Attitudes and Perceptions about Smoking Behavior of Students in the School Environment and Some Suggested Solutions

The trend of tobacco use is increasing among young people, students and evidence shows that tobacco smoke contains nicotine, which is a very strong addictive substance and is harmful to health, especially for children, adolescents and pregnant women. The chemicals in tobacco include acrolein, chemicals, acetaldehyde, carbon monoxide, nicotine, etc. Some of these chemicals are classified as carcinogenic. The cause of the increase of cigarettes stems from products with eyecatching, compact, flavorful, low-cost designs, etc. Tobacco is an addictive products very popular trade items in Vietnam. Today, it is not difficult to buy a pack of cigarettes from a shop, a grocery or at a supermarket. Although the mass media has propagated a lot about the harmful effects of smoking as well as the harmful effects of cigarette smoke to those around them, the proportion of smokers has not decreased. This situation is happening not only in adults but also in young people. Especially, smoking is creeping into the school where nurturing future talents. Although the harmful effects of cigarette smoking as well as the effects of cigarette smoke are widely known by the school as well as the media, the percentage of students smoking is increasing. This paper aims to study the smoking behavior of the students therefore we can assess the effectiveness of the mission of promoting health education to students and young people and finding solutions reduce student smoking rate. Original Research Article Hoi; JPRI, 33(50B): 323-328, 2021; Article no.JPRI.76781 324


INTRODUCTION
According to WHO data, there are about 1.1 billion tobacco users in the world, more than 5.8 trillion cigarettes are smoked annually, that is, tobacco kills 8 million people worldwide, including more than 5 million people die from active smoking and more than 600,000 people die from passive smoking [1]. In Vietnam, each year, the number of people who die from tobacco-related diseases is 40,000 people, the rate of lung cancer patients who smoke is about 96.8%.
Tobacco products that cause a lot of bad effect on our health and many countries have printed health warnings in the front and in the back of each pack of cigarettes. This is to warn us about the harmful effects of smoking, and some countries have also banned all advertising for cigarette sale [2]. Although some students know that smoking is not good but they still use tabacco, especially students and teenagers wgo are under 18 years old. They are the future of the country, that is, they themselves are educated in a modern environment and of course, using substances that causes serious harm to the health of themselves and those around them should be taken into consideration [3].
In addition, smoking can also be fatal for nonsmokers. Second-hand smoke exposure is also associated with adverse health outcomes, causing 1.2 million deaths annually [2]. Nearly half of all children breathe air contaminated by passives moke and 65,000 children die each year from second-hand smoke-related illnesses. Smoking during pregnancy can lead to a number of lifelong health conditions for the baby [1].

METHODOLOGY
The article has been completed based on a survey of a target group of 20 students from middle school to high school to find out the smoking behavior of students in school as well as the influence of smoking in the family and in the community. These are the students have been smoking or used to smoke and were selected to complete the survey according to their relationship with the person who is doing this research. Besides, it also analyzes and synthesizes various documents related to the problem to be researched. By doing survey, the results were collected and then mentioned in the paper.

RESULTS
From Fig. 1 we can see that the students were affected by passive smoking not only from their families but also from school. It shows that smoking has been entering the school, making a significant impact on the psychology and health of students [4].

Families and society
Looking at Fig. 2, the option "friends" is the answer chosen by 5 of the respondents. This means there is a relationship between passive smokers and the smokers, especially percentage of students in school is rather high.
Smoking from a young age will seriously affect our mental health later in daily life. In addition, the percentage of students' relatives who smoke is also very high, which shows that they have been passive smoking not only in our society but also at home.
Through the data of Fig. 3, we can see that friends, relatives as well as people around them, they smoke a lot of cigarettes every day, of which 59% smoked 2 to 3 cigarettes a day, 4 to 10 cigarettes is 29% and more than 10 cigarettes is 12%. It shows that students often Looking at Fig. 2, the option "friends" is the answer chosen by 5 of the respondents. This means there is a relationship between passive smokers and the smokers, especially, the percentage of students in school is rather high.
Smoking from a young age will seriously affect our mental health later in daily life. In addition, the percentage of students' relatives who smoke is also very high, which shows that they have ive smoking not only in our society but Through the data of Fig. 3, we can see that friends, relatives as well as people around them, they smoke a lot of cigarettes every day, of which 59% smoked 2 to 3 cigarettes a day, 4 to s 29% and more than 10 cigarettes is 12%. It shows that students often smoke passively and that is seriously affecting their health every day.
From Fig. 4 we can see that 100% of us know that the harmful effects of inhaling passive smoke are as harmful as smoking directly. This shows that the propaganda work of the school and the society is very effective.
Through Fig. 5, up to 80% of we are interested in propaganda activities against the harmful effects of tobacco. Thereby, we can see that the school has been very active in propagandizing and organizing activities about the harmful effects of tobacco for students, which helps to reduce the proportion of teenagers under 18 years old. tobacco use. smoke passively and that is seriously affecting From Fig. 4 we can see that 100% of us know that the harmful effects of inhaling passive smoking directly. This shows that the propaganda work of the school 5, up to 80% of we are interested in propaganda activities against the harmful effects of tobacco. Thereby, we can see that the school been very active in propagandizing and organizing activities about the harmful effects of tobacco for students, which helps to reduce the proportion of teenagers under 18 years old.

DISCUSSION
Before studying smoking behavior of students and adolescents under 18 years old, we need to find out what smoking is. Tobacco is the name of a product made mainly from tobacco leaves, shredded leaves, rolled or stuffed with paper, cylindrical in shape (usually less than 120 mm in length, approx. 10mm). Cigarettes are usually burned at one end, to smolder for the purpose of creating smoke and this smoke follows the gas stream into the smoker's mouth from the opposite end (usually with a filter attached).
Smoking affects the health of ourself and those around us [5]. Tobacco smoke has more than 7000 substances, of which hundreds are harmful to health, 70 carcinogenic substances, including addictive substances and toxic substances, divided into 4 main groups: Nicotine, carbon monoxide (CO), small molecules in cigarette smoke and carcinogens [3].
According to the 2015 global survey on tobacco use among adults aged 15 and over, Vietnam belongs to the group of 15 countries with the highest number of smokers in the world. The percentage of adult male smokers is 47.4%, and there are currently about 33 million non-smokers who regularly breathe passivesmoke at home and more than 5 million non-smokers breathe in passivesmoke at work. job. Recent studies also show that the trend of tobacco use is increasingly younger, the rate of male smokers under 15 years old is 1.18% and female is 0.31%. Therefore, building a smoke-free school is very necessary to help staff, teachers and students ensure the right to breathe fresh air, contributing to improving health and quality of Column1 teaching and learning, building a civilized and polite lifestyle in schools [6].
Walking around the water bars near the high schools, it is not difficult to see the scene of male and female students gathering to smoke. Students smoke as a hobby, a harmless pastime and to express themselves -smoking is also burning the future of the health of not only the students but also those around them. members in family [2]. According to experts, children who smoke early will do worse in school, the disease that is most often seen is chronic airway inflammation, also known as chronic respiratory failure, irreversible airway obstruction. In addition, tobacco smoke is also the cause of many diseases such as lung cancer, oropharyngeal cancer. The longer the smoking period, the greater the harm, the higher the amount of nicotine in cigarettes stored in the body [1].
One of the important factors leading to the increase in smoking among students is the environment. They are often drawn by their friends, wanting to prove that they are good players, influenced by their academic results, family circumstances, etc. Also, they are curious to know what it feels like to smoke cigarettes. With the mentality of smoking a few cigarettes, we will not become addicted and gradually become a habit we can't quit [4].
Nowadays, in Vietnam, it is very easy for students to buy cigarettes anywhere in urban and rural areas. Because the system of selling and distributing products, especially retailing in cafes, shops and roadside cigarette cabinets, is increasingly popular. In addition, the law has forced the manufacturer to write the words smoking is harmful to health on the pack and has regulations to prevent people under the age of 18 from smoking and selling drugs as well as prohibiting the sale of drugs to people under 18 years old. However, the test has not been processed, so it is not difficult for students to buy cigarettes [6].
Quitting smoking helps protect the health of ourselves and those around us. These are the benefits of not smoking: reduce annual costs, reduce incurable diseases and reduce toxic accumulation in the body, improve the beauty of the body, improve appetite, limit hair loss, gray hair, improve vision and memory, reduce infertility and protect the environment [7].

SOME SUGGESTIONS IN COMPARISION WITH OTHER STUDIES
In order to prevent students from smoking, it is necessary to have many activities aimed at images of healthy lifestyle and actively attract them to participate. No one can fully measure the harmful effects of smoking, especially to students, so besides the school and the state, the family also plays an important role in limiting the smoking status of students [3].
The role of the school needs to bring the content of anti-smoking propaganda into high schools and consider this as a key work. In order to minimize the smoking status of students. We should equip students with the skills to decline invitations to smoke from friends or people. Encourage children to say no to tobacco [5].
The role of the family is often concerned, tightly managed in children's daily activities in terms of time and friendship relationships. Educate children about the harmful effects of smoking. Family members are also not allowed to smoke so that the children can follow the example [2].
The role of the state should focus on implementing measures to reduce demand for tobacco combined with control measures to gradually reduce the supply of tobacco. We need to focus on information, education and communication measures to raise awareness about the harmful effects of tobacco in order to gradually reduce the rate of tobacco use and the harms caused by tobacco. We also carry out interdisciplinary coordination, social mobilization and international cooperation in tobacco harm prevention and control [8]. Of course, we should ensure everyone's right to live and work in a smoke-free environment and to be fully informed about the harmful effects of tobacco. To prevent smoking in students is an urgent job of families, schools and the whole society [1]. Applying appropriate tax policies to reduce tobacco use is necessary. The tobacco business planning must be consistent with the socio-economic development objectives and gradually reduce the supply of tobacco, in line with the reduction of the demand for tobacco use. To encourage and create conditions for domestic and foreign agencies, organizations and individuals to participate in the provision of smoking cessation and counseling services; research on the harmful effects of tobacco, methods of smoking cessation; researching and manufacturing tobacco cessation drugs [3]; cooperate and sponsor for the prevention and control of harmful effects of tobacco; Tobacco users voluntarily quit smoking. We need to encourage and create favorable conditions for organizations and individuals to grow tobacco, produce tobacco, and process tobacco ingredients to change industries [4].

CONCLUSION
Smoking is not good, especially at school age since it seriously affects students' mental health. To reduce smoking in students, there needs to be close cooperation between families, schools and the whole society, that is, it is necessary to raise awareness to wake up our children; equip them with skills to refuse invitations to smoke from friends or people, create a habit of saying no to tobacco. We should take care and manage children's daily activities in terms of time and friendship relationships. In addition, there should be strict regulations and strict sanctions for selling cigarettes to schoolchildren. The resuls show that the most dangerous effect of smoking on teenagers is when it has become a habit. Once addicted to smoking, it will lead to some serious consequences affecting the psychological health of students. In onw word, not only schools but also families must promote persuasive propaganda to reduce the rate of students smoking to keep a safe education environment.

CONSENT AND ETHICAL APPROVAL
As per international standard or university standard guideline participant consent and ethical approval has been collected and preserved by the authors.