A comparison of smoking behaviors among medical and other college students in China

A survey of students' smoking in China (n = 1896), comparing medical students with college students in non-medical majors, was carried out to determine whether a medical education has a preventive effect on smoking uptake. The survey, sampling students from 12 universities in three cities, found no significant differences between medical and non-medical students in smoking prevalence (40.7% versus 45.1% for males, 4.4% versus 6.0% for females), in 'ever smoked' groups, in 'ever smoked 100 cigarettes' groups or in years of smoking. For both student groups, smoking prevalence increased with age and with years of college. However, one significant difference was found among the smokers: medical students were more likely to be occasional smokers than were non-medical students (75.3% occasional smokers among medical students who smoked versus 60.6% among non-medical students). These results suggest that a medical education had little effect on these students' decisions to smoke, but that it may have modified their consumption level. Future studies are needed to ascertain factors affecting the decision to smoke and to identify possible early adopters of a non-smoking culture in China. Action on a societal level is urgently needed to change Chinese social norms regarding smoking.     

Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics, and attitudes

INTRODUCTION: In 1996 we conducted a cross-sectional survey to study the epidemiology of smoking among Kuwaiti adults. METHODS: The 4000 participants were selected using a three-stage stratified cluster sampling design. Altogether 3859 participants (1798 males, 2061 females) returned a completed self-administered questionnaire. RESULTS: The prevalence of smoking was 34.4% (95% confidence interval (CI) = 32.2-36.6) among men and 1.9% (95% CI = 1.3-2.5) among women. Among men, the highest prevalence (56.5%; 95% CI = 36.2-76.8) was observed in the youngest age group (< or = 20 years). Among women the highest prevalence was observed in one of the older age groups (46-50 years) (7.1%; 95% CI = 3.1-11.1). Multiple logistic regression analysis showed that the following factors were independently associated with smoking: lower levels of education (odds ratio (OR) 3.5; 95% CI = 1.5-8.4), lower employment grade (OR = 4.1; 2.5-6.7), and being a separated, divorced, or widowed woman (OR = 4.9; 95% CI = 2.0-11.8). The majority of smokers (68%) began smoking when younger than 20 years; significantly more men (70%) than women (33%) began smoking at these ages (P < 0.0001). On average, men began smoking at an earlier age (18 years vs 21 years; P < 0.001) and therefore had smoked for a longer period (15 years vs 12 years; P < 0.05); men also consumed a higher number of cigarettes each day (26 vs 17; P < 0.05). A large proportion of smokers were ignorant about the health consequences of passive smoking: about 77% of those with children reported that they smoked in the presence of their children. Almost half (47%) of all smokers stated that they wanted to stop smoking, and about 56% had attempted to quit. The biggest perceived barrier to quitting was uncertainty about "how to quit". A total of 338 respondents (8.8%; 95% CI = 5.8-11.9) were classified as former smokers. About half of the former smokers had quit between the ages of 20 and 29 years; the average age of quitting was 28 years. Former smokers were more likely to have smoked fewer cigarettes per day and to have smoked for significantly less time than current smokers. DISCUSSION: Given the fact that free education is provided at all levels by the government, anti-tobacco education and awareness should be included as an integral part of the curriculum in schools and colleges.     

Tobacco smoking habits,attitudes and beliefs among nurse and medical students in Tuscany

In this study we evaluated the smoking habits, beliefs and attitudes of nurse and medical students at the University of Siena and Florence, Italy. Students who entered the 1st year of school in 1998 were asked to complete a self-administered anonymous questionnaire. Two hundred medical students completed the questionnaire; they had a mean age (±SD) of 19.8 ± 1.7 years and 68% were females. A total of 205 nurse respondents answered to the questionnaire; they had a mean age of 21.8 ± 4.1 years and females were 83% of the total. The overall response rate among students always remained higher than 85%. Thirty per cent of medical students were current smokers, and 5% former-smokers. A total of 43% of nurse students were current smokers and 11.5% former-smokers. Nurse students were more likely to smoke than medical students (p= 0.001). Among current smokers, the number of daily cigarettes smoked and the degree of nicotine addiction did not differ between groups. The prevalence of maternal smoking were higher among nurse students. In spite of students' beliefs the knowledge about smoking remained generic in both groups. Nurse students were less aware than medical students of their special responsibility towards people about tobacco smoking. Such a difference remained significant also after adjustment for smoking status (p< 0.01). Students overestimated the prevalence of current smokers among health caregivers of the local hospitals, and Italian people and adolescents. Targeted and continuous training about smoking prevention should be mandatory in Italian medical and nurse schools.     

Density of tobacco retail outlets near schools and smoking behaviour among secondary school students

Objective: To investigate whether the density of tobacco retail outlets near schools in Victoria, Australia, is associated with adolescent smoking behaviour. Methods: Cross‐sectional survey data of 2,044 secondary school students aged 12–17 years was combined with tobacco outlet audit data. Associations between students' self‐reported tobacco use and the density of tobacco outlets near schools was examined using multilevel logistic and negative binomial regression models, with cigarette price at local milk bars and key socio‐demographic and school‐related variables included as covariates. Results: Increased tobacco retail outlet density was associated with a significant increase in the number of cigarettes smoked in the previous seven days among students who smoked in the past month (IRR=1.13; 95% CI 1.02–1.26), but not the odds of smoking in the past month in the larger sample (OR=1.06; 95% CI 0.90–1.24), after controlling for local mean price of cigarettes and socio‐demographic and school‐related variables. Conclusions and implications: This study suggests there is a positive association between tobacco retail outlet density and cigarette consumption among adolescent smokers, but not smoking prevalence, in the Australian context. There is value in considering policy measures that restrict the supply of tobacco retail outlets in school neighbourhoods as a means of reducing youth cigarette consumption.     

Parkinson's disease risks associated with cigarette smoking, alcohol consumption, and caffeine intake

A reduced risk for Parkinson's disease (PD) among cigarette smokers has been observed consistently during the past 30 years. Recent evidence suggests that caffeine may also be protective. Findings are presented regarding associations of PD with smoking, caffeine intake, and alcohol consumption from a case-control study conducted in western Washington State in 1992-2000. Incident PD cases (n = 210) and controls (n = 347), frequency matched on gender and age were identified from enrollees of the Group Health Cooperative health maintenance organization. Exposure data were obtained by in-person questionnaires. Ever having smoked cigarettes was associated with a reduced risk of PD (odds ratio (OR) = 0.5, 95% confidence interval (CI): 0.4, 0.8). A stronger relation was found among current smokers (OR = 0.3, 95% CI: 0.1, 0.7) than among ex-smokers (OR = 0.6, 95% CI: 0.4, 0.9), and there was an inverse gradient with pack-years smoked (trend p < 0.001). No associations were detected for coffee consumption or total caffeine intake or for alcohol consumption. However, reduced risks were observed for consumption of 2 cups/day or more of tea (OR = 0.4, 95% CI: 0.2, 0.9) and two or more cola drinks/day (OR = 0.6, 95% CI: 0.3, 1.4). The associations for tea and cola drinks were not confounded by smoking or coffee consumption.     

Smoking among Chinese Americans: behavior,knowledge, and beliefs

Objectives. This report describes and examines factors significantly associated with smoking among Chinese Americans, using multiple logistic regression methods. Methods. We conducted a population-based survey (n = 644, age = 40-69 years) in Chicago's Chinatown using a Chinese questionnaire based on the National Health Interview Survey (NHIS). Results. Smoking prevalence was 34% for males and 2% for females. Some 93% of current smokers had smoked regularly for 10 or more years. Low education (odds ratio [OR] = 2.41; 95% confidence interval [CI] = 1.31, 4.46), use of a non-Western physician or clinic for health care (OR = 2.64; 95% CI = 1.46, 4.80), and no knowledge of early cancer warning signs and symptoms (OR = 2.52; 95% CI = 1.35, 4.70) were significantly associated with smoking among men. Conclusions. The male prevalence of smoking is higher than those reported in California, the NHIS, and the Behavioral Risk Factor Surveillance System (BRFSS); exceeds the rate for African Americans aged 18 years and older; is comparable with the rate for African American males aged 45 to 64 years; and is far above the Healthy People 2010 target goal of less than 12%. Multisite surveys and smoking cessation campaigns in Chinese are needed.     

Saturation of tobacco smoking models and risk of alcohol and tobacco use among adolescents.

PURPOSE: To examine how saturation of an adolescent's environment with models of cigarette smoking (e.g., parents, siblings, friends) affects the probability of tobacco and alcohol use among junior high and high school students. METHODS: The Health and Smoking Questionnaire was administered to 806 adolescents (182 smokers and 624 nonsmokers; 57.2% female) average age of 15.1 years (SD = 1.6) in a mid-size Midwestern town. The questionnaire contains standardized items in five domains: demographics, smoking status and history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style. RESULTS: Risk for smoking or using alcohol increased dramatically as the number of models who smoke increased in an adolescent's environment. For instance, adolescents with one significant other who smoked were nearly four times (OR = 3.76, p <.001) more likely to smoke than someone with no significant others who smoked. However, if an adolescent had four significant others who smoked, they were over 160 times more likely to smoke (OR = 161.25, p <.001). Similar results were found for alcohol use; adolescents who had one significant other who smoked were more than 2.5 (OR = 2.66, p <.001) times more likely to drink than those without smoking models. Adolescents who had four significant other smoking models were 13 times (OR = 13.08, p <.001) more likely to drink. CONCLUSIONS: As the number of cigarette smokers in an adolescent's environment increases, risk of tobacco and alcohol use increases substantially. These data suggest that multiple models of tobacco use will substantially increase risk for substance use in adolescents.     

Lower Prevalence of Cigarette and Waterpipe Smoking,But a Higher Risk of Waterpipe Dependence in Lebanese Adult Women Than in Men

The objective of this study was to evaluate whether nicotine dependence was higher in Lebanese women smokers compared with men smokers. Data were taken from a national cross-sectional study. Lebanese residents aged ≥ 40 years were enrolled between October 2009 and September 2010. After informed consent, participants answered a standardized questionnaire about smoking behaviors and dependence (measured by the Fagerström-Test-Nicotine-Dependence for cigarettes and the Lebanon-Waterpipe-Dependence-Scale 11 for waterpipes): 1,066 males and 1,134 females were interviewed. 58.7% versus 42.9% of them, respectively, ever smoked cigarettes, while 6.9% versus 6.7% ever smoked a waterpipe (p < 0.001). Moreover, 57.5% in male versus 49.1% in female cigarette smokers (p = 0.041), 35.9% versus 51.6% in waterpipe smokers (p = 0.076), and 67.9% versus 43.6% in mixed smokers were tobacco dependent. A dose-effect relationship was observed with increased rates of women versus men with waterpipe dependence) and an increased odds of dependence among women in multivariable analysis (ORa = 2.28). Positive (smoking waterpipe for pleasure and conviviality) and negative (smoking waterpipe to relax nerves and improve morale) reinforcements were significantly more frequent in women, while no significant sex difference was observed for nicotine dependence or psychological craving. In exclusive waterpipe smokers, significantly higher respiratory diseases and symptoms prevalences were found in females compared with males. Women who smoke waterpipes should receive attention during tobacco health education and smoking cessation.     

The smoking habits of Minnesota physicians.

The prevalence of smoking among physicians has gradually declined over the past 25 years. Few recent studies have examined specific smoking habits. Of 393 physicians in the Minnesota Medical Association who responded to a survey (response rate of 83%), 9% reported smoking any form of tobacco. The prevalence of cigarette smoking was 4.9%, while 5.1% smoked a pipe and 2.1% smoked cigars. The prevalence estimates of current and former smokers were greater among men than women and among older than younger physicians. Cigarette and overall smoking prevalence among physicians continues to be well below levels reported for the general population.     

Do favorite movie stars influence adolescent smoking initiation?

OBJECTIVES: We sought to determine whether adolescents whose favorite movie stars smoke on-screen are at increased risk of tobacco use. METHODS: During interviews, adolescent never smokers taking part in the California Tobacco Survey nominated their favorite stars. We reviewed popular films released during 1994 through 1996 to determine whether stars smoked on-screen in at least 2 films. RESULTS: One third of never smokers nominated a star who smoked on-screen, which independently predicted later smoking risk (odds ratio [OR] = 1.36; 95% confidence interval [CI] = 1.02, 1.82). The effect was strong among girls (OR = 1.86; 95% CI = 1.26, 2.73). Among boys, there was no independent effect after control for receptivity to tobacco industry promotions. CONCLUSIONS: Public health efforts to reduce adolescent smoking must confront smoking in films as a tobacco marketing strategy.     

Lower prevalence of cigarette and waterpipe smoking, but a higher risk of waterpipe dependence in Lebanese adult women than in men

The objective of this study was to evaluate whether nicotine dependence was higher in Lebanese women smokers compared with men smokers. Data were taken from a national cross-sectional study. Lebanese residents aged ≥ 40 years were enrolled between October 2009 and September 2010. After informed consent, participants answered a standardized questionnaire about smoking behaviors and dependence (measured by the Fagerstr?m-Test-Nicotine-Dependence for cigarettes and the Lebanon-Waterpipe-Dependence-Scale 11 for waterpipes): 1,066 males and 1,134 females were interviewed. 58.7% versus 42.9% of them, respectively, ever smoked cigarettes, while 6.9% versus 6.7% ever smoked a waterpipe (p < 0.001). Moreover, 57.5% in male versus 49.1% in female cigarette smokers (p = 0.041), 35.9% versus 51.6% in waterpipe smokers (p = 0.076), and 67.9% versus 43.6% in mixed smokers were tobacco dependent. A dose-effect relationship was observed with increased rates of women versus men with waterpipe dependence) and an increased odds of dependence among women in multivariable analysis (ORa = 2.28). Positive (smoking waterpipe for pleasure and conviviality) and negative (smoking waterpipe to relax nerves and improve morale) reinforcements were significantly more frequent in women, while no significant sex difference was observed for nicotine dependence or psychological craving. In exclusive waterpipe smokers, significantly higher respiratory diseases and symptoms prevalences were found in females compared with males. Women who smoke waterpipes should receive attention during tobacco health education and smoking cessation.     

Smoking among university students: a gender analysis

The main objectives of this paper were to estimate the consumption patterns of tobacco use among King Saud University (KSU) undergraduate students; and investigate different risk factors which may contribute to tobacco use among female students. A representative sample (n=7550) of the total KSU undergraduate student population of 69,498 (males and females) was selected, stratified according to college and gender. A modified version of the WHO/CDC Global Youth Tobacco Survey (GYTS) questionnaire was used for data collection. Overall smoking prevalence among KSU students was estimated at 14.5%, prevalence among male students (32.7%), and females (5.9%). Independent risk factors for smoking among males were found to be: age, father's smoking habits, and "friends' smoking habits"; while among females were: sister's smoking habits and "friends' smoking habits." The findings of this study re-emphasize the significance of peer pressure on smoking among university students of both sexes; influence of family members, usually of same sex. We need to foster gender-sensitive tobacco prevention intervention programs, to prevent youngsters of both sexes from taking up such habit. We also need to raise awareness of girls and young women, of the consequences of smoking in general, water-pipe in specific, on their own health, that of their spouses, families, and off-springs, many of whom could develop chronic respiratory disorders, as passive smokers in the beginning/potential smokers themselves, later on. All such efforts should be backed and supported by strong governmental commitment, to ensure success of their implementation accordingly.     

Tobacco smoking and acute myocardial infarction in young adults: a population-based case-control study

OBJECTIVE: To evaluate the effect of tobacco smoking on the risk of non-fatal acute myocardial infarction in young adults (< or = 45 years), and whether there is modification of this effect by sex. METHODS: We conducted a population-based case-control study with 329 incident acute myocardial infarction cases (42 women; 287 men), consecutively admitted to the Cardiology department of hospitals in Porto, Portugal, and 778 controls (486 women; 292 men), selected within the non-institutionalized Porto population, during 2001-2003. Odds ratios and 95% confidence intervals (OR, 95%CI) were calculated using unconditional logistic regression. RESULTS: The prevalence of current smoking was 80.8% in male cases and 53.8% in male controls (OR=3.63, 95%CI: 2.50, 5.27) and 59.5% of female cases were smokers compared to 35.8% of controls (OR=2.64, 95%CI: 1.39, 5.02). No interaction was found between current smoking and sex on myocardial infarction risk (p=0.401). A dose-effect response was present, the odds favoring myocardial infarction reaching an eight-fold increase for those that smoked > 25 cigarettes/day compared to never smokers. The risk estimate for former smokers was similar to never smokers. CONCLUSIONS: Tobacco smoking is an important independent risk factor for acute myocardial infarction in young adults, with similar strength of association for both sexes.     

河北省1021名教师吸烟与控烟状况调查

目的了解河北省教师吸烟与控烟状况。方法抽取河北省3个城市26所大中小学校的一线教师进行面对面问卷调查。结果共调查22—62岁教师1021名,女性无吸烟者,男性吸烟率为25．7％;吸烟者平均每天吸烟12．4支,香烟价格在20元及以下占98．5％;吸烟者在上班时间和在学生面前吸烟的比例分别为86．8％和47．1％,吸烟的主要室内场所是办公室和卫生间;吸烟者有44．1％曾经戒过烟,45．6％有近期戒烟打算。75．8％的教师对学生讲过吸烟的危害,开展过其他控烟相关教学活动的教师比例不到40％;60．5％的教师所在学校实行全部禁烟,17．6％实行部分禁烟,执行禁烟规定好的学校占有禁烟规定学校的56．3％。结论河北省校园内存在不同程度的教师吸烟现象,应加大对学校特别是大、中学校控烟干预和监督力度。     

Prevalence and determinants of smoking in Tirana city,Albania: a population-based survey

BACKGROUND: Smoking is the leading cause of premature death in Europe yet there are still many countries in which there is little information on its patterns and determinants. Albania is one such country. METHODS: A survey of health and lifestyle, including questions on smoking practice and attitudes, and its determinants was undertaken in Tirana, the capital of Albania in mid 2001. SUBJECTS: One thousand one hundred and twenty adults aged 25 years and over (response rate 72.7%). RESULTS: Forty-one percent of the study population (61% male and 24% female) were current or ex-smokers-28% were current smokers (37.6% of males and 19.3% of females) and 13% were ex-smokers (23.4% of males and 4.7% of females). Age-standardized (to the European standard population) prevalence of smoking for the adult population of Tirana was 31.2% (42.8% in males and 21.2% in females). Smoking was most common among those aged 25-34 years (59% of males and 30% of females in this age group). Of the current smokers, 16.5% smoked more than 20 cigarettes/day, and 67.3% smoked the first cigarette within 30 min of waking. Only 11% of current smokers had tried to quit smoking once during their life. Concern about health was the most common reason for quitting cited by ex-smokers (44%). In men, smoking was inversely associated with educational achievement. While the probability of smoking decreases with age, there was no consistent association with employment or income. CONCLUSION: The prevalence of smoking in Albania is comparable with other Western societies. The high rates of smoking among young men and women suggest that tobacco will make an increasingly large contribution to premature morbidity and mortality in the future. The high rate of smoking among young women in Albania, while a common phenomenon in post-communist countries, is especially worrying. This study emphasizes the need for a robust, evidence-based strategy for tobacco control in Albania.     

Cigarette smoking among medical college students in Wuhan, People's Republic of China.

BACKGROUND: This study examined cigarette smoking among a sample of medical college students in Wuhan, People's Republic of China. Specific cultural factors associated with cigarette smoking in China were discussed and issues which need to be studied in the future are presented. METHODS: A self-administrated questionnaire was administered to a sample of 1,611 medical students in 1995. Smoking status was based on self-reported use of cigarettes within the preceding 180 days. Information about demographic characteristics, home residence, annual family income, and smoking status of family members was also obtained. RESULTS: A total of 1,540 (1,201 males and 339 females) completed and returned the questionnaires (response rate 95.6%). None of the 339 female students surveyed reported cigarette smoking. A total of 37.7% (95% confidence interval (CI) = 35.0-40.5%) of the male medical students were current smokers, and 5. 3% (95% CI = 4.0-6.6%) were former smokers. The mean age of beginning to smoke was 16.5 years (95% CI = 8.7-24.3 years). The major reasons for first smoking were stress (42.8%, 95% CI = 38.2-47. 4%), curiosity (34.4%, 95% CI = 29.6-38.4%), and loneliness (33.7%, 95% CI = 28.7-37.4%). Multivariate analyses suggested that age, college year, and having a family member who smoked were significantly associated with cigarette smoking. CONCLUSIONS: The results indicated a need to provide comprehensive tobacco use prevention programs among medical students.     

Popular perceptions of tobacco products and patterns of use among male college students in India

This paper examines popular perceptions of tobacco products and describes patterns of use among college youth in Karnataka, India. Data are drawn from 25 key informant interviews and six focus groups with male and female college students, interviews with shopkeepers, observational data on youth tobacco consumption, and a college-based survey. The survey was administered to 1587 males attending eleven colleges. Forty-five percent (n = 716) of college students surveyed had used tobacco products. Thirty-six percent (n = 573) had tried cigarettes, 10% (n = 157) had tried bidis, and 18% (n = 290) had tried gutkha. Tobacco consumption among smokers was low; for daily smokers, the mean number of cigarettes smoked was 6 per day. Students attending professional colleges, including engineering, medicine, and law were significantly more likely to have ever smoked and to be daily smokers when compared to students enrolled in other courses of study. In interviews, male students noted that smoking a cigarette enhanced one's manliness, relieved boredom, and eased tension. Although female students interviewed were non-smokers, several suggested that in the future, smoking might be an acceptable behavior among college-going females. When asked about their perceptions of smoking among youth in Western countries, the majority of students believed that three-quarters of male and female youth in the West smoked. This perception has been largely formed through media images, including satellite television and films. With regard to addiction, it was widely believed that filter-tipped cigarettes were one of the most addictive products because they are made of better quality tobacco, and are milder and smoother to smoke. Therefore, a person could easily smoke more of them, which would lead to addiction. Another widely held belief was that the more expensive the cigarette, the less harmful it was for one's health.     

Smoking habits in nursing students: prevalence, attitudes and knowledge]

The purpose of this study has been to evaluate the prevalence of smoking habit, knowledge on the adverse health effects and attitudes towards it among nurses students in their three years of study (University School of Girona). A self-administrated questionnaire was used. A total of 135 questionnaires were answered (88%) from an estimated available population of 154 students (94% females with 21 years old of mean age). The prevalence of current smoking was 34.3%; ex smokers 23.3% and non smokers 42.5%. The mean of tobacco consumption was 367.6 cigarettes/month. 92% no smokers, 91% ex smokers and 76% smokers thought that smoking has adverse health effects (p less than 0.001). They consider the health protection like the first reason to give up smoking. 38% will advise their healthy smokers patients about the risk of their habit. We conclude: 1.-Low prevalence of smoking habit; 2.-Nurses should know methods aimed at lowering smoking rates, assuming that they have determined influence on the population behavior.     

武汉市大学生吸烟现状及现在吸烟影响因素分析

目的 了解武汉市大学生吸烟现状,分析影响大学生现在吸烟的因素,为高校控烟工作提供科学依据.方法 采用分层整群抽样方法,抽取武汉市4所高校的3 000名大学二年级学生进行自填式问卷调查.采用x2检验和Logistic回归对大学生吸烟行为及其现在吸烟影响因素进行分析.结果 2 891名大学生中,27.33％的大学生有尝试吸...     

某医科大学学生吸烟现状及其影响因素

目的了解医学院在校大学生的吸烟现状及其影响因素,为制定有效的控烟措施提供依据。方法采取分层随机抽样方法,对中国医科大学500名在校大学生进行问卷调查。收回有效问卷496份,有效率99.2%。结果被调查的496名医学生的现在吸烟率为6.5%。男生的现在吸烟率明显高于女生(χ2=30.799,P=0.000)。低年级与高年级本科生的现在吸烟率无明显差异,且均明显低于研究生(χ2=7.738,P=0.021)。被调查的32名现在吸烟者平均每日吸烟量为(6.31±2.45)支,平均起始吸烟年龄为(18.01±3.15)岁。好友吸烟人群的现在吸烟率明显高于好友不吸烟人群(χ2=198.948,P=0.000)。父母吸烟人群的现在吸烟率明显高于父母不吸烟人群(χ2=89.271,P=0.000)。医学生对吸烟与疾病关系的认知率较高,医学生吸烟的主要原因是心理压力。结论医学生的吸烟现状不容乐观,应积极采取有效措施控制医学生的吸烟行为。