TOBACCO RELATED CONTENT ON NEW MEDIA AND ITS EXPOSURE AMONG UNIVERSITY STUDENTS IN BANGLADESH

The study investigates the tobacco-related content on new media and its exposure among university students in Bangladesh. A cross-sectional study design based on mixed-method approach had been used to conduct this study. A sample of 405 respondents were selected from eight public universities in Bangladesh for the survey questionnaire. Besides, 20 key informant interviews were conducted with structured question, and a checklist used for new media observation regarding tobacco-related contents. Quantitative analysis performed with descriptive and inferential statistics for survey data, while thematic analysis followed for qualitative data. The study revealed that 43.5% of respondents were exposed to tobacco-related content (TRC) in New Media. Regarding exposure to TRC, Facebook (43.5%) was on the top, followed by YouTube (39.2%), Instagram (35.6%), Online Newspaper (25.2%), Blog (22.2%) and Twitter (12.5%). Study shows that one-fifth of the respondents (20.2%) had an engagement with these TRC by post, share, like and comment through Facebook, YouTube, and Twitter. university students, the tobacco industry has developed different tools and techniques in new media.

promotion as well as fail to address the role of new media in case of tobacco control among university students. For effective uses of new media for tobacco control, it is necessary to know the pattern of tobacco promotional activities by the tobacco industry.

METHODOLOGY Operational Definition New Media
New media refer to the highly interactive digital technology. New media is quickly processed, stored, transformed, retrieved, hyper-linked, and, perhaps most radical of all, quickly searched for and accessed. New media refers to Facebook, Twitter, Instagram, YouTube, Tango, and Online Newspaper. Conceptually, new media can be viewed as a cultural process that reflects societal values and societal transformation (Livingstone & Lievrouw, 2009).

Tobacco-Related Contents Exposure
Tobacco-Related contents refer the advertisement, promotional activities, sponsorship, posting of tobacco products and selling by the tobacco industries in new media place. Exposure refers the like, comments, share, post, view, invitation in tobacco page.

University Students
University students refers the graduate and post graduate students who are the regular users of new media.

Study Design
For conducting this study, the cross-sectional design followed. This research was conducted by following the mixed-method approach, both qualitative and quantitative methods.

Study Area and Population
This study covered eight public Universities of eight divisions in Bangladesh. The study populations were the university's students and regular (daily) users of new media.

Study Period
The study conducted from April to November 2019.

Sampling Design Survey
For the quantitative part, the sample size has been calculated using the following formula: -Equation, n = 405, Where, Z= 1.96 for 5% level of significance P= Percentage of graduate students exposed to the tobacco activities on new media (Unknown) =50% d = Margin of error = 0.05 (considered) Non-response=5% For collecting data through a survey questionnaire, 405 respondents were selected from eight public universities. From those universities, respondents were being chosen randomly for the questionnaire survey. The distribution of respondents by the university are given below-

Key Informant Interview (KII)
For selecting the respondents of KII, the purposive sampling method has followed. Numbers of KII from the different segments are given below-

Data Analysis
The raw data inserted into the database system. For analyzing the collected data of this study database system had been used. For making the data analysis more thorough and suitable, the validity of the data had scrutinized. To analyze the survey data, SPSS had been used. Various statistical tools, such as descriptive statistics, correlation, cross-tabulations, central tendency tests, etc., extensively examined the data collected. Finally, the comprehensive findings of this research have presented.

Ethical issues
Institutional ethical clearances of this study acquired from the Department of Public Administration, University of Dhaka. Informed written consent had taken before conducting the interview. Individual ethical issues had maintained in every tier of the study. The gender and age of the respondents are shown in the above table (Table 4). Among the 405 respondents, 75.8% respondents were male, and 24.2% were female. The average age of the respondents was 21.5 years old. The above table (Table 5) shows the smoking and smokeless tobacco using status of the respondents. Among the 405 respondents, 20.0% were tobacco users. Here, 19.0%respondents consumed smoking tobacco currently, while 3.2% of respondents consumed smokeless tobacco. Types of smoking and smokeless tobacco are shown in Table 6. Among tobacco users, all the respondents consumed cigarettes, and7.9% of respondents consumed both Bidi and E-cigarette. Among smokeless tobacco users, all the respondents' consumed Jarda, and 8.3% finished both sadapata and guys. The above figure ( Figure 1) shows different types of new media by the respondents. Among the respondents, all were Facebook users, followed by 83.2% were YouTube users, 38.5%WhatsApp, 32.6% Instagram, 31.4% Imo, and 28.4% respondents were online newspaper users. Besides, 13.8% of respondents used Twitter, some (4.4%) used Blog, and only 1.2% used other new media types. Table 7. TRC group/page/site/channel/news followed by the respondents on new media An average number of TRC group/page/site/channel/news followed by the respondents in new media are shown in Table 7. On average, respondents viewed 0.74TRC in Facebook, 0.02 TRC in Twitter, 0.66 TRC channel in YouTube,0.28 TRC site in Blog, 0.29TRC page in Instagram and 0.47TRC site in Online newspaper.

Promotional Activities/ Exposure to Tobacco Related Content (TRC)
Any content on new media, which contain the different pro-tobacco scene, tobacco consumption, tobacco product, brand, and sponsorship and have not warned message, are termed as Tobacco-Related Content (TRC). Respondents were exposed to different types of TRC in video, image and text format that is shown below:  The above graph (Figure 3) shows the percentage of the respondents exposed to TRC by new media. Overall, among the respondents, 61.2% exposed to TRC in the last six months on Facebook, 60.1% in YouTube, 47.7% in Instagram, 18.1% in Online newspapers, 17.9% in Twitter, and 7.7% in Twitter Blog.
Note: * Multiple responses Figure 4. Type of TRC post exposed by the respondents Overall, the type of exposed TRC post is shown in Figure 4. Among the exposed TRC post, 74.2% was video, and 73.8% was the image; that is, video and image highly exposed TRC posts in new media. Again, 44.4% revealed TRC was text, and 6.9% was only audio.  Table 8 shows the percentage of the respondents exposed to TRC and their tobacco smoking behavior within the last six months. It was found that among respondents who revealed to TRC, 24.6%usedsmoking tobacco. Similarly, 31.7%respondents used smoking tobacco among them who reacted to TRC. Again, 26.4% used smoking tobacco among the respondents exposed to TRC on Facebook, Twitter, and Instagram.  figure (Figure 6) shows the visibility of health warning messages on the TRC of music videos, drama, movies, and celebrity's posts. Among 322 respondents, 80.7% of respondents found health warning messages in the exposed TRC for most cases, while 34.8% found health warning messages for fewer issues. Only 5.9% of respondents found the health warning note in the exposed TRC for half of the cases.  Table 9 shows the percentage of respondents who tried to consume tobacco seen by the TRC scene in new media. It found that 11.9% of respondents tried to consume tobacco by seeing glamorous TRC scenes in new media, while 88.1% did not try.

Tobacco Control Activities in New Media
Note: * Multiple responses Figure 7. Types of tobacco control content exposed by the respondents Figure 7 shows the types of tobacco control content post on new media. The majority (63.3%) of the respondent exposed to video, 45.3% to image, 48.3% to text, and11.6% to audio on new media.
Note: * Multiple responses; Figure 8. Type of tobacco control activities based on new media The above graph (Figure 8) presents different types of tobacco control activities on new media. It found that 59.5% of respondents were exposed to various publicity workshops, 64.9% to awareness programs, and 18.9% to online seminars on new media.

. Respondents influenced by tobacco control activities in new media
The above figure (Figure 9) shows the percentage of respondents influenced by tobacco control programs based on new media. Almost half of the students (51.1%) said that the tobacco control programs influenced them, and the rest of the respondents were not impacted.
Note: * Multiple responses Figure 10. Tobacco control-related contents by new media The above figure (Figure 10) shows the tobacco control-related contents by new media. The highest majority (89.9%) of the respondents were exposed to tobacco control-related content in Facebook, 31.9% in YouTube, 12.6% in online newspapers, 9.9% in Blogs, 5.7% in Twitter, and 3.5% Instagram.

QUALITATIVE FINDINGS Observation Findings The Pattern of Tobacco Promotional Activities
Presently, tobacco promotional activities have taken place in the new media largely; because of the prohibition of tobacco promotional activities in Bangladesh, there is no specific inclusion of the new media. Besides, mainly Facebook, Twitter, Instagram, YouTube are using for the promotional activities of tobacco for its ease of access; similarly, the young generation or university students think smoking is part of smartness, and they upload their smoking picture in "New Media"; this, by and large, influencing the people.
The Tobacco industry cannot apply the direct techniques by using their logo, name or other things in the promotion, and if they do it, it will be an absolute crime according to the law. There may be the TI sponsorship in the different scenes of movies, drama, or YouTube videos where smoking is being shown as part of heroism. In addition, they have recruited advocates to work in favor of them for promoting their product in "New Media".

Influence Over University Students
Students are the targeted customer of the TI, and utilizing this, it becomes easy to reach and influence them. The age where the university student belongs is fascinating and wants to enjoy everything like a hero. The tobacco industries arrange different types of secret campaigns to spread the smoking tobacco. At the same time, TI hires celebrities to upload their heroism picture with smoking.
The tobacco industry has developed some characteristics in new media via video, pictures with smoking tobacco that represent bravery and heroism. The university students copy those characteristics from the video and image to become competent and valor. This copy becomes a curse for the university students to a large extent, and they began to follow those excessively.

Anti-tobacco Promotional Techniques in New Media
Some organizations, individuals, and the government have taken some initiative for the tobacco control activities in new media. Though it has become the biggest platform, it is not using essentially by the anti-tobacco activists, individuals, and government.
For the anti-tobacco promotional activities, different kinds of patterns are being followed. The designs are seminars, symposiums, awareness programs, drama and those are posted directly in the new media like Facebook, Twitter etc. Within a short time, it becomes easier to reach many populations. At the same time, the new media developed a scope where all kinds of opposing sides of tobacco become possible to telecast in detail.

Government's Role in Combating Tobacco Promotional Activities by Using New Media
The study depicts that government can play a central role in combat tobacco promotional activities in new media by developing a new law related to tobacco promotional activities in the new media and can add substantial punishment for direct and indirect tobacco promotional activities in the new media. There is a problem that the tobacco sector is the second sector for large revenue generation, and here a question may arise about the role of government.

DISCUSSION
The study finds that due to advanced knowledge on technology and being young, university students are highly using new media, and TRC is spreading in new media to a large extent. Different tobacco promotional activities are visible in new media, which have distinct patterns such as Audio, Video, Image and Text. In new media, both individuals and industries share different tobacco-related contents and products, which are exposed very highly to the new media users. These findings meet the demand of Choudhury et al. (2018) to develop a strategy to solve this issue.
This study explored different tobacco promotional activities exposed to university students on which they have significant reactions. It agrees with James and Vishwanathan (2018) study finding regarding tobacco among university students. A substantial number of respondents (61.2%) were exposed to TRC by new media within the last 6-month where Facebook is on the top list. Since the previous 6-month TRC exposure, the use of smoking tobacco was found significantly higher among the respondents who exposed to TRC (24.6% vs 10.2%; p<0.01) and who engaged with TRC (36.5% vs 10.1%; p<0.001) compared to who did not. It indicates that these TRC are contributing to increasing the number of smokers among university students, which needs to draw attention, reflecting the study finding of (Hassan et al., 2019). It means Facebook is one of the easiest ways to promote different tobacco products by targeting young customers.
Individuals and the tobacco industries are also using the other new media to reach the young new media users. Among the respondents who exposed different TRC on new media tend to engage with these in the post, share, like and comment. As a result, these TRC remain visible on new media for a long time and creates a positive attitude and belief about tobacco products, especially smoking tobacco. Non-smoker students are also exposed to TRC on new media and seeing different glamorous TRC posts by their virtual friends. They have tended to post and share TRC following their peer groups to get popularity (like and comment) among friends. As a result of one stage, they have the chance to addict to tobacco.
However, this study explored that any tobacco industries are not directly connected with these TRC, but there may be an indirect link for further research. Although Tobacco industries are not directly affiliated with these TRC in many ways, their name, logo, and glamorous tobacco products are visible with these exposed TRC, which found on the homepage of the respondents on new media. It found that among the exposed TRC, one-fourth of the TRC are clearly showing different tobacco industries name and logo, brands and color that determined from the last 6-month exposure post.
In addition, the new media become an essential segment for the anti-tobacco promotional activities. This supports the finding of Arsenijević and Andevski (2015) regarding making people conscious about tobacco using social media. This study finds that the majority viewed different anti-tobacco promotional activities on Facebook, Twitter, Instagram, Blog, and YouTube. However, various anti-tobacco promotional activities are visible in new media, but student engagement is shallow with these activities 'student engagement.

RECOMMENDATION
 In the tobacco advertisements prohibition law, it is mandatory to include the prohibition of tobacco advertisement in new media.  It is necessary to ensure that no TRC will be allowed to display on new media at personal and industrial levels without warning messages.  The government of Bangladesh should take adequate measures to formulate and implement a university-based intervention program to inform students about the harmful effects of tobacco use. In addition, those programs can telecast in new media.  It is necessary to take the initiative to include the tobacco-related program at formal university education so that they become aware deeply of its harmful effects.
 The government can develop programs related to the harmful effects of tobacco uses regularly and can telecast those in new media via the support of different anti-tobacco activists or organizations.  For reducing the extreme exposure of tobacco at university premises, it is essential to enforce the Smoking and Tobacco Products Usage (control) Act, 2005 and Amendment 2013 and its regulations.  For the students who already expressed to quit smoking, it is necessary to ensure proper assistance and tools for supporting them to stop smoking tobacco forever.  The government should take the initiative for establishing a tobacco cessation center at the university and can provide training to the health professional is students. In addition, still, some TRC scenes are visible in music videos, dramas, movies, and other celebrities post without health warning messages. By seeing this glamorous TRC scene, university students have primarily been influenced by the tobacco promotional activities in new media which indulging them to tobacco products largely. However, it becomes easier to reach millions of people by using new media within a short time, and it would be possible to involve the majority of university students in anti-tobacco promotional activities. The governments need to support and give sponsorships in anti-tobacco promotional activities to make them more efficient and effective to make people aware regarding life threatening impact of tobacco. Besides, findings of this study would be supportive to the policy makers of the government to regulate posting, sharing tobaccorelated content in new media in Bangladesh to save the youth like university students.