Smoking Habits Among Medical Students In

Smoking habits among medical students in

Medical College – Wassit university

Aseel H. Shemal

Wassit University- Medical College

ABSTRACT

Objective: To estimate the prevalence of smoking habits among male medical students at the College of Medicine,Wassit University.

Methods:This study was a cross-sectional study done by using Arabic questionnaires distributed to the medical students in the College of Medicine, Wassit University at different educational levels from October 14, 2010 to February 25, 2011. A total of 150 medical student were included in this study.

Results: The study shows that 23.3 % of male medical students were currently active smokers.Most of them (51.4%),are smokers since 1-2 years.(68.6%) smoke less than 20 cigarettes per day.(57.1%) smoke both cigarettes and sheesha.Most of them(82.9%) are affected by their friends in initiation of smoking behavior.There is significant relationship between smoking and:1-peer pressure,2-respiratory tract infection and 3-academic performance.

Conclusion: There is an urgent need to promote multidisciplinary health education activities at different age groups in order to prevent young age students from smoking, and to help smokers to quit especially in medical students.

الخلاصه

الهدف: ان الهدف من هذا البحث هواجراء دراسه لغرض معرفه العوامل المتعلقه بعادات التدخين بين طلبه كليه الطب في جامعه واسط.

المواد والطرق :اجريت الدراسه للفتره من تشرين الاول 2010 لغايه شباط 2011 بأستخدام العينه المتعدده المراحل حيث كان عدد الطلاب في العينه 150 طالب.لقد تم الحصول على بيانات تتعلق بعادات التدخين بين الطلاب وعلاقتها بمجموعه من العوامل كمده التدخين,عدد السكائر المدخنه في اليوم, نوع التدخين, اسباب بدايه التدخين والنصيحه لترك التدخين,العلاقه مابين التدخين وتأثير الاصدقاء,العلاقه مابين التدخين والاصابات بالتهابات المجاري التنفسيه وكذلك العلاقه بين التدخين والمستوى العلمي.

النتائج: وقد لوحظ ان عدد الطلبه المدخنين هو(23.3%),الغالبيه (4.51%) تتراوح عندهم مده التدخين بين 1-2سنه,كما ان الغالبيه( 68.6 %) يدخنون اقل من 20 سيكاره باليوم, (1 . 57%) يدخنون كلا من السيكاره والشيشه.(82.9%) كان تأثرهم بالاصدقاء هو سبب التدخين.كما وتبين لنا ان هنالك علاقه وثيقه بين التدخين وكلا من: الاصابه بالتهابات المجاري التنفسيه(تمت معرفتها عن طريق سؤال الطالب عن عدد مرات الاصابه بالامراض التنفسيه في السنه), تأثير الاصدقاء والمستوى العلمي (كثره الاجازات المرضيه تؤثر على المستوى العلمي).

الاستنتاج: خرجت الدراسة بجملة من التوصيات ، منها ضرورة وضع برنامج متكامل للتحذير من مخاطرالتدخين لدى هذه الفئه العمريه وبالخصوص لدى طلاب كليه الطب .

INTRODUCTION

Smoking is the leading cause of preventable morbidity and mortality in the world [WHO 2006]. Tobacco use claims worldwide 5.4 million lives each year [WHO2008]. Although overall cigarette consumption has declined for decades in high-income countries, smoking rates are on the rise in low- and middle-income countries [WB. 1999]. The negative health consequences of smoking are considerable and include cancers of the lung and other organs, chronic lung disease, stroke and other cardiovascular disease [Doll R.(2000)- Abol Fotouh M.(2998),Lyon.(2004)]. Smoking during pregnancy can lead to spontaneous abortions, low birth weight, and sudden infant death syndrome [DiFranza JR. (1995)]. Exposure to secondhand smoke also has serious health effects [Deutsches (2005), US D.(2006)].

The benefits of smoking cessation have been well demonstrated. Smoking cessation reduces health risks and improves quality of life. The cumulative risk of dying of cardiovascular and lung diseases can be drastically reduced (up to 90%) if smokers quit smoking, even late in life [Peto R.(2000), Anthonisen NR.(2005)]. Therefore, every smoker should be actively encouraged to give up smoking. Due to tobacco's highly addictive properties, cessation attempts need to be supported by health care professionals to achieve long-term abstinence.

Physicians are in an ideal position to advise and educate patients about the dangers of smoking. Moreover, they act as visible role models and may unintentionally affect the smoking behavior of others [Bandura A.(1986)]. Their own smoking habits may cloud their judgement and influence their ability to adequately counsel smokers. They are also more likely to maintain attitudes that prevent them from providing patients with anti-smoking advice [Cummings KM.(1987), Kossler W.(2002)]. As one can assume many of their personal smoking behaviors and beliefs are formed during their medical education, any successful tobacco control measures within the medical profession will need to begin prior to graduation from medical school. Undergraduate curricula must include teaching modules focusing on the responsibility that doctors have in disease prevention and training in specific smoking cessation techniques.

METHODOLOGY

A cross-sectional study using Arabic questionnaires was distributed randomly to 150 male medical students at different educational level in the College of Medicine, Wassit University , during the period october 14, 2010 to February 25, 2011. A total of 150 medical students responded to the questionnaires with a response rate of 100%. Out of 150 students,39(26%)are in the 1st stage, 34(22.7%)are in the 2nd ,29(19.3%),36(24.4%), 12(8%) respectively.

The data were collected accordingly . Chi-square (χ2) test used XXXto compare the prevalence rate) and the corresponding 95% of confidence interval (95% C.I) were used to estimade the risk factors. The data were analyzed using the statistical package for soaial sciencesXXX(SPSS ver.12). A (p- value < 0.05) considered significant.

RESULTS

Table 1: Distribution of the study group by the stage.

Stage / Frequency / Percentage
1st / 39 / 26
2nd / 34 / 22.7
3rd / 29 / 19.3
4th / 36 / 24.4
5th / 12 / 8.0
Total / 150 / 100.0

Table 2: Distribution of the study group by state of smoking.

Percentage / Frequency / State of smoking
23.3 / 35 / Smoker
76.7 / 115 / Non smoker
100 / 150 / Total

Table 3: Distribution of the study group according to duration of smoking.

Percentage / Frequency / Duration of smoking
51.4 / 18 / 1-2 years
34.3 / 12 / 3-4 years
14.3 / 5 / 5-6 years
100 / 35 / Total

Table 4 :Distribution of the study group according to number of cigarettes per day.

Percentage / Frequency / No. of cigarettes per day
68.6 / 24 / Less than 20
31.4 / 11 / More than 20
100 / 35 / Total

Table 5:Distribution of the study group according to type of smoking.

Percentage / Frequency / Type of smoking
37.1 / 13 / Cigarettes
5.7 / 2 / Sheesha
57.1 / 20 / Both
100 / 35 / Total

Table 6: Distribution of the study group according to causes of onset.

Percentage / Frequency / Causes of onset
8.6 / 3 / Family
82.9 / 29 / Friends
8.6 / 3 / Both
100 / 35 / Total

Table 7: Distribution of the study group according to advice by others to leave smoking or not.

Percentage / Frequency / advice
88.6 / 31 / Yes
11.4 / 4 / No
100 / 35 / Total

Table 8: Distribution of the study group according to influence of peer pressure on smoking habit.

Peer pressure / Smoker / Non smoker / Total
Present / 29(83%) / 6(5%) / 35(23%)
Absent / 6(17%) / 109(95%) / 115(77%)
Total / 35(100%) / 115(100%) / 150(100%)

Chi squared equals 92.803 with 3 degrees of freedom.The two-tailed P value is less than 0.0001,By conventional criteria, this difference is considered to be extremely statistically significant.

Table 9: Distribution of the study group according to relation between recurrent respiratory tract infection and smoking habits.

Respiratory tract infection / Smoker / Non smoker / Total
Present / 24(68.5%) / 8(7%) / 32(21%)
Absent / 11(31.5%) / 107(93%) / 118(79%)
Total / 35(100%) / 115(100%) / 150(100%)

Chi squared equals 60.321 with 3 degrees of freedom. The two-tailed P value is less than 0.0001.By conventional criteria, this difference is considered to be extremely statistically significant.

Table 10: Distribution of the study group according to relation between academic performance and smoking habits.

Academic performance / Smoker / Non smoker / Total
*weak / 22(63%) / 35(30.5%) / 57(38%)
**good / 13(37%) / 80(69.5%) / 93(62%)
Total / 35(100%) / 115(100%) / 150(100%)

Chi squared equals 11.973 with 3 degrees of freedom.
The two-tailed P value equals 0.0075 . By conventional criteria, this difference is considered to be very statistically significant.

**students who pass the exam from the 1st trial.

* students who pass the exam from the 2nd trial

DISCUSSION

Some studies showed that smoking is prevalent among students of health care professionals[ Abol Fotouh M.(1998)]. Other studies showed that smoking prevalence is quite high among health care workers even though they know the harmful effects of smoking[ Anthonisen NR.(2005)].

In this study, 23.3 % were current smokers , and approximately 77% of medical student never smoked. Compared with other study[ Abol Fotouh M.(1998)] which showed that regular smoking has a prevalence rate of 13.6% among medical students at the College of Medicine in Abha, KSA. Another study showed that 29% were current smokers among students of the College of Applied Medical Science in Riyadh, KSA [Hashim T.(2000)]. The present study showed that (51.4%) are smokers since 1-2 years and the number decreasing because different studies showed that smokers were concerned on the smoking hazard, and most of them were knowledgeable about smoking and had favorable attitude against it[ Abol Fotouh M.(1998)]. This result may also related to number of cigarette per day,(68.6) less than 20 cigarette per day.

The present study showed that the common reasons given for smoking behavior were the influence of friends (82.9%). This agrees with other studies, which showed that majority of the smokers started smoking due to friend influences[ Lyon.(2004), Peto R.(2000)].

Friends were the main source of the first cigarette 55.6% as reported by Abol Fotouh M. (1998).

In this study we find that 37.1% of smokers were cigarette smokers 5.7% sheesha smokers and 57.1% smoke both cigarettes and sheesha. In comparison with other studies, the type of smoking among male medical students in Abha were cigarette 70.4%, sheesha 51.9% and cigarette 3.7%.(5 ) ,Behbehani N.(2004) reported a prevalence of sheesha smoking among male physician in Kuwait by 12% and in Bahrain by 6.4%.

About 88.6% advised by the others to quit smoking because all know that smoking linked with cancer, heart disease, respiratory illness, and is the leading source of indoor air pollution[ Hashim T.(2000), Felimban F.(1994) ,Fichtenberg C.(2002)].

In the present study, there were significant association between smoking behavior and peer pressure. [Evans RI.( 1978)] identified peers, parents, and the media as major sources of pressure and in response attempted to familiarize young people with these pressures and with ways of dealing with them. McAlister and others [McAllister (1979), Botwin GJ.(1980)] developed these ideas further and added the use of peer leaders as educators, activities to increase social commitment not to smoke, and the role-playing of situations that needed resistance to social pressure.

This study shows significant correlation between smoking behavior and recurrent respiratory tract infection.Smoking is associated with a number of complaints in adults. It was associated with nocturnal chest tightness, nocturnal breathlessness, breathlessness after activity,increased bronchial responsiveness, wheezing apart from colds, bronchitis symptoms, dyspnea, and physician-diagnosed asthma in adults.[ Leuenberger P.(1994)].

The significant association between smoking and academic performance in this study is also found in another studies which denoted that academic performance for smoker students was weaker than non smokers,because the smokers were more prone to respiratory diseases than the others and hence more sick leaves.[ Richard W.(1998)].

CONCLUSION:

There is an urgent need to promote multidisciplinary health education activities at different age groups in order to prevent young age students from smoking, and to help smokers to quit.

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