer smoking and parental smoking are on adolescent smoking.
However, there are evidence for adolescents being at higher risk to become daily smokers when both parents and two or more close friends are smokers. In this study, the number of smoking parents and the number of smoking friends was measured in the 5th grade, while children’s smoking behaviour was measured in 12th grade. The results showed first of all, that children with non-smoking parents were the least likely to be daily smokers and the ones with two smoking parents were the most likely to be daily smokers. Furthermore, having smoking friends increased this likelihood. So, it was clear that close friends’ smoking effects are cumulative on the effect of parental smoking on adolescent smoking Lianne (2010).
Although, adolescents with smoking parents may have been exposed and are used to tobacco use for a long time, and so learned everything to be competent in smoking, it is expected that they could be more susceptible to peer smoking influences than adolescents with non-smoking parents (Darling and Cumsille, 2003) as cited by Lianne (2010). Yet, this assumption has rarely been considered in past studies. Lianne (2010) citing Engels (2004) notes that even though there is evidence that parental smoking has a direct effect on the smoking initiation of their children, they could not find any support on the assumption that parental smoking behaviour would influence the susceptibility of adolescents to their friends’ smoking behaviour. Thus, with the focus on smoking initiation, there might not be an increase of susceptibility on peer smoking by an adolescent when one or both parents are daily smokers.
And since it is expected that adolescents will not become more susceptible once they are daily smokers, it is not probable that daily smoking adolescents with current smoking parents will be more susceptible to peer influences than daily smoking adolescents with non smoking parents.2.1.
7 Internet Cigarette Advertisement and the Youths’ Smoking BehaviourLing and Glantz (2002) note the potential of the internet as a medium for encouraging youths smoking has been noted. The internet has the potential to influence youth tobacco use not only because it provides possible access to tobacco products, but also because it creates avenue that may stimulate demand through advertising and promotional messages. On the other hand, the internet could also be used as a health promotion tool.In a 2000 analysis of 66 websites that promoted tobacco use, none were dedicated to national cigarette brands and only a few were corporate sites. The corporate sites did not advertise their brands or employ marketing techniques that might appeal to children. Instead, the study concluded that the sites with the greatest youth appeal were not corporate sites, but those devoted to smoking culture and lifestyle (Ribisl, 2003).
These sites featured pictures of celebrities smoking, smoking tips, and chat rooms or discussion boards for building a pro-smoking community. Although some sites warned users that they must be at least 18 to view the contents, there were no mechanisms in place to require age proof or stop access. Several of the smoking culture and lifestyle sites provided links to pornographic websites and some featured sexually orientated photographs.Another study conducted by Risibl (2003) examined the content of smoking culture and lifestyle websites.
It analysed whether the sites were easily accessible to the youths, featured age or health warnings, or mentioned specific tobacco brands. A content analysis of photographs on these sites assessed the demographics of individuals depicted and the amount of smoking and nudity in the photographs. The sample included 30 websites. All of the websites were accessible to the youths, and none required age verification services to enter them. Cigarette brand names were mentioned in writing on 35 percent of sites, and brand images were present on 24 percent of sites. Only four of the 30 sites contained cartoons, and these depicted Joe Camel or The Simpsons.
Five of the 30 sites mentioned ‘smoking fetishes’ and generally featured pictures of clothed and unclothed women smoking and/or showed videos of women smoking. Stories about smoking were featured on over a third of sites. In other sites that contained photographs of people smoking, the images were stylised and glamourised.These websites may encourage the youths’ tobacco use even without the advertising of specific brands, although no studies have been conducted on the proportion of the youths that visit these sites. A number of teen smoking pages have been launched that claim to have been created by teens. Stories supposedly written by other teens are solicited for sites. Stories were often personal accounts of smoking or short stories that described topics ranging from initiation of smoking, standing up for smokers’ rights, and how smoking helped attract potential boyfriends.
Aside from smoking in movies, there are internet sites that provide information on smoking in movies. Some sites have a comprehensive list of famous celebrity smokers. The amount and quality of smoking in movies featuring actresses is reviewed in detail. There are also photos depicting various actresses smoking in real life. There are even sites that have a ‘Teen Celeb Index’ (Ribisl, 2003).
A large number of teen smoking clubs exist. It has been noted that the problem with these websites and chat rooms is that they are far more interactive than the traditional venues for promoting cigarettes such as print advertising. As a result, website viewers might receive a greater ‘dose’ of pro-smoking content.
The extent these types of sites are accessed has not yet been well researched. A study of 15 to 16 year olds in England is one of the only published studies that have examined youth exposure to internet sites for cigarettes or smoking. Exposure to smoking-related internet sites was reported by four percent of non-smokers and current smokers, as well as by eight percent of those who had ever tried smoking (Ribisl, 2003).2.1.8 Gender and Cigarette Smoking Behaviour Epidemiological statistics of smoking prevalence show that in most regions of the world, tobacco smoking is more prevalent among males than females (Vanwalbeek 2002; Eriksen, Mackay and Ross, 2012). The smoking of cigarette has for a long time been associated with maleness and tobacco companies have been found to use advertisements associating smoking with gender equality and women emancipation to market cigarettes to females (Francis, Katsani, Sotiropoulou, Roussous and Roussous, 2007; Hitchman and Fong 2011; Eriksen, Mackay and Ross, 2012) as cited by Catherine, Anna, Kwaku and Inge (2014).
The global estimate of male to female smoking prevalence rate is between 4 or 5 to 1 and this reported ratio varies dramatically across countries (Hitchman and Fong, 2011). The prevalence of males and females smoking is quite similar in high income countries but skewed towards the male gender in middle and low income countries (Morrow and Brands, 2003; Ali, Chaix, Merlo, Rosvall, Wamala and Lindstrom, 2009; Hitchman and Fong, 2011; Eriksen, Mackay and Ross, 2012). In terms of age and gender, however, a study conducted in Sweden found the daily smoking prevalence to be higher among women than men between the ages of 18 and 24 years (Ali, Chaix, Merlo, Rosvall, Wamala, and Lindstrom, 2009). A cohort study by Galanti, Rosendahl, Post and Gilljam (2001) on adolescents’ tobacco use in Sweden found that though boys tend to initiate smoking earlier than girls in pre-adolescence, girls had a more rapid progression to regular smoking than boys. Morrow and Brands (2003) also report that more young women than men now smoke in Denmark and Germany.
In fact, even in regions where the prevalence rates of female smokers are similar or higher than that of males, Ali, Chaix, Merlo, Rosvall, Wamala and Lindstrom (2009) note that it is a recent trend as the smoking prevalence of males have long been higher than that of females (Hitchman and Fong 2011). It has been suggested that females start smoking to assert themselves based on the perception that it shows liberation and equality of rights with their male counterparts (Morrow and Brands 2003; Hitchman and Fong 2011). The trend of smoking by gender especially in high income countries like the United States, Canada, Denmark and Sweden shows that the number of females who smoke are on the increase and this increase has been blamed for the reduction in the life expectancy of females in these countries (Prescott, Clemmensen and Tobak, 2004; Preston and Wang 2006; Trovato and Lalu 2007; Ali, Chaix, Merlo, Rosvall, Wamala and Lindstrom, 2009; Hitchman and Fong 2011). In some social settings however, there is a slow increase in smoking among females but this has been attributed to social disapproval of women smoking in such societies (Hitchman and Fong 2011).Another factor fuelling smoking prevalence among females is the misconception that cigarettes can help in weight control (Morrow and Brands 2003; Francis, Katsani, Sotiropoulou, Roussous and Roussous, 2007).
With fashion trends going in favour of the slim and elegant figures, more ladies are seeing cigarette as a weight-control drug. There is however no scientific evidence to support this claim (U.S. Department of Health and Human Services, 2012).
Africa is one of the regions where the male to female smoking prevalence ratio is still sharply skewed towards men. The adult prevalence rate in sub-Saharan Africa as reported by Chaloupka, Jha, Corrao, Silva, Ross and Ciercierski (2003) show that 28% of males and 8% of females are smokers. In Nigeria, the prevalence rate of adults by gender in the northeastern region was found to be 45.3% (for males) and 18.
4% (for females) giving a ratio of 3 to 1 (Desalu, Iseh, Olokoba, Salawu and Danburam, 2008). Traditionally, it is still not socially acceptable for females to smoke in Nigeria just as it had been in many parts of the world (Hitchman and Fong 2011). Most female smokers in Nigeria cannot smoke in the open because of the stigma attached to the habit.
Stigmatization of smoking has been said to contribute to some smokers hiding their status (Stuber, Galea and Link, 2009). Stigma may, in this instance, also serve as a protective factor against smoking. Stuber, Galea and Link (2009) indicated that stigma may serve as a way of socially controlling tobacco consumption as it can prompt smokers to make decisions to quit in a bid to avoid being socially excluded. While this stigma against cigarette smoking exists to some extent for males too, it is much stronger for female smokers.
Though cigarette smoking is fairly common in Nigeria, Odigwe (2008) notes that adults (especially ladies) do not easily acknowledge being smokers and most youths especially females, who smoke will decline disclosing their smoking behaviour in order not to incur the wrath of their parents or guardians. Unfortunately, stigma may also serve the purpose of fuelling smoking behaviour especially among the youths as it makes it more difficult for smokers to seek help to quit if they need to be assisted to do so (Stuber, Galea and Link, 2009) as cited by Catherine, Anna, Kwaku and Inge (2014).Tobacco companies have viewed women as a potential market to be exploited in order to boost their businesses especially in many developing countries in Africa and Asia where it is still not socially acceptable for females to smoke (Esson and Leeder 2004).
They have in the past been accused of organising fashion shows to encourage smoking among females (Coombs, Bonds, Van and Daube, 2011; Morrow and Brands 2003). These companies are aware that women are in tune with fashion and so seek to link women’s love for fashion with their cigarette brands so as to sell the idea of smoking to unsuspecting young women. These companies therefore use a strategy similar to associative learning (Shanks, 2010) to lure women into forming a positive attitude towards smoking thus encouraging them to initiate smoking.
Although studies have shown the disparity in the prevalence of cigarette smoking along gender lines, there is no study which has explored what is particularly responsible for this skewedness and supported this with evidence from research (Egbe, 2013) 2.1.9 Women, Youths and Prevalence of Smoking Behaviour The profits of the tobacco industry depend on the number of people who use tobacco regularly. The recruitment of new users is essential to increase profits.
In Africa, the tobacco industry has targeted women and youths to recruit new smokers (Lee, Ling and Glantz, 2012; Njoumemi, Sibetcheu, Eko and Gbedji, 2011; Pampel, 2008). Historically, tobacco companies have designed their products and advertising to make cigarettes seem trendy and socially acceptable, and increasingly have sought to grow their market share by appealing to groups with traditionally low smoking rates. Women in particular have been a target of tobacco marketing that has psychological and social appeal. In an assessment of tobacco industry documents and advertisements, researchers note that marketing specialists identified core values such as “social acceptability,” “private time,” and “female camaraderie” and marketed specific brands with those messages (Anderson, Glantz and Ling, 2005, p. 128). More recently, in low- and middle-income countries in particular, the tobacco industry has associated its brands with Western ideals and upward mobility (WHO, 2007), appealing to a new generation of women with greater purchasing power and more exposure to globalisation.
Enticing the youths to smoke ensures a new generation of consumers who will likely be lifetime buyers (Doku, 2010). Youths who start smoking before age 14 are less likely to quit smoking and thus more likely to continue smoking into adulthood than those who start smoking after age 16 (Breslau and Peterson, 1996). In several countries in Africa, tobacco advertisements specifically target the youths by associating cigarettes with trends such as film, sex appeal, well-being, and sports (WHO, 2011a). Tobacco logos can be found on basketball courts and football fields, and “cigarette girls” (usually young and sexy) market cigarettes at night clubs (Doku, 2010, p.
202; Ouedraogo, Quedraogo and Theodore, 2011). Movies and television shows often contain scenes in which smoking is shown to be attractive by trendy individuals (Doku, 2010). While some countries ban advertising, both direct and indirect, tobacco promoters continue to find covert ways of reaching women and youths in attempts to increase their market share in those groups (Njoumemi et al., 2011; WHO, 2011a).
Most African countries do not have comprehensive bans on tobacco advertising, and the youths often report hearing advertisements on radio or seeing billboards, seeing sponsorships at public events, or even receiving cigarettes from company representatives (CDC, 2013a,b). A BBC report in 2008 indicated a number of bans and laws being circumvented, with local tobacco promoters endorsing sales of single sticks; advertising at musical events; and collaborating with celebrities on branded clothing in Malawi, Mauritius, and Nigeria (BBC News, 2008). The Preamble of the FCTC notes that Parties to the Convention have the right (and the obligation under Article 12 of the International Covenant on Economic, Social and Cultural Rights and the Convention on the Rights of the Child) to protect public health, and they are concerned about the increasingly earlier age of smoking initiation.
Thus, Article 4 of the FCTC suggests that “every person should be informed of the health consequences, addictive nature and mortal threat posed by tobacco consumption and exposure to tobacco smoke” (WHO, 2003a, p. 5). Although the evidence of tobacco’s effects on health is overwhelming and its other impacts are increasingly noticeable, this information has not reached all segments of society (Dillon and Chase, 2010; Nsereko, Brysiewicz and Mtshali, 2008; Owusu-Dabo, Lewis, McNeill, Gilmore and Britton, 2011; Salaudeen, Musa, Akande and Bolarinwa, 2011).
A study on early smoking initiation in seven African countries found that 15.5 percent of school children had tried a cigarette before the age of 14 (Peltzer, 2011b). Adolescents and the youths have the right to information regarding tobacco’s negative effects, as well as the tactics used by the tobacco industry to promote misinformation. While the literature is unclear regarding the effects of tobacco prevention programmes in schools (Thomas and Perera, 2008), interventions that solely provide information have not been effective means of changing health-related behaviours (Jepson, Harris, Platt and Tannahill, 2010; Robertson, 2008).
Nonetheless, knowledge is an essential component of broader programmes designed to elicit behavioural change (NCI, 2008; Wakefield, Loken and Hornik, 2010). Some health education programmes have been shown to improve knowledge about the harmful effects of tobacco and to change attitudes and beliefs in ways that can help de-normalise the acceptability of tobacco and the tobacco industry (Lotrean, Dijk, Mesters, Lonut and DeVries, 2010; Salaudeen, Musa, Akande and Bolarinwa, 2011). Evidence suggests that media campaigns have a strong influence in reducing the youths’ uptake of smoking, and the effect may be stronger when combined with the youth-specific interventions, such as in schools (Wakefield, Loken and Hornik, 2010). In a climate in which the tobacco industry invests heavily in recruiting new smokers, providing consistent information from multiple sources about tobacco’s negative effects offers the youths the tools to make informed health decisions.2.
1.10 Effects of Tobacco Advertising on the YouthsThe market for tobacco in Nigeria grew at an annual rate of 4.7% between 2001 and 2006 (World Health Organization, n.d.).
Undoubtedly, there is incriminating evidence that much of tobacco industry marketing activities are geared towards children and adolescents, in an attempt to “recruit” young people as future consumers of their products. The evidence that tobacco advertising and promotion increases tobacco use is solid and extensive. In 2002, the United States National Cancer Institute (NCI) reviewed available research and found a direct correlation between youths smoking behaviours and tobacco advertising. The NCI also found that, there is an unquestionable causal relationship between smoking onset and tobacco marketing.
According to the U. S. Surgeon General, tobacco advertising also increases consumption via “word of mouth” as young people then use peer pressure to influence their peers to begin to smoke as well. Tobacco advertising also appears to encourage those who have previously quit, resuming their former habits by showing an environment in which it is very “normal” and “accepted” to be using tobacco. Three separate studies (Andrews and Franke, 1991; Myers, 2004; ; Roemer, 1993) found that tobacco sales are very much impacted by tobacco advertising. According to the U.S.
Institute of Medicine, the U.S. Department of Health and Human Services, and the World Health Organization, brand advertisements such as the animated character, “Joe Camel” have been deliberately created by tobacco companies to appeal to the younger market and have been found to be directly linked with an increase in consumption. From 1989 to 1993 when the Joe Camel campaign was running, tobacco sales leaped to $43 million from $27 million in the U.S. During the time the Joe Camel campaign was in full force, it was found that there was no change in the size of the adult market, but rather, the number of smokers among the youths increased by over 50 percent (CDC, 1994).
When celebrities are used in an advertisement, children will likely identify with such an individual, and therefore, want to try the product. Bill Cosby was used for many years to advertise Jell-o. Exposure to endorsement led to increased preference for the toy and belief that the celebrity was an expert about the toy (Ross, 1984). Advertisers are also using animated characters as “spokes-characters” to appeal to children and sometimes get the children ‘hooked’ on that particular product.
The use of Joe Carmel by R. J. Reynolds Tobacco Company is a good example. This use of animated characters to appeal to young children has been largely criticised by parents, researchers, government officials, child advocates, and others and has been largely debated (Neely and Schumann, 2004). The use of animated spokes-characters in promoting products to young children ensures that the child can make a correlation between the brand and the character. Children’s advertisements are sometimes loaded with a lot of bargains.
Bargains like half-price off, buy-one-get-one-free (BOGOF), use of coupons, and discounts. All these are to create brand loyalty and to draw children to the stores. Understanding consumers’ reactions to advertisements is the key to making sure a product is noticed and purchased (Slessareva, 2005) as cited by Oluwole, (2013).
2.1.11 Cigarette Smoking and AddictionOne of the active pharmacological agents in tobacco products is nicotine. The interaction of nicotine (an alkaloid) with the nicotinic receptors present in the central nervous system is mainly responsible for the pharmacological basis why tobacco consumers get addicted to this product.
Nicotine produces toxic chemical that makes tobacco users depend on this product. Such exposures lead to sicknesses and diseases, which may lead to death (Ayrton, 1996). According to Billieux, Linden, and Ceschi (2007), “Cigarette smoking is connected to health problems and represents the largest preventable risk factor for premature death in developed countries. A considerable body of research indicates that impulsivity is a central etiological concept in many theoretical models of tobacco addiction”. Smoking is addictive. There has been recent increased interest in utilizing motivational inter-viewing (MI) to increase adolescent campaigns to quit smoking, but attempts to impact quit rates have not been encouraging thus far.
Two factors that are predictive of the readiness for adolescents to quit smoking include negative beliefs about smoking and possessing sufficient confidence to be able to quit smoking (Apodaca, Abrantes, Strong, Ramsey, and Brown, 2007). Tobacco smoking and addiction are regarded as perhaps the best examples of a dangerous consumers’ behaviour habit. Therefore, preventing this behaviour is the most straightforward way to avoid the damage to human health caused by smoking, including diseases such as arteriosclerosis and coronary heart disease, strokes, pulmonary diseases, and cancers of the bladder, mouth, esophagus, larynx, and lung (Bartecchi, Mackenzie, and Schrier, 1994). Therefore, preventive measures, such as educating the public by providing information on the risk of smoking or adopting public policy that prevents smoking in public places must be especially targeted to young people (Mackenzie, Bartechi, and Schrier, 1994).
Developing the smoking habit in adolescence is of a great concern particularly given the psychological effects it will have on this age group. Adolescents are involved in developmental tasks that are unique to that stage of life, such as establishing their own identity as well as independence from their family, which may lead them to adopting risky patterns of behaviour, such as smoking. In addition, adolescents may regard smokers in a favourable way, in that individuals who smoke are more likely to be viewed of as having what might be considered as social assets, or being ”tough” and ”cool” (Comité Nacional para la Prevención del Tabaquismo, 1998).
Thus, this specific age-related psychosocial behaviour, together with the high personal and social costs associated with quitting, becomes particularly important when formulating and evaluating effective anti-smoking policies. The psychosocial theories that explain the consumption of addictive substances have enjoyed substantial development. For example, the Risk Behaviour Models (RBM), which represents a more integrated consideration of individuals in a way that combines the cognitive, affective, and social factors that have the effect of increasing the risk of drug consumption by individuals, has been widely written about (Bry and Krinsley, 1990; Newcomband Felix-Ortiz, 1992). According to Jarvis (2004), most smokers say that cigarettes are relaxing to them when they are under stress and allow them to be able to work more effectively and concentrate more, but there is very little known evidence that even suggests: Smokers typically report that cigarettes calm them down when they are stressed and help them to concentrate and work more effectively, but little evidence exists that nicotine provides effective self-medication for adverse mood states or for coping with stress.
2.1.12 The Nature of SmokersAkintaro (2015) citing Ekrakene and Igeleke (2010) notes that individuals who smoke tobacco are categorised into active smokers, passive smokers and non-smokers. According to hm, active or actual smokers are those that voluntarily inhale tobacco smoke; passive smokers are also known as second-hand smokers and this is the involuntary inhalation of smoke from tobacco products. Akintaro (2015) citing Ekrakene and Igeleke (2010) notes that scientific evidence has shown that exposure to second-hand tobacco smoke causes death, diseases and disability and it is on the basis of the risk that passive smokers are exposed to that led to the prohibition of tobacco smoking in public places because second-hand (passive) smokers are exposed to the same problems as active smokers; lifelong non-smokers with partner who smoke in the home have 20-30% greater risk cancer and those exposed to cigarette smoke in the work place have an increased risk of 16-19%; non-smokers are those who do not inhale tobacco smoke voluntarily or involuntarily which is a very rare thing. 2.
1.12.1 Types of SmokersPrimary or Active Smokers: These are addicted smokers.
They feel the urge to smoke every time. They cannot live without smoking some sticks of cigarette in a day.Secondary or Passive Smokers: They are not addicted to cigarette smoking. They are occasional smokers, as they sometimes indulge in it to socialise.
Tertiary Smokers: They can be said to be unintentional smokers. They inhale the smoke because of their closeness to the scene of the smoke for instance, waiters and waitresses in bars.2.1.13 Tobacco Bans, Tobacco Advertisement and Youths’ Smoking Behaviour Persuasive advertisements are those that use visual and emotional effects.
However, how each advertisement is viewed depends on the particular product, the advertising medium and the nature of consumer demand (Tirole, 2000). According to Nelson (1974), the level of investment in and the effects of advertising will vary based on the product advertised. By promotion, the seller is communicating information to potential consumers, with the hope of influencing their behaviour and attitudes.
Primarily, promotion is intended to inform, persuade, and remind. Dewhirst (2003) indicates that information is important and essential in particular for newly developed or “introduced” products, in which communications efforts are meant to tell potential customers something about the product. According to Cornwell (1997 pg 44), “Worldwide, the marketing and promotion practices of tobacco firms are coming under scrutiny.
Although tobacco advertising in traditional media such as television has been banned in most countries for many years, the use of non-traditional media such as sponsorship has only recently come into question”. 2.1.14 Reasons for the Smoking Behaviour among the Youths Understanding why people start smoking is a complex consumer behaviour issue; that has led researchers into risk factors associated with initiating this behaviour.
In spite of well-established negative health consequences of smoking, one would expect that consumption rate will be low; nevertheless, initiation rates in young people remain high. During the greater part of the twentieth century, cigarette consumption was viewed as a personal choice as well as a “socially learned habit” (Jarvis, 2004). Wang, Fitzhugh, Cowdery and Trucks (1995), conclude that smokers considered smoking to bring them some type of perceived material gain and pleasure. Adolescent smokers were found to have beliefs that contribute to the risky behaviour, such as the thought that smoking would be able to help them relax, reduce their boredom, or even help to take the edge off of their stress level.
Other reasons why people smoke, according to Wang (2010), could be linked to influences from many different realms, and factors such as political, personal, social, and economic influences all seem to factor into the habit. Thus, understanding these factors is crucial in understanding how to determine patterns of smoking use and cessation. According to Jarvis (2004), nicotine’s effects on brain neurochemistry can often be pervasive, activating nicotinic acetylcholine receptors throughout the brain and thus inducing dopamine to be released in the nucleus accumbency. Due to this process, the commonly held belief that the stimulant nicotine can be “calming,” might actually come from the perception of relief from the symptoms of nicotine withdrawal.2.1.
15 Economic Tactics of the Tobacco IndustryTo increase profits, the tobacco industry has routinely employed both illegal and legal economic strategies to increase markets for tobacco so as to promote tobacco consumption (Lee, Ling and Glantz, 2012). Globalisation and economic liberalisation have provided new opportunities for the tobacco industry to consolidate power through transnational mergers and acquisitions. The industry is now controlled largely by four multinational corporations that have amassed significant financial, political, and social influence: British American Tobacco, Imperial Tobacco Group, Japan Tobacco International, and Philip Morris International (Joossens and Gilmore, 2013; Lee, Ling and Glantz, 2012). In an increasingly globalised world, many low- and middle-income countries have adopted more liberal economic policies and trade agreements, resulting in more open markets, while global economic development has simultaneously increased low- and middle-income countries’ purchasing power (Taylor, Chaloupka, Guindon and Corbett, 2000). As cigarettes have become increasingly affordable in these countries, the strategies of the tobacco industry have been successful. From 1997 to 2009, tobacco sales increased 2 percent annually in these countries, as opposed to 0.1 percent in high-income countries (Li and Guindon, 2013; Moodie, Stuckler, Monteiro, Sheron, Neal, Thamarangsi, Lincoln and Casswell, 2013).
Across the African continent, international tobacco companies convinced many governments that tobacco production and the manufacture of tobacco products would lead to economic development. Tobacco companies continue to promote the idea of “green gold”—tobacco as a sustainable cash crop—as well as the idea that large numbers of people are employed in tobacco production, and one of the strongest arguments used by the tobacco industry is its economic benefit (Jha and Chaloupka, 2000; Lee, Ling and Glantz, 2012). Tobacco companies have established agricultural lobbies, such as the International Tobacco Growers’ Association (ITGA), to promote the economic viability of tobacco farming in transitional economies (Otañez, Mamudu and Glantz, 2009). On the surface, tobacco as a cash crop appears to be a lucrative income generator in countries that rely on agriculture, but deeper examination exposes questions around contracting practices; environmental impact; exploitation; and negative health effects, such as green tobacco sickness (Lecours, Almeida, Abdallah and Novotny, 2012; Yach and Bettcher, 2000). Today, African countries that are dependent on tobacco are among the world’s poorest, and tobacco companies continue to exploit African farmers while driving communities and households further into poverty (ASH, 2008; Otañez, 2008).Historically, tobacco companies actively participated in illegal smuggling of tobacco products to the African continent as a strategy for penetrating markets in countries, such as Uganda and Malawi, that restricted tobacco imports and for creating demand for their products (ASH, 2008; Joossens and Gilmore, 2013; Lee, Ling and Glantz, 2012). Illicit trade in tobacco products—which includes smuggled goods as well as illegally manufactured goods—continues to be a challenge for African countries by undermining efforts to improve public health and circumventing customs revenue (an important source of income for many African governments) (Lee et al.
, 2012; Legresley, Lee, Muggli, Patel, Collin and Hurt, 2008; Transcrime, 2012). Limited data are available on the extent of illicit trade in Africa, as illegal activities are difficult to measure, but recent estimates on the illegal trade of cigarettes suggest that approximately 6–12 percent of their consumption in low- and middle-income countries is illicit (Jha, Chaloupka, Moore, Gajalakhmi, 2006; Joossens and Raw, 2012). Some tobacco companies have pledged to help curb illicit trade of tobacco products, but since these same companies have a history of disregarding national borders and laws to maximise profits, these promises should be viewed with caution (Joossens and Gilmore, 2013; Legresley, Lee, Muggli, Patel, Collin and Hurt, 2008).
Article 6 of the FCTC requires Parties to consider prohibiting or restricting the sale and import of tax-free and duty-free tobacco products (WHO, 2003a), and in November 2012, Parties to the FCTC adopted the Protocol to Eliminate Illicit Trade in Tobacco Products to address this issue more comprehensively. Measures include adopting effective control and tracking regulations, increasing national authorities tasked with detecting and deterring illicit trade, cooperating to share information and technology and enhance law enforcement, and providing financial resources as necessary (UN, 2012). The Protocol is currently open for signature and has yet to be entered into force.2.
1.16 Political Tactics of the Tobacco IndustryTo counter tobacco prevention and control strategies, the tobacco industry actively participates in national and transnational politics, deliberately spreads misinformation, and has financed biased research to deceive and misinform the public about the effects of tobacco (Lee, Ling and Glantz, 2012; Moodie, Stuckler, Monteiro, Sheron, Neal, Thamarangsi, Lincoln and Casswell, 2013). Within countries, local and international tobacco companies often lobby policy makers to oppose tobacco regulations, and in some countries, tobacco company executives hold high-level positions within the government or national advisory bodies (Goma, llilonga and Drope, 2011; KTSA Consortium, 2011; Ouedraogo, Quedraogo and Theodore, 2011). The tobacco industry spends millions of dollars every year to influence legislation and has formed “front groups” to oppose tobacco control policies from a seemingly independent perspective (Eriksen, Mackay and Ross, 2012). In Zambia, one tobacco company is known to provide incentives to policy makers, and has even proposed less stringent regulations in place of tobacco control policies (Goma, llilonga and Drope, 2011).
In Kenya, tobacco companies have filed lawsuits to challenge the implementation of tobacco control legislation (KTSA Consortium, 2011). To erode voter support for tobacco control regulations, the industry has also paid scientists and health professionals to publish biased research to counter information on the negative health effects of tobacco (Lee, Ling and Glantz, 2012). In the 1990s, the Chief of Health Services in Malawi wrote an article for a Journal run by a consultant for the tobacco industry that claimed “tobacco-related deaths and illnesses are primarily problems of affluent societies” (Eriksen, Mackay and Ross, 2012, p. 63).
Tobacco companies frequently deceive consumers and take great strides to boost their public image. Publicly, tobacco companies have claimed to recognise their products as “risky” and appear to agree with the need to prevent the youths from taking up smoking, while privately continuing to explore new ways to exploit the addictive properties of tobacco. In some African countries, such as Zambia and Eritrea, tobacco companies provide charitable donations and highlight their corporate social responsibility to deflect attention from the harmful effects of their products (Goma, llilonga and Drope, 2011; Tsighe, Hailemariam, Woldeab, Mebrhatu, Habte, Sium, Bokuretsion, Ahmed, 2011). While national-level strategies that oppose the tobacco industry’s economic and political efforts to undermine tobacco control can have strong effects within a country, addressing these efforts globally requires collaboration and coordination at the multinational and regional levels, such as the AU and the UN (Yach and Bettcher, 2000).
2.1.17 Tobacco Control and Regulation in NigeriaPrevious attempts by the Nigerian government to regulate the activities of tobacco manufacturers date back to the early 1990s. The first significant policy was the Tobacco Smoking (Control) Decree 20, 1990. In 2001, the decree was converted to an Act when Nigeria moved to democratic rule, and was titled “Tobacco (Control) Act 1990 CAP.T16.” The act provided for a ban on smoking in specified public places, and it required warning messages on every tobacco advertisement and sponsorship.
The highly ineffective warning message, “The Federal Ministry of Health warns that Smokers are Liable to Die Young”, was enforced, but the ban on smoking was not enforced in all the specified places, such as schools and stadia. Since 1990, Nigeria has consistently marked the World No Tobacco Day (WNTD) with the tobacco control community creating awareness and disseminating information to members of the public on the adverse effects of tobacco on public health. These efforts were always driven by civil society, but in the late 2000s, the MoH also began to organise WNTD events.After the 1990 legislation, there were a handful of hopeful signs of progress on tobacco control by the government. In 1999, in an effort to reinforce the government’s position on tobacco control, a National Smoking Cessation Committee was inaugurated and a short-term plan of action was developed.
These actions were shortly followed by a “total ban” on tobacco advertisement by the Advertising Practitioners Council of Nigeria (APCON) in 2002. In 2004, Nigeria signed the FCTC and subsequently ratified it on 20 October 2005. In 2007, an Abuja smoke-free policy was introduced by the minister of the Federal Capital Territory (FCT), banning smoking in public places. The Federal Government further demonstrated its political will to regulate the tobacco industry by paying its voluntary FCTC contribution to the World Health Organization (WHO) up to 2007 and halting the establishment of an $80 billion tobacco factory by the Imperial Tobacco Group in Osun State.
The successful mobilisation against the proposed factory was the combined effort of MoH officials and tobacco control non-governmental organisations (NGOs). A national comprehensive tobacco control bill has been a central goal of the tobacco control community for many years. The path of the National Tobacco Control Bill 2009 was a long and often challenging one, particularly through the National Senate but a discussion of its journey serves as an excellent illustration of the power of persuasion and perseverance by its supporters, in and out of government. The National Senate version of the legislation was sponsored by Lagos East senator (and deputy minority leader) Dr Olorunnibe Mamora (MD), and received its official second reading in February 2009.
According to tobacco control advocates, British America Tobacco–Nigeria (BATN) actively sought to quash the bill after the reading, and it was only after vigorous efforts on the part of civil society organisations that the bill advanced to the committee stage. It was considered in a formal public hearing by the Senate Health Committee in July 2009. During this time, the bill received a major boost from the Minister of Health, Professor Babatunde Osotimehin, who spoke out publicly in support of the proposed legislation. Anti-tobacco Bill has spent many years on the shelf of the Nigerian National Assembly. Different Non-Governmental Organisations and Civil Society Organisations have been pushing for the passage of the Bill for years. However, the sixth Senate that passed the bill failed to place outright ban on the use of tobacco products as it only opted for the controlled use of tobacco in the country. The immediate past administration headed by Goodluck Jonathan assented to the Bill.
2.2 Review of StudiesThis section examines studies that provided baseline information on noticeable pattern in the advertisement of cigarette, youths’ exposure to radio and television advertisements, the extent cigarette advertisements affect youths’ attitude, parental influences on the youths’ attitude to cigarette smoking, music and movie stars’ influence on the youths’ attitude to cigarette smoking and effect of peer pressure on the youths’ attitude to cigarette smoking.i. Adebayo, M. A. (2012).
Psychological variables influencing smoking among adolescent students in Senior Secondary Schools in Oyo State, Nigeria. Journal of Sociology, Psychology and Anthropology in Practice. Vol. 4(3) pp 1-5 The researcher studied psychological variables influencing smoking among adolescent students in Oyo State. His argument was premised on the fact that teenagers smoked for many reasons among which is curiosity. Many of the youths who smoke regard it as a symbol of adulthood. The researcher discussed the psychological variables influencing smoking to include self-concept, which is the set of belief young people have about themselves, family and parental influence as well as environment which can have significant impact on the upbringing of an individual, Adebayo (2012) citing Clayton (1991).
The researcher also argued that peer group could not be left out as one of the factors influencing smoking behaviour. He also claimed that family and friends could also influence the youths’ smoking behaviour.The research design employed was the causal comparative or ex-post factor design.
The target population was all adolescent secondary school students in Oyo State. The researcher randomly selected 200 adolescent students within the age range of 12-20 years and their age mean was 16-20 years comprising 114 boys and 86 girls from five schools, each school representing each zone of the five zones of Oyo State.The finding of the study shows a significant relationship between self-concept and smoking behaviour of adolescent students. However, no theory was used to explain the study, and this resulted in poor explanation of concepts in the study. Besides, other mediating factors such as parental influence, peer group, and advertising as an influence on youths’ smoking behaviour were not adequately examined.
ii. Oluwole, I. (2013). Social problems of tobacco marketing in Southwestern Nigeria: A behavioural study. Journal of Business Management and Economics Vol 1 (4) pp 1-13The researcher examined how tobacco companies have been making use of various media to advertise cigarette products. He argued that adolescents are an important segment of the tobacco market. Although, the positive impact of advertising on sales declines as cigarette markets become mature, tobacco advertisements recruit new users, remind and retain existing users of the product.
The potential smokers who live in nations where there are very low bases of income or who may be more naïve or less experienced with marketing and advertising strategies might be much more responsive to tobacco product advertisements and marketing efforts than are smokers in more developed countries such as in the United Kingdom or the United States.Marketing of tobacco by multi-national companies has indeed increased tobacco usage and in essence contributed to the harms caused by tobacco. Even, in spite of many marketing controls, tobacco companies continue to hire consultancies to help the industry design and market new strategies.There are also other clandestine marketing strategies including acts such as placing tobacco in movies. Celebrities are also used in advertisements, and children or youths will likely identify with such individuals and therefore, want to try the product.Market for tobacco in Nigeria grew at an annual rate of 47% between 2001 and 2006 (WHO, nd).
There is incriminating evidence that much of tobacco industry marketing activities are geared towards children and adolescents in an attempt in an attempt to recruit young people as future consumers of their products. The evidence that tobacco advertising and promotion increases tobacco use is solid and extensive.Planned Behaviour Theory was used to explain the study. The study was carried out in Southwestern Nigeria, and made use of survey research design. Questionnaire was used to collect data.
The findings revealed, among others, that the prevalence of tobacco use in the Southwestern Nigeria is attributable to marketing activities.However, the study was limited to the South-Western part of Nigeria. Besides, intervening variables such as parental influence, peer pressure and environmental influence were not discussed in the study. Advertising and marketing were not solely responsible for the youths’ uptake of cigarette smoking.iii. Labib, S., Abir, Q.
, & Ahmed, A. (2012). Knowledge, attitude and practice of university students towards smoking in Irbid, Jordan. Journal of public health and epidemiology Vol. 5(1) pp29-36 Labib, Abir and Ahmed (2012) studied knowledge, attitude and practice of university students towards smoking.
The aim was to explore the university students’ knowledge, attitude and practice and to compare these factors between smokers and non-smokers. A cross-sectional study was used to assess smoking patterns among university students. A modified Arabic version questionnaire of the Global Youth Tobacco Survey that was designed by the Centre for Disease Control was used. The majority of the students were well aware that smoking caused dangerous diseases and that passive smoking had a negative impact on others. The study reveals that there is a significant difference between the two groups concerning the knowledge and attitude of university students towards cigarette smoking. The percentage of smokers who knew that smoking caused dangerous diseases was lower than that of non-smokers. Also, the percentage of non-smoking students who were aware of the adverse effects of passive smoking on people around smokers was significantly more than that of students who smoked.
The attitude of smoking students towards the idea that smoking helped them fit in a group of friends was examined in the study. Students or youths who smoked were more likely to believe that smoking helped them fit into a group of friends when compared to non-smoking students or youths. Smoking female students were believed to have strong personalities and were more attractive than non-smoking females.However, the study had its deficiencies. For one, the study was not hinged on any theory that could help the scholars explain their work better. And, of course, the study failed to consider other accessories to cigarette smoking such as parental influence, peer group and television role models.iv.
Daniel, L.I., Monica, G.P., Alvaro B.
G., ; Maria J. F.C., (2013). Parent and Peer Influence Models in the onset of Adolescent Smoking. Journal of Health and Addiction Vol.
13No.1 59-66The study examined the influence of both parents and peers in the uptake of tobacco use. The aim of this study is to analyse the influence of different socialising agents (parents and peers) in the use of tobacco by adolescents and their intention to use tobacco in the future. It was thought particularly important to know the future intention of tobacco use, taking into account that a third of the sample was 13-years-old or below in this study, and European epidemiological studies state that this is the onset age for smoking.The study employed cross-sectional study in a school setting in Spain.
Survey method was adopted in the study. Teachers administered the copies of questionnaire on the students. The findings indicate that parental influence on adolescent behaviour may be moderated by quality of emotional relations and gender of the young person. An analysis of these variables shows that the group of adolescents with parents who smoked and low emotional bond registers a higher prevalence of use. However, the smoking habit of the parents in itself, taken as a model of tobacco use, represents a specific risk factor and is therefore, more important in explaining tobacco use of children.
There is relative importance of parental influence on adolescent tobacco use. Peer tobacco use is the variable that increases the probability of use the most. Aside from this, Girls are more vulnerable to social pressure, the use or intention to use increases more sharply among girls in the presence of friends who smoke than among boys.
No theory was employed to explain the research work. However, the study examined only two contributory agents in the uptake of cigarette smoking, which are grossly inadequate to explain factors responsible for cigarette smoking among adolescents. Other limitations stemmed from the fact that data were collected by means of self-administered questionnaire, completed in class while the teachers were present in the classroom. This type of study produces a tendency towards a socially desired response, which supposes bias in the validity of the results. v. Eric, V.
B., Othman, M. D. (2011). Role of parental and peer smoking influences in the development of adolescents’ smoking behaviour: A review.
Australian Journal of Basic and Applied Sciences, 5 (11): pp.1054-1061The authors used data from the Youth Smoking Survey (YSS) to determine the degree and the nature of the association between cigarette smoking in adolescents and the smoking habits of friends, and other potentially important influences in the youths’ social environment. A strong association between the smoking habits of close friends and those of the youths in the YSS was found. In sharp contrast, 59% of life time abstainers reported having no close friends who smoke. Life abstainers were less likely to report having no close friends who smoke as they became older.
The study assessed how far associations between possible explanatory variables and smoking onset depended on the use of cross-sectional versus prospective design. It was found that smoking by their best same-sex friend and the proportion of smokers in the peer group was positively associated with current smoking at each time point. Those with a best same-sex friend were more likely to become smokers themselves. The authors also conducted a longitudinal survey of 1,000 young boys aged between 15 and 23 years in West of Scotland. The study was to examine the effect of friends’ smoking on uptake of regular smoking among young people from mid-adolescence to early adulthood; whether such effects were time limited, vary by social class and gender, and the extent to which uptake precedes or follows friends’ smoking.
The results indicated that the uptake of regular smoking between aged 15 and 23 was associated significantly with friends’ smoking behaviour at age 15, 44% of those with ‘most’ friends smoking becoming regular smokers over this period compared with 18% with no smoking friends. The researchers employed a sample of 947 adolescents in New Zealand to investigate the relationship among father’s occupational group, daily smoking, and smoking determinants in a cohort of New Zealand adolescents. It was reported that adolescents who had positive attitudes toward smoking friends or adults, who did not believe in the detrimental effects of smoking, who reported a higher number of reasons to smoke were significantly more likely to smoke daily. Compared with adolescents who strongly agreed with the statements about the harmfulness of smoking, those who just agreed had higher odds of smoking daily. To summarise, there appears to be a reasonably good supportive evidence that peer smoking has an effect on adolescents smoking behaviour, and adolescents who have a positive attitude towards their friends smoking will more likely influence their own smoking behaviour.The study is driven by social learning theory.
The key concepts in social learning theory include behavioural capability, expectancies, observational learning, reinforcements, self-efficacy, and reciprocal determinism. This theory assumed that behaviors learned by individuals are based on what they see and learn from people close to them, such as their parents, friends, and siblings.However, the findings may not be applicable in Nigeria because of differences in culture, as the scholars carried out the studies in European Nations.
2.3 Theoretical Framework This study is hinged on three different theories. They are social cognitive theory, observational learning and imitation behaviour theory and social learning theory.2.3.1 Social Cognitive TheoryThe study is hinged on social cognitive theory.
The theory is most suitable for the study because it postulates how individuals could be affected by parents and advertisements to take up cigarette smoking. The social cognitive theory as expressed by Dimpka and Wilcox (2016) citing McAlister, Perry and Parcel (2008) posit that individuals are influenced in several ways by certain interacting variables such as cognition, environment and behaviour. The theory explains how an individual can initiate and maintain a given behaviour. For instance, in terms of quitting smoking, there is a specific role played by the interactional effects of cognitive, environmental and behavioural factors (McAlister et al.
, 2008).First, the cognition is connected with various mental processes that occur within the individual such as behavioural capability, outcome expectancies and feelings of self efficacy. Second, the environment comprises any factor, physically external to the individual that can have an impact on his or her behaviour.
Thus, the environment includes social factors such as the family, friends, i.e observational learning; and the physical such as the weather, availability of tobacco products, etc (McAlister et al., 2008) as cited Dimpka and Wilcox (2016).Third, behaviour is the outcome of any kind of influence. In other words, it refers to the way in which the individual reacts to various inputs from the social or physical environment (i.
e. self regulation). In view of this study, the researcher is specifically connecting with this theory from the perspective of environmental influences on behavioural disposition of an individual. In other words, certain environmental forces may have a link with the cigarette smoking habits cultivated by a person. For example, the researcher views two major environmental factors that influence behaviour to include the home and the peer group as responsible for the youths’ smoking behaviour. The home factor consists of parents, siblings, guardians and neighbours whose behaviours affect the individual either overtly or covertly.
Furthermore, the peer group may include school mates, friends or other adults within the youth’s environment. Thus, the study views the cigarette smoking behaviour of the youth as one that may be determined by environmental influences.2.3.2 Observational Learning and Imitation Behaviour TheoryThis theory is relevant to the study because most youths imitate their movies and television role models with regard to cigarette smoking.
This study is also hinged on observational learning theory as stated by Pavlov and Skinner (1957). They argue that an individual’s behaviour is affected by the message from the mass media to which he is exposed. In the movies or television, the audience members identify with the behaviour of their television or movies’ role models or heroes. The youths are stimulated to imitate the behaviour of their television and movie role models. If the television and movie role models engage in cigarette smoking, the youth will likely imbibe the same behaviour.Both theories assume that people, especially children, tend to learn aggression from the mass media and to model their behaviour on that of a dramatis personae. The learning process is similar to that by which children imitate the behaviour of adults around them.
The chances of actualisation when a pertinent situation arises are enhanced when the subjects expect to be rewarded for such behaviour, and there is a close similarity between the dramatised violence and real life situation the subject subsequently encounters. However, the likelihood of exhibiting learned aggression is moderated by personal circumstances such as social class and the pertinent social situation. Observational learning theory is rooted in all the three perspectives on media effects: individual differences, social categories and social relations perspectives. 2.3.3 Social Learning TheorySocial learning theory, according to Bandura (1977) has been used often in smoking behaviour research.
Social learning theory views behaviours as a result of the dynamic, reciprocal relationship between personal factors and social environmental influences. The key concepts in social learning theory include behavioural capability, expectancies, observational learning, reinforcements, self-efficacy, and reciprocal determinism. This theory assumes that behaviours learned by individuals are based on what they see and learn from people close to them, such as their parents, friends, and siblings. According to this theory, a child who looks up to an older sibling who is a smoker is more likely to start smoking as well, as long as she or he has the self-efficacy to do it.
The way this theory has been commonly tested in research is by asking respondents about the smoking history of people close to them, whether they view smoking as socially desirable, and whether they have the access and ability to smoke.CHAPTER THREERESEARCH METHODSThis chapter deals with the methods, techniques and procedures adopted in carrying out the study. It is discussed under these sub-heads:iResearch DesigniiPopulation of the StudyiiiSample Size and Sampling ProcedureivDescription of Research InstrumentsvValidity of Research Instruments viReliability of Research InstrumentsviiMethod of Data CollectionviiiMethod of Data Analysis3.1 Research DesignA study of this kind which borders on attitude requires the survey method of gathering data to ascertain knowledge, belief, views and opinions of the youths about tobacco advertising and cigarette smoking. Survey research design was employed in this study because the study involved a large population. Tuckman (1972) observes that “survey research measures what a person knows (Knowledge or Information), what a person thinks (attitude and belief) and what a person likes and dislikes (Values and preferences)”. Survey method is the process of extracting information from a target population through the use of observations, questionnaire or interviews, and subjecting the data that are obtained for statistical analysis for the purpose of drawing conclusions.
Thus, the survey was chosen as the research design for this study; it was used basically to determine the youths’ attitudes, knowledge, belief and opinions about tobacco advertisements and cigarette smoking in Oyo State.3.2 Population of the StudyThe study population consisted of young cigarette smokers and non-smokers in Oyo State. The African Union (2006) describes a youth as “a person that falls between the age of 15 and 35”.
The age selected in this study for consumption or use of tobacco is put between 15 and 35 years. Oyo State has 33 Local Government Areas, with a 2010 projected population estimate of 5, 580, 894 (Federal Republic of Nigeria, 2010) while those that fall between 15 years and above represent 62.6 percent (National Bureau of Statistics, 2013) see Appendix V. Consequently, the population for the study is 3,493,639 representing 62.6 percent of the population.However, a representative of the Oyo State Ministry of Health and the Director of Marketing in the British-America Tobacco-Nigeria were interviewed in line with the objectives of the study.
3.3 Sample Size and Sampling ProcedureThe young cigarette smokers and non-smokers constituted the population for this study with a total number of 3, 493, 639, which is however adjudged too large for the study. However, the sample size of 400 was arrived at using confidence level of 95% and confidence interval of ±5 assumed population statistics. This was generated with the aid of the Sample Size Calculator. Therefore, the sample size of 400 was used.
The sampling technique adopted for the study was multi-stage sampling. This is because the sampling procedure required different procedures at different stages of population selection. The stratified sampling method was later used to access respondents from the three Senatorial Districts of Oyo State. A stratified sample is the approach used to get adequate representation of a subsample, and it decreases probable sampling error.
Rather than select a sample from the total population, the researcher ensured that appropriate numbers of elements were drawn from subsets of that population.To get a stratified sample of the youths in Oyo State, the population was organised into three senatorial districts as shown below:Summary of Population of Youths in the Three Senatorial Districts of Oyo StateSenatorial Districts Youths’ PopulationOyo Central 1,176,341Oyo South 1,106,736Oyo North 1,210,562Total 3493639Source: National Bureau of Statistics 2013 projectionUsing a sample size of 400, the proportionate sampling method was used at this stage to select the actual number of respondents for the study in each of the strata. This is because the population of each senatorial district is different.
Consequently, the percentage of each stratum is shown below:Oyo Central Senatorial District = 136Therefore 136 youths in Oyo Central Senatorial District formed the population for the study.Oyo South Senatorial District = 125Therefore 125 youths in Oyo South Senatorial District formed the population for the study. Oyo North Senatorial District = 139Therefore 139 youths in Oyo North Senatorial District formed the population for the study.At this stage, the respondents were arbitrarily selected from the popular clubs, beer joints and bars in each of the thirty-three Local Government headquarters of Oyo State. Oyo Central Senatorial District covered Jobele, Moniya, Egbeda, Ajaawa, Iresaadu, Iyana-Offa, Idi-Ayunre, Akanran, Kosobo, Ojongbodu and Offa-Meta. Oyo South Senatorial District covered Eruwa, Iwo Road, Onireke, Mapo Hill, Oluyole Estate, Igboora, Agodi-Gate, Ayete and Eleyele. Oyo North Senatorial District covered Saki, Ago-Amodu, Ago-Are, Kisi, Igbeti, Okeho, Iwere-Ile, Ogbomosho, Arowomole, Oluwole, Igboho, Ikoyi-Ile and Otu.
3.4 Description of Research Instruments The instruments for the survey were questionnaire and personal in-depth interview schedules. The questionnaire and interview schedule were designed to elicit answers to the research questions raised in the study. This was to enable the researcher to determine the extent to which respondents held particular attitude or perspective about tobacco advertising and cigarette smoking. To this end, the major instrument for data collection was the questionnaire and interview, the second instrument.
`The interview schedule guide was used for the in-depth interview. The interview enabled the researcher to clarify issues and the respondents freely aired their views on the subject matter of investigation. Consequently, representatives of the State Ministry of Health and the Director of Marketing in the British-America Tobacco-Nigeria located in the State Capital were interviewed based on the following contents: The quit programmes or anti-smoking campaigns of the Ministry of Health in Oyo State;The roles of public health officials in educating the youths about health effects of cigarette smoking;Cigarette advertisements and the epidemic of terminal diseases;Effectiveness of warnings on cigarette packets;Influence of cigarette-smoking parents on the youths or wards;Peer pressure and positive attitude to smoking among youths;British-America Tobacco Nigeria’s compliance with APCON rules with regard to cigarette advertisements;viii The media and other means used by the British-America Tobacco Nigeria to influence positive attitude to its product.The questionnaire consisted of a thirty-five (30) items. Section A covered gender, age, and other demographic information of the respondents.
Under Section B, 1-5 looked at the different kinds of cigarette advertisements. Question 6-10 elicited responses on the youths’ level of exposure to radio and television cigarette advertisements. Question 11-15 elicited responses about extent cigarette advertisements affect the youths’ attitude to smoking. Questions 16-20 looked at the influence of the warning by the Ministry of Health on cigarette packets on the youths’ smoking habit. Question 21-25 treated the effects of parental influence on the youths’ attitude to smoking. Question 26-30 took a look at the extent peer pressure affects the youths’ attitude to cigarette smoking.3.5 Validity of Research Instruments As a way of validating the research instrument for the study, face validity was required. Experts in mass communication, public health and research supervisor scrutinised the contents of the questionnaire and interview schedules and corrections were made as appropriate. The questionnaire was assessed to make sure the items raised in the study agreed with the objectives of the study. Also, the interview questions were scrutinised by scholars in the fields of communication and public health to ensure that they elicit accurate responses from the respondents.3.6 Reliability of Research InstrumentsTo achieve the reliability of the instrument, a pre-test was conducted on a pilot group of 20 randomly selected respondents not connected with the study from Achievers University, Owo, Ondo State, using Cronbach’s Alpha. After computation, a reliability index of 0.97 or 97 percent was achieved which was considered significant. Each item in the instrument, based on its relevance to the research questions and objectives of the study, was regarded as reliable. Details of the reliability test are shown in the appendix IV. 3.7 Method of Data CollectionCopies of the questionnaire were administered on the respondents who were drawn from the club members in each of the thirty three Local Government Headquarters of the State. To achieve this, research assistants who were thoroughly trained in line with the requirements of the study were recruited to assist in the administration of the questionnaire on the respondents in their different locations and retrieve the questionnaire on the spot. Data from copies of administered questionnaires were collated for analysis. Similarly, the interviews were conducted by the researcher. This enabled the researcher to gather more data from follow-up questions as well as clarify any issue realised from the field. Key interviewees were representatives of the State Ministry of Health and the Director of Marketing in the British-America Tobacco-Nigeria.3.8 Methods of Data AnalysisData gathered from the survey were sorted and tabulated in frequency distribution tables and percentages. Also, the interview data were analysed and interpreted qualitatively using explanation building method. However, hypothesis one (H?) was tested using the Chi Square, while the other two hypotheses (H2 & H3) raised in the study were tested using the Pearson Product Moment Correlation Coefficient (PPMCC). The formula for Pearson Product Moment Correlation Coefficient (PPMCC) is:R= n xy – (x) (y )n( x2 – (x )2) n( y2 – (y )2)Where: x and y= original scores N= number of pairs of scores? = summation of symbolxy = sum of the products of each x and y3.9 Ethical IssuesThe respondents were duly informed about the purpose of this study and were not made to fill in the copies of the questionnaire under duress or compulsion. I did not also infringe on the private lives of the respondents, and I ensured that the identity of the respondents was protected during and after the research work. In the same vein, I did not employ any deceptive means or fake my identity to gather information from the respondents. My identity and the purpose of the research work were clearly stated in the copies of the questionnaire administered on the respondents. The research procedure or the data gathering procedure did not, in any way, cause any physical or emotional harm to the respondents. The data I gathered from the respondents were properly guarded in order not to reveal the identity or submissions of respondents in the study. The data were analysed in line with the objectives of the study, and were not distorted or manipulated to achieve selfish ends.I explained the purpose of the research to the respondents I interviewed in the course of gathering data, and they expressed their readiness to be interviewed. I did not collect data from them under duress or interview them forcibly against their wish. CHAPTER FOURDATA PRESENTATION AND ANALYSIS Data from this study were analysed using the qualitative and quantitative methods of data analysis. Consequently, the demographic data of the respondents, answers to the research questions raised in the study, results of hypotheses testing and discussion of findings are presented in this chapter. 4.1 Data Presentation and Analysis Out of 400 copies of the questionnaire that were given to the respondents, 384 copies were returned and used for the analysis. The questionnaire addressed the issues raised in the research objectives which also helped in the generation of data for hypotheses testing.4.1.1 Analysis of Questionnaire Data4.1: Demographic Data of RespondentsTable 1: Distribution of Respondents by gender, age, occupation, marital status and educational qualifications Options Number of Respondents Percentage 1.1 Gender Male 231 60Female 153 40 Total3841001.2 Age15-19611620-242346025-29641730-3420535 & above52Total384100OccupationStudent30278Artisan3510Civil Servant297Unemployed113Trader72Total 3841001.4 Marital StatusSingle31080Married7218Divorced22Total3841001.5 Educational QualificationsPrimary School154OLevel/ SSCE14037OND/NCE10527HND/BSC/B.A/B.Ed/B.Tech11329M.A/ MSC/Ph.D113Total 384 100Source: Fieldwork, 2017Table 4.1 indicates that young men were more inclined to cigarette smoking than young women. Here, 231(60) were males, while 153(40) were females.Most of the respondents (234) representing 60% were between the ages of 20 and 24. Only 5 respondents representing (2%) were aged over 35 years.Three hundred and two respondents representing 78% were students. Only 7 respondents representing 2% were traders.Three hundred and ten respondents representing 80% were single, seventy-two respondents representing 18% were married, while 2 respondents representing 2% were divorced.One hundred and forty respondents representing 37% had their OLevel/SSCE certificates. Only 11 respondents representing 3% had their M.A, MSC/Ph.D certificates. Table 2: Respondents’ awareness of the different kinds of cigarette advertisements disseminated in the media in Oyo StateMedia Number of respondents percentage2.1 Awareness of cigarette advertisementsRadio114 30Magazines5615Newspapers 4812Internet328Billboard/Street Banners82 21Television5214Total3841002.2 How often do these mediaAdvertise cigarette products?Very Often14438Often10828Less Often7018Not at all6216Total3841002.3 Apart from traditional media, Through which other means do you getCigarette advertisementMovie12232Kiosk9024Club 6617Through friends4812Posters 5815Total3841002.4 Have you ever made a purchase of a brand of cigarette products Advertised in the media?Yes28875No9625Total 384 100Source: Fieldwork, 2017Table 2 shows that 114 respondents representing 30% were aware of cigarette advertisements on radio. Only 32 respondents representing 8% were aware of cigarette advertisement in the Internet.One-hundred and forty-four respondents representing 38% said the media advertised cigarette products very oftenOne-hundred and twenty-two respondents representing 32% said they also got to know of cigarette advertisements in the movie. Only 48 respondents representing 12% said they also were aware of cigarette advertisements through friends. Two-hundred and eighty-eight respondents representing 75% said they had purchased a brand of cigarette products advertised in the media.Table 3: Level of youths’ exposure to radio and television cigarette advertisement in Oyo State Options Number of Respondents Percentage3.1 Exposure to RadioCigarette advertisement Very High11229High5414Medium 6918Low6216No Exposure at All8723Total3841003.2 Exposure to TelevisionCigarette advertisementVery High 7921High 8523Medium7720Low6015No Exposure at All8321Total3841003.3 Exposure to Cigarette AdvertisementIn Sporting EventsVery High10928High 10126Medium6918Low4612No Exposure at All5916Total3841003.4 Exposure to Cigarette AdvertisementIn StoresVery High6617High6918Medium8322Low9425No Exposure at All7218Total3841003.5 Exposure to Cigarette AdvertisementIn the outdoor mediaVery High8923High6016Medium8121Low7018No Exposure at All8422Total 384 100Source: Fieldwork, 2017Table 3 shows that most respondents 112 representing 29% had a high exposure to radio cigarette advertisement. Only 62 respondents representing 16% had a low exposure to cigarette advertisement on radio. Seventy-nine respondents representing 21% had a very high exposure to television cigarette advertisement, while 60 respondents representing 15% had a low exposure to television cigarette advertisement.One-hundred and nine respondents representing 28% had a very high exposure to cigarette advertisement in the sporting events, while 46 respondents representing 12% had low exposure to cigarette advertisement in the sporting events.Ninety-four respondents representing 25% had a low exposure to the cigarette advertisement in stores, while 83 respondents representing 22% had a medium exposure to the cigarette advertisement in stores.Eighty-nine respondents representing 23% had a very high exposure to cigarette advertisement in the outdoor media. Only 60 respondents representing 16% had a high exposure to the cigarette advertisement in the outdoor media.Table 4: The extent cigarette advertisement affects youths’ attitude to smoking in Oyo StateOptions Number of Respondents Percentage4.1 Cigarette advertisement inducepositive attitude to smoking in the youthsVery Great 12833Great Extent6718Some Extent8222Little Extent4110Very Little Extent6617Total3841004.2 Cigarette advertisement encouragesthe uptake of cigarette smokingVery Great Extent8623Great Extent10327Some Extent8522Little Extent6116Very Little Extent4912Total3841004.3 Cigarette advertisements encourage formersmokers to resume smokingVery Great Extent9224Great Extent6417Some Extent7920Little Extent6918Very Little Extent8021Total3841004.4 Advertisements encourage youths to smoke for pleasure Very Great Extent12934Great Extent9324Some Extent7620Little Extent3810Very Little Extent4812Total 384 100Source: Fieldwork, 2017Table 4 indicates that 128 respondents representing 33% were of the opinion that cigarette advertisements induced positive attitude to smoking in the youths. Only 41 respondents representing 10% stated that cigarette advertisements induce positive attitude to smoking in the youths to little extent.One-hundred and three respondents representing 27% acknowledged that cigarette advertisements encouraged the uptake of cigarette smoking to a great extent. Only 49 respondents representing 12% stated that cigarette advertisements encouraged the uptake of cigarette smoking to a very little extentNinety-two respondents representing 24% were of the view that cigarette advertisements encourage former smokers to resume smoking to a very great extent. Only 64 respondents representing 17% were of the view that cigarette advertisements encourage the former smokers to resume smoking to a great extent.One-hundred and twenty nine respondents representing 34% were of the view that advertisements, to a very great extent, encouraged youths to smoke for pleasure. Only 48 respondents representing 12% believed that advertisements, to a very little extent, encouraged youths to smoke for pleasure.Table 5: The effect of warnings on cigarette packets Options Number of Respondents Percentage5.1 Warning on Cigarette IncreaseCessation Behaviour among smokers Very Effective11630Effective9625Less Effective7319Slightly Effective6216Not Effective at all3710Total3841005.2 Warnings on Cigarette Packets Increase knowledge about health effects of smokingVery Effective 15039Effective8522Less Effective7720Slightly Effective3810Not Effective at All34 9Total3841005.3 Text-only warning labels helpCigarette smokers quitVery Effective5013Effective6517Less Effective8823Slightly Effective10828Not Effective at All7119Total3841005.4 Image-based warning labels decreaseLevel of cigarette smokingVery Effective13636Effective9625Less Effective6216Slightly Effective5414Not Effective at All369Total3841005.5 Do You Smoke?Yes27672No10828Total3841005.6 Have You Quit Smoking?Yes208 7No 68 25Total2761005.7 Why Did You Quit Cigarette SmokingCigarette smokers are liable to die young8842Quitting lowers the risk of cancer-related ailments 5024Quitting has major and immediate health benefits 3617Ex-smokers live longer than those who keep smoking 2211Quitting cigarette smoking saves time and money 126Total 208 100Source: Fieldwork, 2017Table 5 indicates that one hundred and sixteen respondents representing 30% were of the view that warnings on cigarette packets were very effective in increasing cessation behaviour among youths. Only 96 respondents representing 25% were of the opinion that warnings on cigarette packets were effective in increasing cessation behaviour among youths.One-hundred and fifty-four respondents representing 39% were of the opinion that warnings on cigarette packets increased knowledge about health effects of smoking. Only 34 respondents representing 9% were of the view that warnings on cigarette packets were not effective at all in increasing knowledge about health effects of smoking.One-hundred and eight respondents representing 28% said text-only warning labels were slightly effective in helping cigarette smokers quit. Only 55 respondents representing 13% submitted that text-only warning labels were very effective in helping cigarette smokers quit.One-hundred and thirty-six respondents representing 36% submitted that image-based warning labels were very effective in reducing level of cigarette smoking. Only 36 respondents representing 9% stated that image-based warning labels were not effective at all in reducing the level of cigarette smoking.Two-hundred and seventy-six respondents representing 72% said they smoked and 208 respondents representing 75% said that they had quit cigarette smoking.Eighty-eight respondents representing 42% said they quit smoking because smokers were liable to die young. Only 50 respondents representing 24% said they quit smoking because it lowered the risk of cancer-related ailments.Table 6: Effect of parental influence and peer pressure on youths’ attitude to smokingOptions Number of Respondents Percentage6.1 A cigarette-smoking parent mayPositively influence the child toTake up smokingVery Great Extent24565Great Extent6417Some Extent348Little Extent174Very Little Extent246Total3841006.2 Positive parental attitude to smoking mayEncourage youths to initiate regular useVery Great Extent14238Great Extent10126Some Extent8723Little Extent328Very Little Extent225Total3841006.3 Negative parental attitude to cigarette smokingMay prevent child’s uptake of cigarette smoking Very Great Extent11530Great Extent7519Some Extent8522Little Extent6116Very Little Extent4813Total3841006.4 A non-smoker may imitateA cigarette smoking peerVery Great Extent17345Great Extent9725Some Extent4612Little Extent298Very Little Extent3910Total3841006.5 Peer pressure promotes positive attitudeand belief about cigarette smokingVery Great Extent10929Great Extent9725Some Extent10627Little Extent4512Very Little Extent277Total3841006.6 Peer pressure may generate loyaltyTo a brand of cigaretteVery Great Extent10126Great Extent10628Some Extent8622Little Extent6417Very Little Extent277Total 384 100 Source: Fieldwork, 2017Table 6 shows that 245 respondents representing 65% submitted that a cigarette-smoking parent, to a very great extent, influenced the child to take up smoking. One-hundred and forty-two respondents representing 38% stated that positive parental attitude, to a very great extent, encouraged the youths to initiate regular cigarette use. One-hundred and fifteen respondents representing 30% were of the view that negative parental attitude, to a very great extent, prevented a child’s uptake of cigarette smoking. One-hundred and seventy-three respondents representing 45% submitted that a non-smoker may imitate a cigarette-smoking peer to a very great extent. Twenty-nine respondents representing 8% stated that a non-smoker might imitate a cigarette-smoking peer to a little extent.One-hundred and nine respondents representing 29% were of the opinion that, to a very great extent, peer pressure promoted positive attitude and belief about cigarette smoking. However, 27 respondents representing 7% stated that peer pressure promoted positive attitude and belief about cigarette smoking to a very little extent.One-hundred and six respondents representing 28% were of the view that peer pressure, to a great extent, might generate loyalty to a brand of cigarette. However, 27 respondents representing 7% submitted that peer pressure may generate loyalty to a brand of cigarette to a very little extent.4.2 Presentation of Interview Reports1. Interview with Deputy Director of Public Health in the Oyo State Ministry of HealthI. The quit programmes or anti-smoking campaigns initiated by Oyo State Ministry of HealthThe Deputy Director of Public Health in the Directorate of Public Health in the Oyo State Ministry of Health, Dr Olabode Ladipo, said that the Oyo State Ministry of Health had worked in conjunction with the Federal Ministry of Health in the area of prohibiting cigarette smoking in public places, that is, places that are designated by the government as non-smoking areas. He said there was a serious effort seven years ago when the Federal Ministry of Health collaborated with State Ministries of Health to prohibit the advertisement of tobacco and allied products in Nigeria. The Oyo State Ministry of Health enforced the prohibition in certain places in Oyo State. The Oyo State House of Assembly also passed a Bill prohibiting smoking in public places and in commercial vehicles on June 2, 2016. The state has actually tried to see how best to limit the issue of smoking and the issue pertaining to second-hand smoking. Part of the Non-smoking Act by the Oyo State House of Assembly was to enforce selling cigarette to only people that are above 18 years. He, however, said he could not definitely say how the Enforcement of that Act was carried out. He was not too sure whether the Law Enforcement Agents had that instrument or perhaps utilised the instrument in their own operations. But, there is an existing law that prohibits people less than the age of 18 from being able to purchase tobacco and even alcohol.The Oyo State Government has put a mechanism in place to stop smoking in schools-either private or public. However, places such as motor parks, recreational, bars, hotels, beer parlours and clubs are not designated areas for non-smoking. Enforcement of non-smoking in those non-designated areas is not realisable. The issue of law enforcement in this country is still under the purview of Federal Ministry of Interior. So, the state may not have the instrument for enforcement in terms of arrest and prosecution. This is one area that needs to be considered in terms of enforcing the anti-smoking law.II The role of public health officials in educating the youths about the health effects of cigarette smokingPublic health workers, most times, go to health care facilities in the state to offer useful advice to people with regard to their health. As part of the general health talks given, things that perhaps promote ill-health especially the issue of smoking and alcoholism are specifically mentioned to people when they come to health facilities. They actually sit or wait to listen to health talks. In addition to that, the Ministry of Health has worked in collaboration with the Ministry of Information to generate jingles and messages that are disseminated in the media, talking about the effects or ills of smoking or alcoholism. He said the Ministry of Health was trying to ensure that each key person that is involved, gets the information, perhaps at health facilities, schools, banners and face-to-face interactions, or anti-smoking rallies organised by some Non-Governmental Organisations. Then, if those means are not utilised, the mass media are used to enlighten the consumers of alcohol and cigarette smokers in the State about the dangers of those habits.Most of the households have at least a radio set, even if it is a tiny transistor radio. So, one way or another, people get health information. The initial problem they had some years ago was the fact that a lot of things were broadcast from Ibadan- the State Capital. So, those messages broadcast from Ibadan did not actually get to the rural areas in Oyo State. But now, the Oke-Ogun FM at Alaaga takes care of the information needs of the people in Oke-Ogun. There is another at Gambari christened “Ajilete FM” disseminating relevant information to Ogbomosho people. The Ministry had equally devised a means by which those outlets disseminate relevant health information to the rural citizens. The rural dwellers are the ones that actually utilise health facilities unlike urban dwellers. They usually listen to doctors and are much more patient than urban dwellers. They listen to the health information and they ask questions and one way or the other, the Ministry has better interactions with the people in the rural areas because they are much more inclined to accept things coming from the health workers than the urban dwellers. Attending to urban dwellers is sometimes problematic because they come to health facilities impatient and always in a hurry to get treated and get out. The urban dwellers are not always ready to listen to health talks.Going from one school to another and educating the students about the health effects of cigarette smoking could actually be effective if the manpower and the logistics were available. Perhaps, the best way to do that is to invite the Ministry of Education which will instruct the teachers to talk to students about the health effects of cigarette smoking. Pictures could be shown to students in schools about a dying cigarette smoker to educate them.III Cigarette advertisements on media and epidemic of terminal diseasesTobacco companies are very strong multinationals that have the capacity to produce creative advertisements and convince the young people to make a purchase. Tobacco actually kills faster than HIV/AIDS. Nicotine, an addictive substance in cigarette, impedes the smokers from quitting. In spite of health warnings and sensitisation about the dangers of cigarette smoking, the number of initiates keeps increasing. For this reason, the rate of stroke, heart failure, dental problems, lung cancer, cancer of the throat, etc is on the increase among cigarette smokers nowadays. IV Effectiveness of warnings on cigarette packetsDr Olabode Ladipo said he was part of the committee that recommended that minimum of two-third of the cigarette packets should have the warning signs boldly written on it-“Smokers are liable to die young” and “cigarette should not be taken by anybody less that 18 years”. But then, just like cigarette, which is not meant to be sold to someone less than 18 years, it is also written on the bottles of the alcoholic drinks that drinkers should drink responsibly. But still, adults take it with relish, and children watch them do so. It will therefore be a herculean task to convince these children that alcoholism is not good. Cigarette is addictive because it has nicotine. Nicotine is an addictive substance in tobacco that makes quitting cigarette smoking very difficult.People tend to take decisions when they are scared of something. If the picture of a dying cigarette smoker could be engraved on the packets of cigarette, people will start to take a precaution. Text-only warning can only work for people that can read and write English Language. The use of image-based warning is more effective because it breaks illiteracy barrier. V Influence of cigarette-smoking parents on the youths or wardsThis is even a worse case because it will be difficult for a father that smokes to tell his 16-year old boy that smoking is not good for his health. What moral justification has that parent got to tell the child that smoking is bad? This is logical. Having cigarette-smoking parents can actually propel children to develop interest in cigarette smoking. There are several families like that. It is even worse when those parents are not often around to curtail that habit, especially when such parents are not regular at home or often come back late from work. There would be little level of supervision and control. So, by the time the habit is noticed in the child, he would have become addicted. So, stopping such child from continuing smoking will now require health-care interventions. Health-care interventions, in this sense, mean that you will need some level of specialised care such as psychiatry, withdrawal, and rehabilitation. It is not only addicted drinkers of alcohol or users of hard drugs that need rehabilitation, addicted cigarette smokers also need rehabilitation.VI Peer pressure and positive attitude to smoking among youthsPeer pressure is one of the major influences of youths’ involvement in cigarette smoking habit. Sometimes, the unusual confidence and brilliance that some students display might be inspired by their use of tobacco and other hard drugs. One of the issues that has been acknowledged in Health Education is peer group influence. Once youths see something that is considered trendy, they copy it blindly. The same thing applies to cigarette smoking. Many youths take up cigarette smoking because their friends smoke cigarette.Interview with the Representative of Oyo State Signage and Advertising AgencyI.British-America Tobacco Nigeria’s compliance with APCON rules with regard to cigarette advertisementsMr Akin Adesola, a member of staff of the Oyo State Signage and Advertising Agencies, said the British-America Tobacco Nigeria complies with the APCON rules through advertising agencies. For example, when tobacco and allied products are advertised, they must carry a warning message such as “The Federal Ministry of Health warns that smokers are liable to die young” whether advertised on television, radio, newspaper or billboard. Tobacco companies make use of advertising agencies to advertise their products, with a strict observance of rules and regulations guiding the advertising of tobacco products, as laid-down by the Advertising Practitioners Council of Nigeria (APCON). The outdoor advertising agencies register with Oyo State Signage and Advertising Agencies and, on behalf of the advertisers, use billboard and other media to advertise tobacco products. Oyo State Signage and Advertising Agencies ensures that billboard advertisements comply with Oyo State Environmental Laws as well as give due consideration to the public health, especially if the advertisement has to do with products that may have negative effects on the health of the people. Such products include alcohol, tobacco and allied products and other harmful substances. Warnings are conspicuously engraved on the billboard or packets of tobacco products. Warnings are loudly voiced and heard if the tobacco advertisements are done in the broadcast media.II. The media used most by BATN to advertise its product The British-America Tobacco Nigeria uses billboard, television and radio most to reach their customers. This is because these channels have the capability to reach a large number of people at the same time. Besides, many people can get exposed to the billboard messages many times over. BATN also advertises its product through the electronic billboard, that is, Local Eletronic Display (LED), often erected at major road intersections.III. Collaboration between BATN and Oyo State Ministry of Health aimed at enlightening the public about the dangers in smokingBritish-America Tobacco Nigeria has collaborated with the state government in enforcing non-smoking in designated areas. It is collaborating with other Non-Governmental Organisations to enforce non-smoking among youths in Oyo State. To ensure that smoking is reduced among youths in Oyo State, the Oyo State House of Assembly has enacted a law banning smoking in public places.The Non-Smoking Law in Oyo State was given publicity on May 31, which is the World Non-Smoking Day. However, before the day, some Non-Governmental Organisations and the British America Tobacco Nigeria were contacted to support the rally. Unfortunately, the British-America Tobacco Nigeria failed to come for the rally and no reason was given for their absence. IV British-America Tobacco Nigeria and non-interference in public health issuesBritish-America Tobacco Nigeria is investing in other profitable agricultural projects like tree planting to enhance the economy of the community where they operate. They have planted trees in some parts of Oke-Ogun. So, when these trees are grown, they can be felled and sold to make income. V. The media and other means used by the British-America Tobacco Nigeria to influence positive attitude to its product Tobacco companies acquire kiosks, paint them with the company’s colour and use them to sell different brands of cigarette. This is a subtle means through which the tobacco companies have been advertising and selling their products to the consumers.Cigarette smoking is a habit. Smokers need a special sensitisation to stop smoking. So, the tobacco companies are exploiting this weakness on the part of the smokers to force their products on the consumers. The tobacco companies have new customers because of imitation, stress, emotional factors, parental influence, and peer pressure. Tobacco companies normally erect their kiosks where there is a large number of people like markets, motor parks, hotels, bars, places where they could influence brand loyalty or uptake of cigarette smoking.4.3 Test of Hypotheses The summary of the testing of the hypotheses are presented below. The three hypotheses were tested at 0.05 level of significance.Hypothesis 1H1: Youths’ exposure to cigarette advertisement leads to more positive attitude to smoking.Ho: Youths’ exposure to cigarette advertisement does not lead to more positive attitude to smokingStatistical Test Advertisement Induced Not InducedSmokers 184 62 246SmokersTotal 82 266 56 118 138 384 O E O-E O-E² O-E² Ea 184 170.4 13.6 184.96 1.085b 62 75.59 -13.59 184.68 2.443c 82 95.59 -13.59 184.68 1.932d 56 42.40 13.6 184.96 4.362Total 9.822Source: Fieldwork, 2017 X² = 9.822Table = 3.841Level of significance = 0.051 dfIf the table value is greater than the computed value Ho is upheld, while H1 is rejected. But if the table value is less than the calculated value, H1 is upheld, while Ho is rejected. In this case, the calculated value is greater, therefore H1 is upheld and Ho is rejected. Consequently, youths’ exposure to cigarette advertisement leads to more positive attitude to cigarette smoking.Hypothesis 2 H2: Youths will be influenced more by peer pressure to take up cigarette smoking than by their parents.Ho: Youths will not be influenced more by peer pressure to take up cigarette smoking than by their parents.Statistical Testr= n xy – (x) (y )n( x2 – (x )2) n( y2 – (y )2)384(1210)-639(734)?384(1219)-639² 384(1612)-(734)²=464640-469026 ?468096-408321 619008-538756-4386?59775 80252-4386?4797063300-4386=69260.83525=-0.063Then, r²= (-0.063)² = 0.0040r calculated= rn-1, ?/2= r 383, 0.025= 0.1055 ?X ?X² ?XY rcal rtab Decision ?Y ?Y²Peer Pressure 639 1219 1210 -0.063 0.1055 *not sigInfluence Parental 734 1612Influence Source: Fieldwork, 2017Tables 6 and 7 show the summary of the correlation test for influence of peer pressure and parental influence. The result of analysis shows that the r value (Correlation Index) of -0.063 is lower than table value of (0.1055). This indicates that youths will not be more influenced by peer pressure to take up cigarette smoking than by parents. Therefore, the alternate hypothesis is rejected, while the null hypothesis is accepted.Hypothesis 3H3: Youths will tend to pay more attention to cigarette advertisement than to the warnings on cigarette packets.Ho: Youths will not tend to pay more attention to cigarette advertisement than to the warnings on cigarette packets.Statistical Testr= n xy – (x) (y )n( x2 – (x )2) n( y2 – (y )2)384(1280)-689(722)?384(1463)-689² 384(1605)-727² 491520-500903?561792-474721 616320-528529= -9383 ?87071 (87791)= -9383 ?7644050161= -9383 87430.25884= -0.1073Then, r ²= (-0.1073)² = 0.0115r tabulated = r n-1, ?/2= r 383, 0.025= 0.1055 ?X ?X² ?XY rcal rtab Decision ?Y ?Y²Attention to 689 1463 1280 -0.1073 0.1055 *not sigcigarette advertAttention to 727 1605warnings on cigarette packets Source: Fieldwork, 2017Table 5 shows the summary of Correlation test for youths’ attention to cigarette advertisement and attention to warnings on cigarette packets. The result shows that the r value (Correlation Index) of -0.1073 is lower than the tabulated value of (0.1055) This indicates that youths will not pay more attention to cigarette advertisement than to the warnings on cigarette packets. Therefore, the null hypothesis is accepted, while the alternate hypothesis is rejected.4.3 Discussion of FindingsThe aim of this study was to examine tobacco advertising and youths’ attitude to smoking in Oyo State. To achieve this, the survey method was used to gather data for the study. Personal interviews were conducted with some personnel of the Oyo State Ministry of Health and Oyo State Signage and Advertising Agency. The opinions of the respondents gathered through the questionnaire were represented in tabular format. The analysis and discussion of findings were guided by the research questions as follows:Research Question 1:What are the different kinds of cigarette advertisements disseminated in the media in Oyo State?Answers to Research Question 1 can be found in tables 2.1-2.4. Cigarette products are advertised on radio, magazines, newspapers, Internet, billboard and television in Oyo State. Results in table 2 show that 114 respondents representing 30% got to know of cigarette advertisement on radio, 56 respondents representing 15% got to know of cigarette advertisement in the magazines, 48 respondents representing 12% got to know of cigarette advertisement in the newspaper, 82 respondents representing 21% got to know of cigarette advertisement on the billboard, 52 respondents representing 14% got to know of cigarette advertisement on television, while 32 respondents representing 8% were aware of cigarette advertisement on the Internet. The pervasiveness of cigarette advertisement causes young people to overestimate smoking prevalence among their peers and adults. The linking of cigarette smoking with athletic and sexual achievements leads young people to underestimate the risks involved in cigarette smoking. Radio cigarette advertisement in particular has contributed in no small measure to the massive awareness of cigarette smoking among youths. This is due to the omnipresent nature of the medium. Cummings (2004) found out that there is a correlation between the intensity of a cigarette product advertisement and awareness, preferences and market shares among youths. Radio remains the most powerful and pervasive media of advertisements not only because it breaks illiteracy barriers, but also has the capacity to reach people of diverse backgrounds in isolated places and it is very cheap of all the media of advertisement.Data in table 2.2 show that one-hundred and forty-four respondents representing 38% stated that media advertised cigarette products very often. Most media, including the government-owned ones thrive on the money realised from advertisements. As a result, commercials and advertisements have to be aired by the broadcast media organisations and published by newspaper and magazine organisations as many times as possible to keep the media organisations alive and well.Data in table 2.3 show that one-hundred and twenty-two respondents representing 32% stated that they were aware of cigarette advertisement in the movies. Only 48 respondents representing 12% said they were aware of cigarette advertisement through friends. Empirical research suggests that the mass media can potentially influence behaviour. For example, research indicates that the more adolescents are exposed to movies with smoking the more likely they are to start smoking (Dalton, Sargent, Beach, Titus-Ernstoff, Gibson and Ahens, 2003). Furthermore, research has shown that the likeability of film actors and actresses who smoke (both on-screen and off-screen) relates to their adolescent fans’ decisions to smoke (Distefan, Gilpin, Sargent and Pierce, 1999). Films tend to stigmatise drinking and smoking less than other forms of drug taking (Cape, 2003). However, the media transmit numerous positive messages about drug use and other potentially risky behaviours, and it is plausible that such favourable portrayals lead to more use by those that watch them (Will, Porter, Geller, and DePasquale, 2005) as cited by Mark (2010). Akah and Emeribe (2011) also noted that movies recruit new cigarette smokers from among young folks. Movies encourage them to experiment, and once they start experimenting with cigarettes, other factors take hold. Movies create the impression and expectation that smoking will turn out satisfying. In another dimension, Akah and Emeribe (2011) in a related study observed that young people who begin by experimenting with cigarette often graduate to cannabis, and then to cocaine and other stronger drugs. Once they experiment with cannabis, they are most likely to become addicted. Such addiction makes them naturally disposed and addicted to violence as a lifestyle, with time they graduate to different shades of crime.Data in table 2.4 indicate that two-hundred and eighty-eight respondents representing 75% said they had purchased a brand of cigarette products advertised in the media. Lynch and Bonnie (2004) found out that tobacco advertising strategies are indeed quite effective for creating awareness about different tobacco products and are responsible for increasing the rate at which young people buy cigarette products and start cigarette smoking. Also, Giglio (2006) found out that tobacco industry’s advertising tactics have remained the most vital tool for the propagation of availability of different kinds of tobacco products, recruitment of new users and the retention of the old users. Research Question 2:What is the level of the youths’ exposure to radio and television cigarette advertisements in Oyo State?Answers to Research Question 2 can be found in tables 3.1-3.5. Results in table 3.1 show that majority of the respondents had exposure to cigarette advertisement at different levels. One hundred and twelve representing (29%) had a very high exposure to radio cigarette advertisement. Only 62 respondents (16%) had a low exposure to radio cigarette advertisement.Data in table 3.2 show that most respondents had exposure to television cigarette advertisement at different levels. Eight-five respondents (23%) had a high exposure to television cigarette advertisement, while 60 respondents representing (15%) had a low exposure to television cigarette advertisement.Youths, who are heavy viewers of cigarette advertisement in the media, are more likely to be influenced to take up cigarette smoking than those who are light viewers of cigarette advertisement. The youths, who are frequently exposed to the cigarette advertisement, are more likely to form a positive attitude about cigarette smoking compared to those who are not frequently exposed to cigarette advertisement. Wakefield (2003) affirms that the youths who are frequently exposed to tobacco advertising record increased positive attitudes about smoking, intention to smoke and smoking initiation. Also, Christophi (2009) found out that frequent exposure to various indicators of pro-cigarette advertisements is significantly associated with uptake of cigarette smoking among youths. Sargent (2008) also conducted a research on the relationship between exposure to tobacco advertising and adolescent smoking and found out that a greater exposure to cigarette advertisement implied a higher risk of cigarette smoking among youths. Exposure to tobacco advertising is associated with current smoking across adolescence but the impact is strongest during early adolescence. Data in table 3.3 indicate that most respondents had exposure to cigarette advertisement in sporting events at different levels. One hundred and nine respondents representing (28%) had a very high exposure to cigarette advertisement in the sporting events, while 46 respondents (12%) had a low exposure to cigarette advertisement in the sporting events. Wakefield and Sloan (2005) studied sporting environment and noted that the environment can influence a number of behaviours and attitudes, including satisfaction, repurchase intentions, desire to stay in the facility and the perceived value attached to the sporting events.Data in table 3.4 show that 83 respondents (22%) had a medium exposure to cigarette advertisement in stores, while 94 respondents (25%) had a low exposure to cigarette advertisement in stores. Exposure to cigarette advertisement is low in stores because many customers are absorbed in the products they intend buying.Data in table 3.5 indicate that 89 respondents (23%) had a very high exposure to cigarette advertisement in the outdoor media. Only 81 respondents (21%) had a medium exposure to cigarette advertisement in the outdoor media. Billboards are erected in strategic places. Billboards and other facilities such as schools and stadia are erected to capture the attention of the youths, who throng such places daily. The billboard is an effective medium for the exposure of the youths to tobacco advertising. Billboard advertisements expose youths repeatedly to pro-tobacco messages while giving the erroneous impression that smoking is pervasive and normative. Douglas, Emily and Yael (2000) found out that the billboard has provided the tobacco industry with a relatively low cost method for cigarette advertising and is used to reach either a broad audience or specific targeted population. Because of its static location, and the fact that many people use the same travel routes to work, schools, shopping etc, people are frequently exposed to billboard tobacco advertisement.Research Question 3: To what extent do cigarette advertisements affect youths’ attitude to smoking in Oyo State?Answers to the Research Question 3 can be found in table 4.1-4.4. Results in table 4.1 show that majority of the respondents said that cigarette advertisement induced positive attitude to smoking in the youths at different levels. One hundred and twenty-eight representing (33%) were of the opinion that cigarette advertisements, to a very great extent, induced positive attitude to smoking in the youths, while 41 respondents (10%) stated that cigarette advertisements induced positive attitude to smoking to a little extent in the youths. Pechmann and Knight (2002) found out that the increased demands for cigarettes and positive attitude to smoking are the results of advertisement and other promotional activities like product placement in movies, retail display advertising, free product sampling, sports sponsorship, packaging graphics, filter design and product attributes. Also, smoking scenes in television and movies positively arouse young viewers, enhance their perceptions of smokers’ status, induce positive attitude to smoking in the youths and increase their intent to smoke.Table 4.2 indicates that 86 respondents 103 respondents (26%) aligned with the fact that cigarette advertisement, to a great extent, encouraged the uptake of cigarette smoking, while 49 respondents (12%) said that cigarette advertisements, to a very little extent, encouraged the uptake of cigarette smoking. Wakefield, Flay, Nichter and Giovono (2003) found out that increases in adolescents’ uptake of cigarette and positive attitude to cigarette smoking are strongly associated with increased levels of exposure to cigarette advertisement. Smoking uptake usually occurs during adolescence, while the vast majority of smoking-related deaths occur in middle-aged and elderly people. The longer the onset of smoking is delayed, the less likely a person is to become addicted. Young people who smoke may imbibe the habit and become addicted before reaching adulthood, making them less able to quit smoking and more likely to have a tobacco related-health problem. Table 4.3 shows that 92 respondents (24%) were of the view that cigarette advertisement, to a very great extent, encouraged former smokers to resume smoking. Only 64 respondents (17%) believed that cigarette advertisement, to a great extent, encouraged former smokers to resume smoking. Apodaca, Abrantes, Strong, Ramsey and Brown (2007) argue that there has been a recent increased interest in utilising motivational interview (MI) to increase adolescent campaigns to quit smoking, but attempts to impact quit rates have not been encouraging thus far. Two factors that are predictive of the readiness for adolescents to quit smoking include negative beliefs about smoking and possessing sufficient confidence to be able to quit smoking. Tobacco smoking and addiction are regarded as perhaps the best examples of a dangerous consumers’ behaviour habit. Therefore, preventing this behaviour is the most straightforward way to avoid the damage to human health caused by smoking, including diseases such as arteriosclerosis and coronary heart disease, strokes, pulmonary diseases, and cancers of the bladder, mouth, esophagus, larynx, and lung. Therefore, preventive measures, such as educating the public by providing information on the risk of smoking or adopting public policy that prevents smoking in public places must be especially targeted at young people.Table 4.4 indicates that 129 respondents (34%) aligned with the fact that advertisements, to a very great extent, encouraged youths to smoke for pleasure. Only 48 respondents (12%) stated that advertisements, to a very little extent, encouraged youths to smoke for pleasure. Wang, Fitzhugh, Cowdery and Trucks (1995) found out that smokers considered smoking to bring them some type of perceived material gain and pleasure. Adolescent smokers were found to have beliefs that contribute to the risky behaviour, such as the thought that smoking would be able to help them relax, reduce their boredom, or even help to take the edge off of their stress level. Other reasons why people smoke could be linked to influences from many different realms, and factors such as political, personal, social, psychological and economic influences all seem to factor into the habit. Thus, understanding these factors is crucial in understanding how to determine patterns of cigarette use and cessation.Research Question 4: What influence does warning on cigarette packets by the Ministry of Health have on the youths’ smoking habit in Oyo State? Answers to the Research Question 4 can be found in table 5.1-5.7. Results in table 5.1 show that 116 respondents representing 30% were of the view that warnings on cigarette packets were very effective in increasing cessation behaviour among youths. Only 96 respondents representing 25% were of the opinion that warnings on cigarette packets were effective in increasing cessation behaviour among youths. Hammond (2011) affirms that smokers report high levels of awareness for health warnings on tobacco packages. Health warnings on cigarette packets have been found to be a prominent source of health information for non-smokers and the general public. Hammond (2011) found out that 86% of non-smokers in Canada agreed in a national survey that the warnings on cigarette packs provide them with important health information. Non-smokers also report high levels of recall for specific health messages on packs.Table 5.2 indicates that 154 respondents representing 39% were of the opinion that warnings on cigarette packets increased knowledge about health effects of smoking. Only 34 respondents representing 9% were of the view that warnings on cigarette packets were not effective at all in increasing knowledge about health effects of smoking. Hammond (2011) affirms that cigarette packet warnings are a compelling communication strategy. The combination of high exposure, nearly universal reach, and very low cost has made warnings a core tobacco control strategy globally. Hiilamo, Crosbie and Glantz (2014) affirm that warnings have evolved through several stages over the past four decades- from simple, vague messages on the side packs of the rotating messages on the front of packs focused on specific health effects, often accompanied by colours.Table 5.3 indicates that 108 respondents representing 28% said text-only warning labels were slightly effective in helping cigarette smokers quit. Only 55 respondents representing 13% submitted that text-only warning labels were very effective in helping cigarette smokers quit.Table 5.4 shows that 136 respondents representing 36% stated that image-based warning labels were very effective in reducing level of cigarette smoking. Only 36 respondents representing 9% stated that image-based warning labels were not effective at all in reducing the level of cigarette smoking. Noar, Hall, Francis, Ribisl, Pepper, and Brewer (2016) conducted a meta-analysis of experimental studies which demonstrated that pictorial cigarette pack warnings are superior to text warnings in attracting attention and stimulating cognitive elaboration , and they are consistently perceived as more effective than text warnings.Table 5.5 shows that 276 respondents representing 72% said they smoked in the past but in table 5.6, 208 respondents representing 75% said they had quit cigarette smoking.Table 5.7 shows that 88 respondents representing 42% said they quit smoking because smokers were liable to die young. Only 50 respondents representing 24% said they quit smoking because it lowered the risk of cancer-related ailments. Wakefield (2003) found out that quitting reduces the risk of early death, developing and dying from cancer. The risk of premature death and the chance of developing cancer from smoking depend on many factors, including the number of years a person smokes; the number of cigarettes he or she smokes per day; the age at which he or she began smoking; and whether or not he or she was already ill at the time of quitting. For people who have already developed cancer, quitting smoking reduces the risk of developing a second cancer. Research Question 5: What effects do parental influence and peer pressure have on the youths’ attitude to smoking in Oyo State? Answers to Research Question 5 can be found in table 6.1-6.7. Results in Table 6.1 indicate that 245 respondents (65%) affirmed that a cigarette-smoking parent, to a very great extent, influenced a child’s involvement in smoking cigarette. Only 17 respondents (4%) said that a cigarette-smoking parent, to a little extent, influenced a child’s involvement smoking cigarette. Social cognitive theory provides an explanation for the impact of parental smoking on adolescents’ smoking behaviour. It emphasises that adolescents observe the smoking behaviour of their parents, consider it to be normal, and initiate the smoking behaviour (White, Hopper, Wearing, and Hill, 2003). Adolescents may also see smoking as an adult activity, and they may initiate this behaviour to indicate their maturity into adulthood (Milton, Dugdill, Porcellato, and Springett, 2008). Various studies link parental smoking with smoking behaviour of children. Such as Gilman, Rende, Boergers, Abraham, and Buka (2009) who found that adolescents whose parents were regular smokers had a higher likelihood of initiating smoking as compared to adolescents whose parents had never smoked.Table 6.2 shows that 142 respondents (38%) affirmed that positive parent attitude to cigarette smoking, to a very great extent, influenced the youths’ initiation of regular cigarette use, while 22 respondents (5%) said that positive parental attitude to cigarette smoking, to a very little extent, influenced the youths’ initiation of regular cigarette use.Table 6.3 indicates that 115 respondents (30%) were of the belief that negative parental attitude to smoking, to a very great extent, discouraged a child’s from involving in smoking cigarette, while 48 respondents (13%) were of the view that negative parental attitude to cigarette smoking, to a very little extent, influenced a child’s involvement in smoking cigarette.Parental views on smoking can have an impact on adolescent smoking intentions and behaviour. However, the verdict on this is mixed. Haraken, Scholte, Vermulst and Engels (2010) found out that strong parental anti-smoking views may directly reduce smoking intentions of adolescents, and will also weaken adolescent tendencies to see smokers (in the media, and real life) in a positive light. On the other hand, Sargent and Hannewinkel (2008) suggested that the media were the dominant influence, and that seeing smoking in movies had the effect of undermining parental anti-smoking practices. McCool, Cameron, and Robinson (2011) also found out that adolescents whose parents had clear and unambiguous rules against smoking had a less favourable view of smokers in the media, while in households where conflicting views about smoking were expressed, adolescents were more likely to have relatively positive views about smoking, which in turn will promote smoking intentions. Young people therefore internalise parental views about tobacco use and this will go on to shape their smoking behaviour (Jackson, 2002).Table 6. 4 shows that one-hundred and seventy-three respondents representing (45%) affirmed that a non-smoker may, to a very great extent, imitate a cigarette-smoking peer, while 29 respondents (8%) maintained that a non-smoker may, to a little extent, imitate a cigarette-smoking peer.Sergeant, Beach, Adachi-Mejia, Gibson, Titus-Ernstoff, Carusi (2005) found out that some of the factors that appear to be associated with adolescent smoking include peer smoking, exposure to pro-tobacco marketing, easy access to tobacco products, adolescent age group, genetics, among many others. Peer smoking and pro-tobacco marketing are especially important because several research studies have demonstrated their impact on adolescent smoking behaviour. Peer smoking has been considered as being the most significant predictor of adolescent smoking (Abroms, Simons-Morton, Haynie, and Chen (2005). However, Arnett (2007) disagreed to this assertion, stating instead that adolescents select their friends based on their own characteristics and that parental smoking plays a greater role in adolescent smoking.Table 6.5 shows that one-hundred and nine respondents (29%) said that peer pressure, to a very great extent, promotes positive attitude and belief about cigarette smoking, 106 respondents (27%) said that peer pressure, to some extent, promotes positive attitude and belief about cigarette smoking, while 45 respondents (12%) affirmed that peer pressure, to a little extent, promotes positive attitude and belief about cigarette smoking.Larson (2007) affirms that attitudes represent the degree of like or dislike for an object. Attitudes are generally positive or negative views of a person, place, thing or event. Attitudes may be learned, they can be affected or driven by feelings and they may be indicators of future actions. Markham, Aveyard, Thomas, Charlton, Lopez, and De Vries (2004) argue that a dislike for smoking would be associated with negative beliefs about smoking and negative intentions to smoke. De Leeuw, Engels, Vermulst and Scholte (2008) found out that past smoking may affect subsequent attitudes, suggesting that adolescents who previously smoked developed less negative attitudes towards smoking.Table 6.6 indicates that one-hundred and one respondents (26%) said that peer pressure, to a very great extent, may generate loyalty to a brand of cigarette, while 106 respondents (27%) said that peer pressure, to a great extent, may generate loyalty to a brand of cigarette. Hoffman, Monge, Chou and Valente (2007) suggest that both social selection and social influence explain the similarities in friends’ smoking behaviours, although peer influence was more salient than the peer selection. The results of another study by Wakefield (2003) indicates that adolescents who were initially non-smokers are more likely to become smokers if they belong to a smoking group and group members who change groups between phases were more likely to select groups with smoking behaviour congruent to their own. Mercken, Candel, Willems and De Vries (2007) examined the roles of social selection and social influence within reciprocal and non-reciprocal friendships. The scholars suggest that within non-reciprocal friendships only social selection explains the similarities in smoking among friends, whereas within reciprocal friendships it is social influence as well as possibly also social selection.CHAPTER FIVESUMMARY, CONCLUSION AND RECOMMENDATIONSThis study set out to examine the influence of tobacco advertising on youths’ attitude to smoking in Oyo State. A number of health literatures have revealed the health outcome of cigarette smoking by both the old and the young in the society. Apart from a number of terminal diseases that arise from cigarette smoking, cigarette smokers die 15 years earlier than non-smokers. To access the diverse opinions of the youths in Oyo State, the study employed both quantitative (survey) and qualitative (interviews) methods in the gathering data used for the study.The survey design (questionnaire) was used to establish the extent tobacco advertising influences the youths’ uptake of cigarette smoking in Oyo State. The interviews conducted provided additional information and validated the data gathered through the questionnaire.The population of the study consisted of youths in Oyo State. This includes the youths in the Local Government Areas in the three Senatorial Districts- Oyo Central Senatorial Districts, Oyo North Senatorial District and Oyo South Senatorial Districts respectively. The total population of the youths of the State as projected by the National Bureau of Statistics as at 2013 stood at 3, 493, 639 which represents the population for the study.Sample size calculator was used in determining the sample size. A sample of 400 was arrived at, using the sample size calculator. The sampling technique adopted for this study is the stratified sampling method. Rather than choose a sample from the total population, the researcher ensured that appropriate number of respondents were drawn from the subsets of that population (senatorial districts).Data gathered from the questionnaire were analysed using simple percentages. Data gathered from the interviews added depth to the study, while Pearson Product Moment Correlation Coefficient (PPMCC) and Chi Square were used to test the hypotheses raised in the study 5.1 ConclusionAs much as advertisement is a crucial factor in the marketing of goods and services, effort should not be spared in controlling advertisements of products that may endanger the health of the people. In spite of varied sanctions by both Federal and State Governments, tobacco companies continue to find their way around the sanctions, retain old smokers and recruit new users of tobacco products. Findings reveal that cigarette advertisement encouraged the youths to take up cigarette smoking. Cigarette advertisement recruits new users of tobacco products almost on a daily basis. To reduce cigarette smoking rates, government needs to adopt a comprehensive approach to tobacco control. This should include a range of measures such as sustained increase in tobacco taxation combined with measures to curb snuggling, smoking cessation and health education campaigns, strict measures against advertisement of tobacco products, and the regulation of tobacco to standards agreed by health community rather than those set by tobacco industries. Findings in this study indicate that image-based warnings are more effective in spreading the evils of cigarette smoking in the society because pictures have the capacity to break illiteracy barriers. The illiterate smokers cannot read the warnings engraved on the cigarette packets, but they can easily understand pictorial warnings. However, the Federal and State Ministries of Health should mandate tobacco companies to, in addition to spoken warnings that accompany cigarette products on broadcast media, engrave the pictorial warnings on the packs of cigarette products to enlighten the smoking public about the danger inherent in cigarette smoking. Radio medium is the major means by which cigarette smokers are aware of the different brands of cigarette. It has the capacity to penetrate and tread the terrains other media dread. Radio propagates information about cigarette to most respondents because it can be operated with or without electricity. As a result of this, anti-smoking campaigns of the state and federal Ministries of Health should make use of radio medium to sensitise people both in the rural and urban sectors of the society about the health effects of cigarette smoking.Findings in this study show that text-only warnings on cigarette packets are not much effective in spreading the danger inherent in cigarette smoking because many cigarette smokers are non-literate, and therefore do not understand the warning messages on cigarette packs. This situation has sent many of them to their early graves. Therefore, a means of educating the non-literate smokers about the risks involved in cigarette smoking should be devised by the Federal and State Ministries of Health. Implicitly, the graphic pictures of lungs of smokers and non-smokers should be engraved on the packets of cigarette products to break illiteracy barriers about health effects of cigarette smoking. Findings also revealed that positive parental attitude to cigarette smoking encourages the youths to initiate cigarette smoking. Parents’ smoking behaviour has direct effect on children’s cigarette smoking initiation. Parents should not smoke cigarette in the presence of their wards so as to guard against initiating them. Of course, parents should monitor the kind of movies their children watch and the kind of friends their children have in order not to be influenced to take up cigarette smoking.Kiosks selling cigarette products must not be stationed very close to primary, secondary or tertiary institutions, as this has been the means by which tobacco companies recruit the young users of cigarette products in Nigeria. Besides, government should clamp down on the advertisement of cigarette products during sporting events.5.2 Summary of FindingsThis study found out among other things that:i. Different kinds of media were used to advertise cigarette products in Oyo State. However, radio being a ubiquitous medium of communication had the highest number of respondents who were exposed to cigarette advertisement through this medium. This was followed by the billboard/newspaper/television/Internet among others. Most respondents stated that these media were used to advertise cigarette products very often in Oyo State. The respondents also mentioned other channels through which they were exposed to cigarette advertisement in Oyo State. These include movie, kiosk, club, posters and friends. However, movie was another major means through which youths got exposed to advertisement of cigarette products. Most of the respondents, who had been exposed to cigarette advertisements in the various media, have made a purchase of a brand of cigarette advertised in the media. ii. Exposure to radio cigarette advertisement was very high among the youths in Oyo State. This is because radio medium can appeal to both literate and non-literate members of the society. Apart from this, radio medium can penetrate the rural terrains, which other media of communication such as the newspapers, magazines, Internet and television may not be able to reach. Of course, for the youths in Ibadan and other towns in Oyo State, their exposure to television cigarette advertisement is on the high side. British-America Tobacco Nigeria advertises cigarette on television. The exposure of the youths to cigarette advertisements in sporting events is very high, and this environment can influence a number of behaviours and attitudes, including smoking of cigarette, repurchase intentions, desire to stay in the facility and the perceived value attached to the sporting events. However, the exposure of youths to the cigarette advertisement in stores is low. In-store signs influenced items sales and can actually encourage the prospective buyers or users of a product to have a positive attitude towards such product. Billboard is one of the most adopted media for advertising tobacco products in Oyo State. Most youths in the state get exposed to cigarette advertisement on billboards at road intersections in the State. The British-America Tobacco Nigeria (BATN) features a woman on the billboard with a beautiful Adire Fabric under which “YES” is inscribed. Yes is a brand of cigarette produced by the company.iii. Most respondents averred that cigarette advertisements induce positive attitude to smoking in the youths in Oyo State. The essence of advertisement is to stimulate demand and influence the buyers to make purchase decisions. Most respondents submitted that cigarette advertisements actually encouraged the uptake of cigarette smoking by the youths in the State. Young people acquire smoking habit and become addicted before reaching adulthood, making them unable to quit smoking and more likely to have a tobacco-related health problem later in life. The respondents maintained that cigarette advertisements encourage former smokers to resume smoking. Advertising stimulates desire for the purchase of a product. Besides, cigarette smoking is addictive because it contains nicotine, and the former smokers may resume smoking if exposed to the cigarette advertisement in the media. iv. Most respondents said that they quit smoking because smokers are warned that they could die young. They also claimed that quitting cigarette smoking lowers the risk of cancer-related ailments, and that packet warnings are very effective in increasing cessation behaviour among smokers of cigarette. Packets warnings inform the smokers and non-smokers of the health effects of cigarette smoking, and also increase the young people’s knowledge about dangers inherent in cigarette smoking. The respondents submitted that text-only warnings are less effective in encouraging the smokers to quit smoking because many smokers are non-literate. However, many respondents affirmed that image-based warnings are effective in encouraging the smokers to quit smoking because pictures break illiteracy barrier. Both literate and non-literate members of the society can actually understand what a picture communicates.v. Most respondents affirmed that cigarette-smoking parents can actually influence a child to initiate or take up cigarette smoking. In this instance, a parent is the first role model to a child. Consequently, a child whose parent smokes will likely take up smoking later in life. Of course, most respondents maintained that indifference and positive parental attitude to cigarette smoking can encourage a child to take up cigarette smoking as well.vi. Most respondents claimed that a non-smoker may imitate a cigarette-smoking peer. Peer influence is an important factor in the tobacco and health studies. Peer influence is one of the major causes of the youths’ cigarette smoking uptake. Having a friend that smokes may likely influence a non-smoker to take up cigarette smoking. Most of the respondents claimed that peer pressure may promote positive attitude and belief about cigarette smoking, it may generate loyalty to a brand of cigarette and peer pressure can also serve as a gateway to other illicit use of drugs apart from cigarette smoking. 5.3 Contributions to KnowledgeThis study unearthed cigarette advertisement as the major factor in the motivation of youths to taking up cigarette smoking. Prior exposure to tobacco advertising and promotion is associated with future cigarette smoking among youths, and that youths who smoke are more aware of cigarette advertisement than those who have not started cigarette smoking. The health effects of cigarette smoking are diseases, disability and death emanating from pancreatic cancer, cervical cancer, cancer of the throat, stomach cancer, cancer of the lung, and stroke! It is worthy of note that cigarette smoking kills Nigerians silently more than HIV/AIDS. This research work exposed the youths to dangers in initiating cigarette smoking through cigarette advertisements and suggested means to arrest high incidence of cigarette smoking among youths.Apart from the influence of cigarette advertisement on the youths’ uptake of cigarette smoking, parental influence also plays a prominent role in influencing the youths in the uptake of cigarette smoking. Parents are the first role models whose behaviour, actions and character are copied by the youths. It has been well-established that youths whose parents are cigarette smokers equally become cigarette smokers later in life.Peer pressure also plays a significant role in the youths taking up cigarette smoking. The likelihood to take up cigarette smoking increases when a young man has a friend who smokes. In the same vein, movie and television role models also influence the youths to take up cigarette smoking. Youths imitate the behaviour of their football stars, movies and television heroes or role models. If the heroes or role models smoke cigarette, the likelihood of youths taking up cigarette smoking increases. 5.4 RecommendationsThis study on “Tobacco Advertising and Youths’ Attitude to Smoking in Oyo State” has raised a number of issues that require urgent attention from both government and Civil Society Organisations if the adverse effect of tobacco-related ailment will be curtailed. Among issues raised in the study are the ineffectiveness of text-only warnings engraved on cigarette packets, positive attitude of the young people about cigarette smoking, parental and peer influences on the smoking initiation by the youths, and the non-challant attitude of the governments towards strengthening anti-smoking campaigns in both urban and rural sectors of the society.Information is an indispensable component of development. For any meaningful development to be attained in the society, information should be given a pride of place. Government at all levels must embark on the sensitisation of the citizenry in the rural, urban, semi-urban sectors of the society about the negative health outcome of cigarette smoking. Cigarette smoking is a killer! And both non-cigarette and cigarette smokers must be made to realise this. The following are recommendations from the study:As the findings have shown, the use of text-only warnings on cigarette packets is almost ineffective in the propagation of the health hazards of cigarette smoking. However, the graphic picture of a normal lung of a non-smoker and an addicted smoker may be engraved on the cigarette packets so as to warn the subsisting smokers of health outcome of cigarette smoking and deter the prospective smokers from initiating cigarette smoking. Anti-smoking campaigns on television are geared towards discouraging people from smoking. However, suffice it to say that the campaigns have yielded little or no result because the anti-smoking campaigns are often prepared and served in English Language, the language of the elite. So, most rural dwellers, who are non-literate, do not understand the warnings. Local languages can best explain the evils of cigarette smoking to the rural dwellers. Local languages should be used to disseminate information about the anti-smoking campaigns of the Ministries of Health. Apart from the use of conventional media in the spread of anti-smoking campaigns, a task force should be constituted by the Ministries of Health whose responsibilities is to move from one Motor Park to another to spread the message on the evils of cigarette smoking to the National Union of Road Transport Workers (NURTW) and the passengers. In addition to this, they should move from one market to another educating the parents about the evils of cigarette smoking so that those parents, in turn, can admonish their wards against cigarette smoking. iv. A more understandable approach to propagating the health risks involved in cigarette smoking is for the public health officials to make use of traditional rulers, religious leaders and local chiefs to educate their people about the health outcome of cigarette smoking, especially smokers living in the rural areas of Nigeria.v.World No Tobacco Day should not be observed only in the cities. It must be taken to tertiary institutions and secondary schools where there is a large population of youths, who are susceptible to initiate cigarette smoking.vi.The public health officials should make use of the traditional rulers, local chiefs, religious leaders, opinion leaders in spreading the anti-smoking messages to the people in the rural areas of Nigeria. For anti-smoking campaigns to be effective in some communities and rural settings, the traditional rulers, religious leaders and opinion leaders should be used by the Ministries of Health. This is due to the fact that people believe in the message coming from this category of people more because the source has credibility, face-to-face interaction is possible, and questions can be asked on areas of inconsistencies. vii.Advertising Practitioners’ Council of Nigeria (APCON) should mandate their members to strictly abide by the code of conduct of the profession. On no account should a member of the Association of Advertising Agencies of Nigeria (AAAN), on behalf of tobacco companies or their representatives, advertise tobacco products in the media without accompanying warnings. viii.The Federal and State Governments should always make funds available to the Ministries of Health to strengthen anti-smoking campaigns in Nigeria. ix.Peer pressure has been one of the major means by which youths are recruited into the world of cigarette smoking. Parents are duty-bound to know the kind of friendship that their wards keep. This will assist parents to keep their children from initiating cigarette smoking habit. x.In spite of anti-smoking bills passed in many states in Nigeria, there has not been an efficient enforcement of non-smoking in designated areas in Nigeria. In the light of growing evidence regarding the health impact of passive smoking, government should adopt measures to tighten enforcement of non-smoking in designated areas in Nigeria. xi.The Standard Organisation of Nigeria (SON) has a role to play here. Standard Organisation of Nigeria is an instrument for protecting the public from harmful products and unsafe business practices. It can help to adequately implement the mandate of National Tobacco Control Bill and other tobacco control regulation measures.xii.To check the excesses of the tobacco companies in Nigeria, an implementation of Framework Convention on Tobacco Control should, as a matter of urgency, be implemented. Taxation, as prescribed in the Framework Convention on Tobacco Control, is one of the means through which cigarette smoking can be reduced among smokers. Government will save lives of the citizenry, and the higher the price of tobacco products, the fewer the people that have the capability to make a purchase.Xiii. Parents should not smoke in the presence of their children in order not to recruit and initiate them. Cigarette smoking in the presence of the children will most likely influence them to take up cigarette smoking later in life. xiv.Since government in Nigeria works in the interest of public health, it should terminate all partnerships with any operator in the tobacco industry, withdraw all incentives to operators in the tobacco industry and monitor and implement a fair and equitable regulation in the industry.5.5 Suggestions for Further StudyThis study deconstructed tobacco advertising and youths’ attitude to smoking in Oyo State. However, several other areas may serve as a vista for further research. 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Effective Advertising and its Influence on Consumer Buying Behaviour. European Journal of Business and Management, 3(3) : 2222-2889APPENDIX 1QUESTIONNAIREDepartment of Communication ArtsUniversity of UyoP.M.B 1017UyoDear Respondent,I am carrying out a research on the topic titled “Tobacco Advertising and Youths’ Attitude to Smoking in Oyo State” as part of the requirements for the award of PhD in Mass Communication in the University of Uyo. This questionnaire is designed to assist researcher in the gathering of relevant information on the subject and it is intended that the information gathered will be used solely for academic purposes.I, therefore, crave your indulgence to respond accurately to the questions as the researcher is banking on you for accurate information that will aid in the treatment of the subject matter.Thanks in anticipation of your willingness and prompt response to the issue at hand.Yours sincerely,James Adebayo John15/PG/AR/CA/PhD/005SECTION A. DEMOGRAPHIC VARIABLES DATAPlease identify your sex: Male ?Female ?What is your age bracket: 15-19 ?20-24 ? 25-29 ? 30-34 ? 35 and above ? Occupation: Student ? Artisan ? Civil Servant ? Unemployed ? Trader ?Marital Status: Single ? Married ? Divorced ?Highest Educational Qualification: Primary School ? O/Level, SSCE ? OND, NCE ? HND, Bsc, BA, BEd, BTech ? M.A, MSC, PhD ?SECTION BQUESTIONNAIRE ITEMSPlease tick (?) where appropriate, and fill in your responses when neededAwareness of Different Kinds of Cigarette AdvertisementsWhat kind of cigarette advertisements have you been exposed to?(a)Radio cigarette advertisement ? (b) Magazine cigarette advertisement ? (c) Newspaper cigarette advertisement ? (d) Internet cigarette advertisement ? (e) Billboard/other outdoor cigarette advertisement ? (f) Television cigarette advertisement? 2. How often do these media advertise cigarette products?(a) Very Often(b) Often(c) Less Often(d) Not at all 3 Apart from conventional media, which other means do you get cigarette advertisement?MovieKioskClubThrough friendsPosters 4 Have you ever made a purchase of cigarette product advertised in the media?Yes NoThe level of youths’ exposure to radio and television cigarette advertisements in Oyo State Exposure Level VH H M L NAExposure to radio cigarette advertisements Exposure to television cigarette advertisements Exposure to cigarette advertisements in the sporting events Exposure to cigarette advertisements in stores Exposure to cigarette advertisements in the outdoor media Key: VH= Very High; H= High; M= Medium; L= Low; NA= Not at AllThe extent cigarette advertisements affect the youths’ attitude to smoking Youths’ Smoking Attitude VGE GE SE LE VLECigarette advertisements induce positive attitude to smoking in the youths Cigarette advertisements encourage the uptake of cigarette smoking Cigarette advertisements reduce young smokers’ motivation to quit Cigarette advertisements encourage former smokers to resume smoking Youths engage in cigarette smoking for pleasure Key: VGE= To Very Great Extent; GE= To Great Extent; SE= To Some Extent; LE= To Little Extent; VLE= To Very Little ExtentD.Influence of the warnings by Ministry of Health on cigarette packets on youths’ smoking habit? 1 Warnings on cigarette packets increase cessation behaviour among smokers A B C D EVery Effective Effective Less Effective Slightly Effective Not Effective at All2 Warnings on cigarette packets increase knowledge about health effects of smoking A B C D EVery Effective Effective Less Effective Effective Not Effective at All3Text-only warning labels can help cigarette smokers quitA B C D EVery Effective EffectiveLess EffectiveSlightly EffectiveNot Effective at All4Image-based warning labels can help decrease the level of smoking A B C D EVery EffectiveEffectiveLess EffectiveSlightly EffectiveNot Effective at All5 Do you smoke? Yes No 6 Have you quit smoking Yes No 7 Why did you quit cigarette smoking? A B C D ESmokers are liable to die young Quitting lowers the risk of cancer-related ailments Quitting smoking has major and immediate health benefits Ex-smokers live longer than people who keep smoking Quitting cigarette smoking saves money and timeE.Effects of parental influence on the youths’ attitude to smoking in Oyo StateParental Influence VGE GE SE LE VLEA cigarette-smoking parent may positively influence the child to take up cigarette smoking Positive parental attitude to cigarette smoking may encourage youths to initiate regular cigarette use Negative parental attitude to cigarette smoking may prevent child’s uptake of cigarette smoking Parental indifference may lead to child’s uptake of cigarette smoking Key: To Very Great Extent; GE= To Great Extent; SE= To Some Extent; LE= To Little Extent; VLE= To Very Little ExtentThe extent peer pressure affects youths’ attitude to cigarette smokingPeer Pressure VGE GE SE LE VLEA non-smoker may imitate a cigarette-smoking peer Peer pressure may not influence a non-smoking peer to embrace cigarette smoking Peer pressure promotes positive attitude and belief about cigarette smoking Peer pressure may generate loyalty to a brand of cigarette Peer pressure may serve as gateway for a peer to use other drugs apart from cigarette smoking Key: To Very Great Extent; GE= To Great Extent; SE= To Some Extent; LE= To Little Extent; VLE= To Very Little ExtentAPPENDIX 11INTERVIEW SCHEDULE(REPRESENTATIVE FROM THE OYO STATE MINISTRY OF HEALTH)What quit programmes or anti-smoking campaigns has the Oyo State Ministry of Health embarked upon?What roles do public health officials play in educating the young cigarette smokers and non-smokers about the health effects of cigarette smoking in Oyo State? In what ways have radio, television and newspaper cigarette advertisements aided the epidemic of terminal diseases such as cancer, stroke etc?In your own assessment, do warnings on cigarette packets have any influence on youths’ smoking habit? Do you think having cigarette-smoking parents influences youths’ positive attitude to smoking?In what way does peer pressure contribute to positive attitude to cigarette smoking among youths?INTERVIEW SCHEDULE (REPRESENTATIVE FROM THE BRITISH-AMERICA TOBACCO-NIGERIA)iIn what way does the British-American Tobacco Nigeria comply with the rules and regulations of the Advertising Practitioners Council of Nigeria with regard to cigarette advertisements in Oyo State?iiWhich of the mass media does the British-America Tobacco-Nigeria use most to advertise its products, and why? iiiApart from the anti-smoking campaigns sponsored by the Federal Ministry of Health, have there been any collaborative efforts between British-America Tobacco-Nigeria and Oyo State Government to enlighten the smoking public about the health effects of cigarette smoking?ivIn your assessment, how does the British-American Tobacco Nigeria comply with the non-interference in public health and related issues as stated in the nine new regulations by the Federal Ministry of Health?vApart from cigarette advertisements in the media, what other means are employed by the British-America Tobacco-Nigeria to influence positive attitude towards its products?viHas the British-America Tobacco Nigeria been sanctioned by the Oyo State Government or Federal Ministry of Health for non-conformity with cigarette advertising? If yes, what was the reaction of BATN?APPENDIX IIISummary of Youths in the Three Senatorial Districts of Oyo StateSENATORIAL DISTRICTS YOUTHSOYO CENTRAL 1176341OYO NORTH 1210562OYO SOUTH 1106736TOTAL 3493639Source: National Bureau of Statistics 2013 ProjectionUsing a sample size of 400, the proportionate sampling method was used at this stage to select the actual number of respondents for the study in each of the strata. This is because the three senatorial districts are not equal in terms of population. Consequently, the percentage of each stratum is shown below:iOyo Central Senatorial District: 1176341 X 400 =136 3493639 1Therefore 136 respondents in Oyo Central Senatorial District formed the population for the studyiiOyo North Senatorial District: 1210562 X 400 =139 3493639 1Therefore, 139 respondents in Oyo North Senatorial District formed the population for the studyiiiOyo South Senatorial District: 1106736 X 400 =125 3493639 1Therefore, 125 respondents in Oyo South Senatorial District formed the population for the studyAppendix IVComputation of Reliability of Questionnaire Using Cronbach AlphaCronbach Alpha = ? = (kk-1) * ( 1- si2sx2 )Where: K = number of items on the test.Si2 = Sum of the variances of the item scoresSx2 = Variance of the test scores (all K items)Items 1 2 3 4 5 6 7 8 9 10Variance 0.12 0.10 0.02 0.01 0.18 0.06 0.08 0.84 3.90 3.90Items 11 12 13 14 15 16 17 18 19 20Variance 0.54 0.5 0.33 0.76 0.48 3.90 3.90 0.36 0.04 0.92K = 20Si2 =21.45Sx2 = 293.6SD = 4.36? = (2020-1 ) * (1- 21.45293.6 ) = (2019 ) * (1- 0.073 ) = (1.0526)(0.9269)= 0.97 or 97 %Appendix VSample Size Distribution by Local Government Areas of Oyo StateLocal Government under Oyo Central Senatorial DistrictHeadquarters 2010 PopulationProjection 15+62.6% NBS, 2013 Sampleproportion1 Afijio Jobele 132,184 82,748 92 Akinyele Moniya 211,811 132,594 153 Egbeda Egbeda 283,643 177,561 224 Ogo Oluwa Ajaawa 65,198 40,814 55 Surulere Iresaadu 140,339 87,852 106 Lagelu Iyana-Offa 148,133 92,732 117 Oluyole Idi-Ayunre 203,461 127,366 158 Ona-Ara Akanran 265,571 166,247 199 Oyo East Kosobo 124,095 77,683 810 Oyo West Ojongbodu 136,457 85,422 1011 Atiba Offa-Meta 168,246 105,322 121,879,135 1,176,341 136OYO NORTH S.D 12 Saki West Saki 273,268 171,066 2013 Saki East Ago-Amodu 108,957 68,207 814 Atisbo Tede 109,965 68,838 815 Irepo Kisi 121,240 75,896 916 Olorunsogo Igbeti 81,339 50,918 617 Kajola Okeho 200,528 125,531 1418 Iwajowa Iwere-Ile 102,847 64,382 819 Ogbomosho North Ogbomosho 198,859 124,486 1420 Ogbomosho South Arowomole 100,379 62,837 721 Iseyin Oluwole 255,619 160,017 1922 Oorelope Igboho 104,007 65,108 623 Orire Ikoyi-Ile 149,408 93,529 1124 Itesiwaju Out 127,391 79,747 91,933,807 1,210,562 139OYO SOUTH S.D 25 Ibadan North Agodi-Gate 308,119 192,882 2226 Ibadan North East Iwo-Road 331,444 207,484 2327 Ibadan North West Onireke 154,029 96,422 1128 Ibadan South East Mapo-Hill 266,457 166,802 1929 Ibadan South West Oluyole Estate 283,098 177,219 2130 Ibarapa Central Igboora 103,243 64,630 731 Ibarapa North Ayete 100,293 62,783 732 Ibarapa East Eruwa 117,182 73,356 833 Ido Ido 104,087 65,158 71,767,952 1,106,736 125 TOTAL 5, 580, 894 3,493,639 400Source: National Population Commission 2010APPENDIX VIRAW DATA FOR HYPOTHESES TESTINGAdvertisement Induced Not Induced Respondents 184 62 246Respondents 82 56 138Total 266 118 384Source: Fieldwork, 2017 X Y XY X2 Y21 1 1 1 12 2 4 4 41 3 3 1 92 4 8 4 162 1 2 4 13 1 3 9 11 1 1 1 12 1 2 4 12 1 2 4 11 1 1 1 12 1 2 4 13 1 3 9 12 1 2 4 11 2 2 1 41 1 1 1 11 2 2 1 42 1 2 4 12 3 6 4 93 1 3 9 11 2 2 1 42 3 6 4 93 2 6 9 41 3 3 1 91 2 2 1 42 1 2 4 12 2 4 4 42 1 2 4 11 2 2 1 42 2 4 4 41 2 2 1 42 2 4 4 41 2 2 1 42 4 8 4 163 1 3 9 11 1 1 1 12 3 6 4 91 2 2 1 41 2 2 1 41 1 1 1 12 3 6 4 93 1 3 9 11 2 2 1 42 2 4 4 41 1 1 1 12 3 6 4 91 2 2 1 41 3 3 1 91 1 1 1 11 2 2 1 43 2 6 9 42 2 4 4 43 1 3 9 11 1 1 1 12 2 4 4 41 3 3 1 93 2 6 9 41 1 1 1 13 3 9 9 92 1 2 4 11 1 1 1 12 4 8 4 163 2 6 9 42 1 2 4 11 2 2 1 41 2 2 1 42 2 4 4 41 2 2 1 42 4 8 4 162 4 8 4 161 4 4 1 162 2 4 4 42 3 6 4 91 2 2 1 42 2 4 4 41 1 1 1 12 1 2 4 11 3 3 1 91 2 2 1 42 1 2 4 12 2 4 4 41 2 2 1 42 3 6 4 92 2 4 4 42 1 2 4 11 1 1 1 11 2 2 1 43 2 6 9 41 3 3 1 92 2 4 4 42 2 4 4 42 1 2 4 13 2 6 9 41 2 2 1 41 3 3 1 92 2 4 4 42 1 2 4 11 2 2 1 43 1 3 9 11 2 2 1 42 1 2 4 11 3 3 1 92 2 4 4 41 2 2 1 42 2 4 4 42 1 2 4 11 1 1 1 13 1 3 9 11 1 1 1 11 2 2 1 43 2 6 9 41 2 2 1 41 3 3 1 91 2 2 1 41 3 3 1 91 1 1 1 12 2 4 4 42 1 2 4 11 2 2 1 41 1 1 1 11 2 2 1 41 3 3 1 92 2 4 4 42 2 4 4 41 1 1 1 11 2 2 1 42 2 4 4 41 1 1 1 12 3 6 4 91 2 2 1 42 2 4 4 41 1 1 1 11 4 4 1 161 1 1 1 12 2 4 4 41 2 2 1 42 1 2 4 12 2 4 4 43 2 6 9 42 1 2 4 11 2 2 1 42 2 4 4 42 3 6 4 92 2 4 4 43 1 3 9 12 2 4 4 41 1 1 1 11 2 2 1 41 3 3 1 92 2 4 4 42 2 4 4 42 1 2 4 11 2 2 1 41 3 3 1 91 1 1 1 11 2 2 1 41 2 2 1 42 2 4 4 41 3 3 1 91 1 1 1 11 3 3 1 92 1 2 4 12 1 2 4 11 1 1 1 12 2 4 4 41 2 2 1 42 2 4 4 43 2 6 9 42 3 6 4 92 2 4 4 41 3 3 1 91 2 2 1 42 2 4 4 41 2 2 1 43 2 6 9 42 1 2 4 13 2 6 9 42 3 6 4 91 2 2 1 42 3 6 4 93 3 9 9 91 2 2 1 42 3 6 4 91 1 1 1 12 2 4 4 41 2 2 1 42 3 6 4 92 2 4 4 42 1 2 4 12 3 6 4 92 2 4 4 41 3 3 1 92 2 4 4 42 1 2 4 11 2 2 1 41 2 2 1 42 3 6 4 91 2 2 1 42 2 4 4 41 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 42 1 2 4 11 1 1 1 12 1 2 4 12 1 2 4 11 1 1 1 12 1 2 4 11 4 4 1 162 3 6 4 92 2 4 4 41 2 2 1 42 2 4 4 42 2 4 4 41 2 2 1 42 2 4 4 41 1 1 1 12 1 2 4 11 2 2 1 41 3 3 1 92 2 4 4 42 1 2 4 12 2 4 4 42 1 2 4 11 2 2 1 41 1 1 1 12 2 4 4 42 2 4 4 41 2 2 1 42 3 6 4 91 1 1 1 12 2 4 4 41 2 2 1 42 1 2 4 12 2 4 4 41 1 1 1 12 2 4 4 41 2 2 1 42 3 6 4 91 2 2 1 42 1 2 4 12 2 4 4 41 3 3 1 91 2 2 1 42 3 6 4 92 1 2 4 11 1 1 1 12 2 4 4 42 1 2 4 11 3 3 1 92 2 4 4 42 1 2 4 12 2 4 4 41 2 2 1 42 1 2 4 11 2 2 1 42 2 4 4 41 2 2 1 42 2 4 4 41 2 2 1 42 2 4 4 42 1 2 4 12 1 2 4 11 2 2 1 42 1 2 4 13 2 6 9 43 2 6 9 43 2 6 9 42 2 4 4 42 1 2 4 11 1 1 1 12 1 2 4 12 2 4 4 42 2 4 4 42 1 2 4 13 1 3 9 11 2 2 1 42 2 4 4 42 3 6 4 91 1 1 1 12 2 4 4 41 2 2 1 42 3 6 4 92 2 4 4 42 1 2 4 12 2 4 4 42 3 6 4 92 2 4 4 41 3 3 1 91 2 2 1 41 2 2 1 42 1 2 4 11 2 2 1 42 1 2 4 13 2 6 9 41 2 2 1 42 3 6 4 92 2 4 4 41 2 2 1 41 3 3 1 91 2 2 1 42 2 4 4 42 1 2 4 12 1 2 4 12 2 4 4 41 2 2 1 43 2 6 9 42 2 4 4 42 1 2 4 11 2 2 1 43 3 9 9 92 2 4 4 42 1 2 4 12 2 4 4 42 1 2 4 11 2 2 1 41 1 1 1 11 2 2 1 41 3 3 1 91 2 2 1 43 1 3 9 12 2 4 4 43 3 9 9 92 2 4 4 41 1 1 1 12 3 6 4 92 2 4 4 42 1 2 4 12 1 2 4 11 2 2 1 42 3 6 4 91 2 2 1 42 3 6 4 91 2 2 1 41 2 2 1 42 1 2 4 12 3 6 4 92 2 4 4 41 3 3 1 91 2 2 1 41 1 1 1 12 3 6 4 91 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 42 1 2 4 13 2 6 9 42 3 6 4 92 2 4 4 43 1 3 9 12 3 6 4 92 1 2 4 13 2 6 9 42 1 2 4 12 2 4 4 41 3 3 1 93 2 6 9 42 2 4 4 42 3 6 4 92 2 4 4 42 2 4 4 41 2 2 1 42 1 2 4 11 3 3 1 92 2 4 4 42 2 4 4 42 3 6 4 91 2 2 1 41 3 3 1 92 2 4 4 42 1 2 4 11 2 2 1 42 3 6 4 91 2 2 1 42 2 4 4 41 1 1 1 11 2 2 1 41 1 1 1 11 1 1 1 12 1 2 4 1639 734 1210 1219 1612R= nxy-xynx2-x2ny2-y2R = 3841210-6397343841219-63923841612-7342r= -0.063X Y XY X2 Y21 1 1 1 11 3 3 1 91 1 1 1 11 3 3 1 91 1 1 1 11 2 2 1 41 1 1 1 12 1 2 4 11 3 3 1 91 2 2 1 41 3 3 1 92 2 4 4 43 2 6 9 41 1 1 1 11 2 2 1 42 3 6 4 91 3 3 1 92 3 6 4 91 2 2 1 42 4 8 4 163 2 6 9 42 2 4 4 41 4 4 1 163 1 3 9 12 1 2 4 11 1 1 1 12 1 2 4 11 1 1 1 11 1 1 1 11 1 1 1 12 2 4 4 41 1 1 1 13 2 6 9 42 1 2 4 12 1 2 4 13 1 3 9 11 2 2 1 42 2 4 4 42 1 2 4 14 1 4 16 11 3 3 1 92 3 6 4 91 1 1 1 12 1 2 4 11 2 2 1 41 3 3 1 92 3 6 4 91 2 2 1 42 2 4 4 42 2 4 4 42 3 6 4 91 2 2 1 43 1 3 9 12 3 6 4 91 2 2 1 41 4 4 1 162 1 2 4 11 3 3 1 92 3 6 4 91 1 1 1 13 2 6 9 43 3 9 9 92 2 4 4 43 3 9 9 92 2 4 4 43 3 9 9 93 3 9 9 92 2 4 4 41 3 3 1 92 2 4 4 43 3 9 9 92 3 6 4 91 2 2 1 41 3 3 1 92 3 6 4 92 1 2 4 14 2 8 16 42 2 4 4 43 1 3 9 14 1 4 16 12 2 4 4 42 3 6 4 91 1 1 1 11 2 2 1 42 2 4 4 42 3 6 4 94 1 4 16 12 3 6 4 91 2 2 1 42 1 2 4 13 2 6 9 41 2 2 1 43 1 3 9 12 3 6 4 92 2 4 4 43 2 6 9 41 1 1 1 11 2 2 1 44 1 4 16 13 2 6 9 42 2 4 4 42 2 4 4 43 1 3 9 14 2 8 16 43 1 3 9 13 2 6 9 42 3 6 4 92 3 6 4 93 2 6 9 41 1 1 1 12 1 2 4 13 2 6 9 43 2 6 9 42 3 6 4 92 2 4 4 42 2 4 4 43 2 6 9 41 2 2 1 43 1 3 9 13 2 6 9 41 2 2 1 41 2 2 1 42 2 4 4 41 3 3 1 91 2 2 1 42 3 6 4 91 2 2 1 42 1 2 4 12 2 4 4 42 3 6 4 93 3 9 9 93 2 6 9 42 3 6 4 93 2 6 9 42 2 4 4 42 1 2 4 11 2 2 1 42 1 2 4 13 3 9 9 92 1 2 4 12 3 6 4 92 2 4 4 42 1 2 4 13 1 3 9 12 3 6 4 93 3 9 9 92 2 4 4 42 3 6 4 92 2 4 4 43 1 3 9 12 2 4 4 42 1 2 4 12 1 2 4 13 2 6 9 42 1 2 4 11 3 3 1 92 3 6 4 91 1 1 1 12 2 4 4 43 1 3 9 12 1 2 4 13 1 3 9 11 2 2 1 43 1 3 9 12 1 2 4 13 2 6 9 41 2 2 1 42 1 2 4 12 1 2 4 13 2 6 9 42 1 2 4 11 2 2 1 41 2 2 1 41 2 2 1 42 1 2 4 13 2 6 9 41 3 3 1 93 2 6 9 42 1 2 4 11 2 2 1 43 1 3 9 12 2 4 4 41 1 1 1 12 3 6 4 92 2 4 4 43 1 3 9 11 2 2 1 42 3 6 4 93 2 6 9 42 1 2 4 13 2 6 9 41 1 1 1 12 2 4 4 42 3 6 4 92 1 2 4 13 1 3 9 11 3 3 1 93 2 6 9 41 1 1 1 12 2 4 4 41 3 3 1 92 2 4 4 42 1 2 4 11 2 2 1 42 1 2 4 12 2 4 4 42 3 6 4 91 2 2 1 41 3 3 1 91 2 2 1 44 3 12 16 91 2 2 1 42 1 2 4 11 2 2 1 42 3 6 4 92 2 4 4 42 3 6 4 93 2 6 9 41 1 1 1 12 2 4 4 41 3 3 1 91 2 2 1 41 3 3 1 91 2 2 1 41 4 4 1 161 3 3 1 91 3 3 1 91 2 2 1 41 3 3 1 91 2 2 1 41 1 1 1 11 2 2 1 42 2 4 4 41 1 1 1 11 3 3 1 91 2 2 1 41 3 3 1 91 1 1 1 12 2 4 4 41 3 3 1 92 2 4 4 41 2 2 1 42 1 2 4 11 3 3 1 91 1 1 1 13 2 6 9 42 1 2 4 12 1 2 4 12 3 6 4 91 3 3 1 94 2 8 16 42 1 2 4 12 1 2 4 12 3 6 4 93 2 6 9 42 3 6 4 93 2 6 9 42 2 4 4 42 1 2 4 12 2 4 4 41 2 2 1 42 2 4 4 42 1 2 4 11 2 2 1 42 1 2 4 11 1 1 1 12 2 4 4 41 1 1 1 11 2 2 1 42 2 4 4 41 1 1 1 12 1 2 4 12 2 4 4 41 2 2 1 42 3 6 4 91 2 2 1 42 2 4 4 42 1 2 4 11 2 2 1 42 1 2 4 11 2 2 1 41 3 3 1 92 1 2 4 11 3 3 1 91 2 2 1 42 3 6 4 92 2 4 4 43 1 3 9 12 1 2 4 12 2 4 4 41 1 1 1 12 1 2 4 11 1 1 1 12 3 6 4 91 2 2 1 41 2 2 1 43 3 9 9 92 2 4 4 42 1 2 4 11 2 2 1 41 2 2 1 42 1 2 4 12 3 6 4 91 2 2 1 42 1 2 4 11 2 2 1 42 1 2 4 11 2 2 1 41 1 1 1 12 3 6 4 91 3 3 1 91 2 2 1 42 1 2 4 12 1 2 4 11 2 2 1 42 1 2 4 11 2 2 1 41 2 2 1 42 2 4 4 41 1 1 1 12 1 2 4 12 1 2 4 11 3 3 1 92 2 4 4 42 2 4 4 42 3 6 4 91 2 2 1 41 1 1 1 12 3 6 4 91 2 2 1 41 1 1 1 12 1 2 4 11 2 2 1 42 2 4 4 43 1 3 9 12 2 4 4 41 2 2 1 42 1 2 4 12 1 2 4 12 2 4 4 41 2 2 1 42 1 2 4 11 2 2 1 41 2 2 1 41 2 2 1 41 2 2 1 41 1 1 1 11 1 1 1 12 2 4 4 41 1 1 1 12 1 2 4 12 1 2 4 11 2 2 1 41 1 1 1 12 1 2 4 11 1 1 1 12 1 2 4 11 2 2 1 41 2 2 1 41 1 1 1 12 1 2 4 12 1 2 4 11 1 1 1 11 2 2 1 42 2 4 4 41 2 2 1 41 1 1 1 12 2 4 4 42 1 2 4 12 1 2 4 12 2 4 4 42 3 6 4 91 1 1 1 12 2 4 4 41 1 1 1 12 3 6 4 92 1 2 4 11 3 3 1 92 1 2 4 11 3 3 1 91 2 2 1 43 3 9 9 91 2 2 1 44 2 1 16 4689 727 1280 1463 1605R= nxy-xynx2-x2ny2-y2R =3841280-6897273841463-63923841605-7272r= -0.1073