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Introduction: Tobacco use in children and adolescents is reaching pandemic levels. The World Health Organization predicts that India will have the fastest rate of rise in deaths attributable to tobacco in the productive years of adult life, as a consequence of an addiction acquired in youth. Materials and Methods: A cross-sectional questionnaire study based on global youth tobacco survey was undertaken to study the prevalence of tobacco use among 15-20 years old college students. A simple random sampling method was used to select the students from Government and Private schools and Colleges in Bengaluru city. Results: In the study population of 2399 in the age group of 15-20 years, 307 (12.8%) subjects reported use of cigarettes among whom 176 (7.3%) reported current use and 240 (10%) reported ever use of smokeless tobacco. Majority 226 (73.6%) belonged to private institutions and 81 (26.4%) to government institutions. About 41 (1.7%) were daily smokers. Conclusion: Prevalence of smoking was much higher among the private institution students as opposed to students of government institutions; also, it was observed that the percentage of smokeless tobacco users were higher in this age group when compared to cigarette smokers. Keywords: Global youth tobacco survey, smokeless tobacco use, tobacco use
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24
Journal of Indian Association Of Public Health Dentistry
Vol. 13, Issue 1, | January-March 2015
Prevalence of tobacco use among 15-20 years old college
students in Bengaluru city
Vasudha Sharma, S. S. Hiremath1, Manjunath Puranik2, Shweta Somasundara
Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, 1Department of Public Health Dentistry, Oxford Dental
College and Hospital, 2Department of Public Health Dentistry, Government Dental College and Research Institute Dental College and
Hospital, Bengaluru, Karnataka, India
Address for correspondence:
Dr. Vasudha Sharma, Dep artment of Pub lic Health Dentistr y, Rajaraje swari Dental Co llege and Hospi tal, No. 207, Kambip ura, Kumbal Godu, My sore
Road, Ben galuru, Karnat aka, India. E-mail: vashu77@gmail.com
ABSTRACT:
Introducon: Tobacco use in children and adolescents is reaching pandemic levels. The World Health Organization predicts that
India will have the fastest rate of rise in deaths attributable to tobacco in the productive years of adult life, as a consequence of
an addiction acquired in youth. Materials and Methods: A cross-sectional questionnaire study based on global youth tobacco
survey was undertaken to study the prevalence of tobacco use among 15-20 years old college students. A simple random sampling
method was used to select the students from Government and Private schools and Colleges in Bengaluru city. Results: In the study
population of 2399 in the age group of 15-20 years, 307 (12.8%) subjects reported use of cigarettes among whom 176 (7.3%)
reported current use and 240 (10%) reported ever use of smokeless tobacco. Majority 226 (73.6%) belonged to private institutions
and 81 (26.4%) to government institutions. About 41 (1.7%) were daily smokers. Conclusion: Prevalence of smoking was much
higher among the private institution students as opposed to students of government institutions; also, it was observed that the
percentage of smokeless tobacco users were higher in this age group when compared to cigarette smokers.
Key words:
Global youth tobacco survey, smokeless tobacco use, tobacco use
INTRODUCTION
Tobacco use is a serious public health challenge in
several regions of the world. According to estimates
made by the World Health Organization (WHO), currently
about 5 million people die prematurely every year in
the world due to the use of tobacco, mostly cigarette
smoking. By 2030, it would double to 10 million deaths
every year, with about 7 million of the deaths taking
place in developing countries. India will have the fastest
rate of rise in deaths attributable to tobacco and many
of these will occur in the productive years of adult life,
as a consequence of an addiction acquired in youth.[1]
The global literature is only of limited help in assessing
the problem of tobacco use in India since the dominant
and the most researched form of tobacco use globally is
cigarette smoking. In India, cigarette smoking comprises
a small part of the tobacco smoking problem and a minor
part of the overall tobacco problem, a major problem
being beedi smoking, and the oral use of smokeless
tobacco products. Adolescents are the most vulnerable
population to initiate tobacco use. However, it is now well
established that most of the adult users of tobacco start
tobacco use in childhood or adolescence.[2]
Many studies across the world and in the country have
focused on 13-15 years age group using global youth
tobacco survey (GYTS) while global adult tobacco survey
has been used for adult population. The present study
was an attempt to specically study the pattern tobacco
use both smoking and smokeless forms among the
15-20 years old as 15 years is a transition age group
from school to college, which offers more freedom than
rigid school systems and 17 years is transition from
junior college to senior college in our country. However,
very few studies have been conducted with respect to
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DOI:
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ORIGINAL ARTICLE
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Sharma, et al.: Prevalence of tobacco use in Bengaluru city
25
Journal of Indian Association Of Public Health Dentistry
Vol. 13, Issue 1, | January-March 2015
prevalence of use of tobacco in any form among especially
college going students in our country. Hence, the aim of
the study was to assess the prevalence of smoking and
smokeless tobacco use among 15-20 years old college
students in Bengaluru city.
MATERIALS AND METHODS
This was a cross-sectional questionnaire-based study
conducted on 15-20 years old college students in
Bengaluru city. List of colleges was obtained from The
Directorate of Pre University Education Bengaluru and
collegiate education.
Colleges in Bengaluru are divided into north and south
zones with 306 colleges in south and 236 colleges in north
zone respectively. From north Zone, 4 Government and
1 Private College and from south zone, 3 Government
and 3 Private Colleges offering pre university and degree
courses were selected randomly until the required sample
size was satised. The study participants were selected
using simple random sampling from Ist year, IInd year pre
university and Ist, IInd and IIIrd year degree students to
suit the age group of the study.
A pilot study was conducted, and the population
proportion of tobacco use was estimated at 40%. Based
on this, sample size was estimated at 2304 subjects. It
was then rounded off to 2400 study subjects.
Ethical clearance was obtained by the institutional ethical
committee. Necessary permissions were obtained from
Board of Pre-University and collegiate education and the
study and colleges. The required permissions to conduct
the study were taken from the college authorities.
The study participants were allotted a number and
were asked not to disclose their name to protect the
condentiality of the information provided. Demographic
information regarding the age, sex, education, parental
education level, occupation and socioeconomic status
was collected. Information regarding smoking and use
of smokeless tobacco among students were ascertained
using a questionnaire derived from the GYTS[3] and
modied to suit the present study. The students were
asked to assemble in a classroom and explained the
purpose of the study. The questionnaire was then
administered and was collected after they had completed
answering all questions.
Ascertainment of tobacco exposure was done using the
terminologies suggested by GYTS. Ever users of cigarettes
or ever smokers were dened as those who reported
having smoked >100 cigarettes during their lifetime.
Current smokers were dened as those who reported
having smoked >100 cigarettes during their lifetime and
who currently smoked every day or some days. Never
smokers were dened as those who reported not having
smoked >100 cigarettes during their lifetime. Ever use
of tobacco products other than cigarette was dened as
having used these products at least 20 times in their life.
The category of current smokers in this study included
those who reported to be occasional smokers, frequent
smoker and daily smokers.
Descriptive statistics was used to analyze the data.
Statistical analysis was performed using SPSS version 14
(spss inc. Chicago, USA).
RESULTS
Demographic prole
Table 1 shows the distribution of participants in
different age groups. Of 2400 students, one student did
not respond and hence statistical analysis and result
reporting was done using the final sample of 2399
students: 1391 (57.9%) belonged to private institution
and 1009 (42.04%) to government institutions. About
1366 (57%) were males, and 1033 (43%) were females.
Prevalence of smoking in various groups
Prevalence of ever use
In the study population of 2399, 307 (12.8%) subjects
reported ever use of cigarette, 262 (85.3%) were males and
45 (14.9%) were females, 226 (73.6%) belonged to private
institutions and 81 (26.4%) to government institutions
Prevalence of current use of cigarettes
In the present study, 176 (7.3%) reported current use
of cigarette. Among the 176 students who reported
current use, 123 (5.1%) were ex-smokers, 112 (4.7%)
were occasional smokers, 23 (1%) were frequent smokers
and a total of 41 (1.7%) reported to be daily smokers.
Among the 1367 males, 16% reported ever use of cigarette
and among the 1033 females, 4.5% reported ever use
of cigarette. Table 2 shows the distribution of current
smokers with respect to gender.
Table 1: Demographic prole
Age in
years
n=2400 Education n (%) College n (%)
PUC Degree Government Private
15 106 106 (9) 82 (8.1) 24 (1.7)
16 410 405 (34.5) 5 (0.4) 212 (21) 198 (14.2)
17 734 530 (45.1) 204 (16.7) 243 (24.1) 491 (35.3)
18 608 119 (10.1) 489 (39.9) 233 (23.1) 375 (27)
19 300 11 (0.9) 289 (23.6) 103 (10.2) 197 (14.2)
20 241 3 (0.3) 238 (19.4) 135 (13.4) 106 (7.6)
Did not
respond
01 ‑
Gender
Male 1366 (57) 765 (65.1) 601 (49.1) 616 (45) 751 (55)
Female 1033 (43) 410 (34.9) 623 (50.9) 393 (38) 640 (62)
Total 2399 (100) 1175 (48.9) 1224 (50.8) 1009 (42) 1391 (58)
PUC ‑ Pre‑university college
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Sharma, et al.: Prevalence of tobacco use in Bengaluru city
26
Journal of Indian Association Of Public Health Dentistry
Vol. 13, Issue 1, | January-March 2015
Distribution of study population with respect to current use
of cigarettes and age
Out of 176 current users of cigarette, 2 (1.1%) students
were of the age 15 years; 20 (11.3%) were 16 years old;
about 41 (23.2%) were 17 years of age; 48 (27.2%) were
18 years of age; 30 (17%) students were 19 years of age
and 35 (19.8%) were 20 years old. Of the 41 subjects
who were daily smokers, 1 (2.4%) student was of the
age 15 years; 1 (2.4%) was 16 years old; 7 (17.1%) were
17 years of age; 16 (39%) subjects were 18 years of age
and 12 (29.3%) were 20 years of age.
Distribution of study population with respect to age, gender
and current use of cigarettes
Out of 147 males who were current users of cigarette,
2 (1.3%) students were of the age 15 years, 15 (10.2%)
were 16 years old, about 36 (24.4%) were 17 years
of age, 37 (24.5%) were 18 years of age, 26 (17.6%)
students were 19 years of age and 31 (21%) were
20 years old.
Out of 29 females who were current users of cigarette,
5 (17.2%) were 16 years old, about 5 (17.2%) were
17 years of age, 11 (37.9%) were 18 years of age,
4 (13.7%) students were 19 years of age and 4 (13.7%)
were 20 years old.
Distribution of study population with respect to age of
initiation of the habit among pre university and degree groups
Among the 307 ever smokers, 89 (28.9%) reported
smoking before the age of 15 and 218 (71.1%) reported
smoking after the age of 15 years. Table 3 shows the age
of initiation among ever smokers.
Prevalence of use of tobacco products other than
cigarettes
Distribution of users of tobacco products other than
cigarettes among the pre university and degree group
Among the total population of 2399 students, 240 (10%)
of the students have reported ever use of tobacco
products like guthka, khaini, snuff, hookah. Among
the 240 students who reported ever use, 106 (44.1%)
belonged to the pre university category and 134 (55.8%)
were degree students.
Among the 176 who reported current use of cigarettes,
51 (28.9%) reported ever use of tobacco products like
guthka, khaini, snuff, hookah Furthermore, it was
observed that 14 (34%) of the daily smokers reported
concurrent ever use of smokeless tobacco and among the
students who reported no use of cigarettes, 153 (6.3%)
reported use of only smokeless tobacco. Table 4 shows
the distribution of ever users of tobacco products other
than cigarettes among students in different college
categories. Table 5 shows the ever use of tobacco
products other than cigarettes among students who
reported to be current smokers.
DISCUSSION
Tobacco use is one of the major preventable causes of
premature death and disease in the world. The WHO
estimated that the proportion of deaths that result from
tobacco-related diseases will rise in India, from 1.4% of all
deaths in 1990 to 13.3% of all deaths in 2020. In India’s
case, the population is expected to grow by about 300
million between 2000 and 2020.[1] Most of the expansion
will occur in the age group of 15–20 years.
Prevalence of ever users and current users
In the present study, among the total population,
176 (7.3%) reported current use of cigarettes, 147 (6.1%)
males and 29 (1.2%) females reported current cigarette
use. A study in Haryana in 1995 among adolescents[4]
and 2002 among college students[2] reported 7.1%, which
is similar to the present study. Whereas, according
to GYTS – India 2002–2004,[1] prevalence of current
smoking among students was 8.3%, study among
college students in Andhra Pradesh,[5] prevalence of
current smokers was 8.2%, CDC-MMWR[6] reported
9.2%, Western Nepal 2007[7] reported 9.4% and in a
study in Greece[8] in 2007, 10.4% students were current
Table 2: Distribution of current smokers with respect
to gender
Current smokers Gender Total (%)
Male Female
Occasional smokers 90 (61.2) 22 (75.8) 112 (4.7)
Frequent smokers 22 (14.9) 1 (3.4) 23 (1)
Daily smokers 35 (23.9) 6 (20.6) 41 (1.7)
Total (%) 147 (83.5) 29 (16.4) 176 (7.3)
Table 3: Distribution of ever users of cigarettes with
respect to age of initiation of the habit and education
category
Age of initiation of the
habit among ever smokers
<15 years >15 years Total
PUC students 43 (48.3) 80 (36.7) 123 (40)
Degree students 46 (51.6) 138 (63.3) 184 (59.9)
Total (%) 89 (28.9) 218 (71.1) 307 (100)
Table 4: Distribution of students reporting ever use
of tobacco products other than cigarettes with and
education category and college category
Ever use of tobacco
products other
than cigarettes
Education College
PUC Degree Government Private
Did not respond 1 (0.1) 3 (0.1) 1 (0.1) 2 (0.1)
Yes 106 (9) 134 (11) 93 (9.2) 147 (10.6)
No 1068 (90.9) 1087 (88.9) 915 (90.7) 1240 (89.3)
Total 1175 (48.9) 1224 (50.9) 1009 (42) 1389 (58)
PUC ‑ Pre‑university college
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Sharma, et al.: Prevalence of tobacco use in Bengaluru city
27
Journal of Indian Association Of Public Health Dentistry
Vol. 13, Issue 1, | January-March 2015
smokers. Study in Maharashtra 1998[9] reported 10.6%,
country wide study in 2004[10] reported 19.4%, Youth
tobacco surveillance New York[11] reported 16.3% and
Georgia youth tobacco survey[12] reported 14% which is
much higher, this can be attributed to sociocultural and
geographic differences.
Among the 307 ever users, the majority 226 (73.6%)
belonged to private institutions and 81 (26.4%) to
government institutions, whereas in a study in Chennai
in 2006[13] reported that smoking was more in the
corporation students which is not in line with the
present study. Similarly, a study in Delhi and Chennai
2004[14] has reported that the prevalence of ever smoking
was 18.9% in government sector when compared to
12.2% in private sector which is again, not in line with
this study. Among the 176 current smokers, 132 (72%)
belong to private institutions and 44 (18%) belong
to government institutions. Of the 41 daily smokers,
25 (60.9%) are from private institutions and 16 (39.9%)
are from government institutions. Whereas in a study in
Bombay in 1991[15] reported that 22.5% of the smokers
belonged to private English institution when compared
to 13.8% in the municipal sector, which is less than the
present study.
Age of initiation
In the present study, nearly 29% reported initiation of
ever use of cigarette before the age of 15 similar to other
studies, however, the age range of initiation spans from as
low as 10 years in certain studies to as high as 18. Among
the 307 ever users 89 (28.9%) reported smoking before
the age of 15 and 218 (71.1%) reported smoking after the
age of 15 years whereas in the study in Western Nepal
2007[7] 89.6% of ever smokers had initiated smoking
between the ages 12 and 18 years with a median age of
16 years and 30.2% of ever smokers initiated before the
age of 15 years. In a study in Uganda 2004,[16] 37.8% had
smoked before the age of 10 years. Whereas a study in
Harayana in 1995 among adolescents[4] reported that the
majority of smokers had started at the age of 10-15 years
and almost 36% had smoked before the age of 10 years.
Whereas study in 2002 among college students,[2]
reported that 40% of students, majority males had started
the habit between the ages of 10 and 15 years. However,
in a study in Karachi 2007[17] reported that the mean age
of starting cigarette in males was 13.1 years.
There has been reporting of different ages with respect
to age of initiation in various studies. This may be
on account of the various age groups used in these
studies and also to the cultural differences in the study
populations of these studies. There may be differences
also due to the fact that the age of initiation again is
self-reported by the participant.
Age of current smokers
Out of 176 current users of cigarette, 2 (1.1%) students
were of the age 15 years, 20 (11.3%) were 16 years old,
about 41 (23.2%) were 17 years of age, 48 (27.2%) were
18 years of age, 30 (17%) students were 19 years of age
and 35 (19.8%) were 20 years old.
On the whole, among the current users, use of cigarettes
was seen more in the age group of 17–20 years. However,
a study in Alaska 2004[18] reported than cigarette smoking
seems to peak at the ages from 18 to 24 years.
Prevalence of use of tobacco products other than
cigarettes
In the present study, the overall prevalence of smokeless
tobacco use is about 10%, there was a wide variation
of percentage of tobacco products other than cigarettes
use, ranging from 10% to as high as 55.6%. According
to the GYTS – India 2002–2004,[1] 14.6% were the
current smokeless tobacco users ranging from 2% in
Himachal Pradesh to 55.6% in Bihar. In the GYTS 2002
in Uttaranchal,[19] the prevalence was 17.6%, higher than
the present study; in a study in Jamnagar 2007,[20] the
prevalence of smokeless tobacco use among 17–19 years
age group was 36.26%, much higher than the present
study. Maharashtra 1998[9] study reported 6.7%, A study in
Mumbai 2006[21] reported overall smokeless tobacco use as
10% which is comparable to the present study. In a study
in Greece[8] in 2007, the prevalence of smokeless tobacco
use was 10.9%.Whereas, the prevalence of smokeless
tobacco in Canada 2004[22] was 14%. Tobacco use survey
in high school students in US[6] showed the prevalence
to be 12.8%, Karachi 2007[17] was 16.1%. According to
Florida youth tobacco survey-2006,[23] current smokeless
tobacco use among high school students is about 6%,
Youth Tobacco Surveillance, New York[11] reported 3.2%,
CTUMS Ontario[24] reported use among 15-19 years old
youth as 7%, Western Nepal 2007[7] study reported 6.5%,
which is lower than the present study.
Table 5: Distribution of current users of cigarette reporting ever use of tobacco products other than cigarettes with
education category and college category
Ever use of tobacco products
other than cigarettes
Current use of cigarette (%) Total (%)
Never user Ex-smoker Occasional smoker Frequent smoker Daily smoker
Did not respond 4 (0.1) 0 0 0 0 4 (0.1)
Yes 153 (7.3) 36 (29.3) 27 (24.1) 10 (43.5) 14 (34.1) 240 (10.0)
No 1943 (92.6) 87 (70.7) 85 (75.9) 13 (56.5) 27 (65.9) 2155 (87.7)
Total 2100 (87.5) 123 (5.1) 112 (4.7) 23 (0.9) 41 (1.7) 2399 (100)
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Sharma, et al.: Prevalence of tobacco use in Bengaluru city
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Journal of Indian Association Of Public Health Dentistry
Vol. 13, Issue 1, | January-March 2015
It was also observed that the percentage of smokeless
tobacco users was slightly higher in the students from
the private institution when compared to government,
also was higher among the degree students than
pre-university students.
The prevalence of smokeless tobacco use among these
students was much higher than use of cigarettes. Some of
the reasons for this trend may be that smokeless tobacco
consumption can be done more discreetly as there is no
associated smoke or odor, can be used inside classrooms.
Comparatively more economical compared with cigarettes
as a single packet can be used over an entire day. The
small pouches can be concealed easily and also easier
to hide the habit from family members.
Limitations
Global youth tobacco survey is limited to students
especially in the ages 13–15 years and most of the data
are available from sporadic surveys is in this age group.
The present study was conducted on age groups 15
through 20 years and hence comparability was limited.
Furthermore, in India, there is a huge dropout rate in
education after schooling, it is important that tobacco
use survey must be extended to those youth who do not
attend schools or colleges.
Second, these data apply only to youths who were in
college on the day of the survey and who completed
the survey. However, student response rates were
high suggesting that bias attributable to absence or
nonresponse was limited. Finally, data were based on
the self-report of students, who might underreport or
overreport their behaviors or attitudes. The extent of this
bias cannot be determined from these data.
CONCLUSION
The gloomy predictions about the growing magnitude
of tobacco threat to India relate to a rise both in the
proportion of deaths attributable to tobacco and in the
absolute number of persons who consume tobacco.
The age group of 15–20 encompasses most of the high
school/pre university and degree students, which is
most vulnerable to acquiring and continuing the tobacco
addiction. It was observed in this study among the
176 current smokers, 72% belong to private institutions
and 18% belong to government institutions. Of the
41 daily smokers, 60.9% are from private institutions and
39.9% are from government institutions. The prevalence
of smoking was much higher in the private institution
as opposed to government institutions; this may be
attributed to greater nancial independence of students
in private institutions, prevalent peer pressure. Also, it
was observed that the percentage of smokeless tobacco
users were higher in this age group as compared to
cigarette smokers.
Therefore, it is necessary to monitor the trends in age
of initiation as well as the prevalence of tobacco usage
patterns in this age group of college going students at
the national level. Measures to curb the increasing use
of tobacco among the youth have to be enforced more
strictly.
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How to cite this article: Sharma V, Hiremath SS, Puranik M, Somasun-
dara S. Prevalence of tobacco use among 15-20 years old college students
in Bengaluru city. J Indian Assoc Public Health Dent 2015;13:24-9.
Source of Support: Nil, Conict of Interest: None declared.
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... Sharma Vasudha, Hiremath S.S, Gupta Kumar Vinay, Puranik Manjunath, [8] 2016 ...
... Parent's behavior of taking tobacco and/or alcohol influenced the habit of their youngsters. Sharma Vasudha, Hiremath, S.S Gupta Kumar Vinay, Puranik, Manjunath (2016) [8] study found that the prevalence of smoking was much higher among the private institution students as compared to student of government institution. Study observed that the percentage of smokeless tobacco was higher in daily smokers. ...
... [14,[16][17][18] Raj Kumar et al. [12] in their study conducted among 2599 Delhi university college students, in 2010, reported that 15.8% were current smokers which were similar to our finding. Sharma V et al. [19] reported that 12.8% of college students were smokers in their study conducted in Bengaluru. Sharma R et al. [20] found the prevalence of smokers to be 16% among the students of Delhi. ...
... [2] Also, in our study the age of initiating smoking was observed to be 17-18 years for the majority of the participants. Similarly, Sharma N et al., [14] Raj Kumar et al., [12] Gupta et al., [16] and Sharma V et al. [19] also observed that most of the college students started tobacco smoking at the age of 15-20 years. The age of initiating tobacco as per GATS-2 was 18.9 years which was similar to our finding. ...
Article
Full-text available
Background: According to the report on tobacco control in India, tobacco use causes eight to nine lakh deaths annually in India. Tobacco use is on the rise among youngsters especially the college students. The Government of India has made a mandatory display of pictorial health warnings for both smoking and smokeless forms of tobacco products under the Cigarettes and Other Tobacco Product Act, 2003. The objective of the present study was to assess the prevalence of tobacco smoking and to assess nicotine dependence among the college students of the University of Delhi. Methods: A cross-sectional study was conducted among 400 college students of Delhi University from October to December 2019. A semi-structured self-administered questionnaire method was used to collect data on smoking; pictorial warnings and Fragerstrom criteria were used to assess nicotine dependence. Result: Out of the 400 study participants 92 (23%) participants were ever smokers. Among 62 current smokers, the mean age (±SD) of initiation of smoking was 17.3 years (±2.07), median (interquartile range [IQR]) number of cigarettes smoked per day was 3 (2-6), a majority (80.7%) used to smoke after 30 min of waking up in the morning, majority (59.7%) had low nicotine dependence. About half of the past smokers 47% (14 out of 30) and the current smokers 58% (36 out of 62) told that they had no effect of pictorial warning for quitting or decreasing smoking. Conclusion: The present study revealed the tobacco smoking pattern among college students of Delhi. The majority of smokers and non-smokers perceived that pictorial warning is ineffective in driving to quit smoking.
... [10,[12][13][14][15][16] Majority, i.e., 99 (66.89) of the women in the present study reported to have started consuming tobacco products in the age group of 16-30 years and the mean age at initiation was 23.57 ± 9.08 years similar to the findings of other studies [10,15,[17][18][19] and use of tobacco by parents, siblings and peers/friends were the most influencing factors for them to start consuming in confirmation with other studies. [3,[17][18][19] Tobacco use by family members not only influences young children and adolescents to initiate tobacco consumption by developing a positive and favorable attitude towards it but also plays a significant role in the continuation of the habit. ...
... ± 9.08 years similar to the findings of other studies [10,15,[17][18][19] and use of tobacco by parents, siblings and peers/friends were the most influencing factors for them to start consuming in confirmation with other studies. [3,[17][18][19] Tobacco use by family members not only influences young children and adolescents to initiate tobacco consumption by developing a positive and favorable attitude towards it but also plays a significant role in the continuation of the habit. ...
Article
Full-text available
Background: Tobacco use is one of the most important causes of death and disease globally. Nearly one-third of the population in India uses tobacco, and smokeless form is culturally acceptable even among women. Objectives: (1) To estimate the prevalence of consumption of smokeless tobacco (SLT) products among women in the reproductive age group in the study setting. (2) To determine the various factors associated with the consumption of SLT. (3) To estimate the prevalence of exposure to second-hand smoke among the study participants. Materials and methods: A cross-sectional study was conducted in the field area of primary health center Irkalgad, Koppal in March 2018. A cluster sampling technique was used and a total of 829 women were included. Data were collected using pretested and semi-structured questionnaire and analyzed using the Epi info software version 3.5.4 (Centers for Disease Control and Prevention" (CDC), Atlanta, Georgia, United States of America). Results: The prevalence of consumption of SLT products was 17.85%, and the most common product consumed was tobacco with betel quid. Tobacco consumption was found to be significantly associated with age, literacy, marital, and employment status of the study participants. Conclusion: The present study concludes that SLT consumption is high among women in the reproductive age group in the study setting and identifies multiple determinants for effective planning of interventions.
... Young people and adolescents are most likely to use tobacco products [13][14][15][16][17]. The typical age of tobacco initiation in the current research was 25.4 ± 6.3 years. ...
Article
Full-text available
Objectives There is a lack of knowledge on oral cancer and oral potentially malignant disorders (OPMDs) among the local communities of Northeast India. Since the habit of tobacco is linked to the culture and oral cancer is a widespread epidemic here, it is pertinent to assess the knowledge about risk factors and readiness to quit the habit among the study population. Methods The present research was done in the Tobacco Cessation Centre (TCC), Department of Public Health Dentistry (PHD) of Regional Dental College (RDC), Guwahati, Assam, from Jan 2023 to June 2023. This cross-sectional research was done among 200 patients aged 15-65 years. We have utilised the transtheoretical model (TTM) for assessing behaviour change. Oral inspection using a mouth mirror and explorer with adequate illumination was used to visualise the lesions. Data was collected through a self-administered questionnaire. Chi-square and odds ratio (OR) tests were used to see the association among the variables. The data was analysed with Microsoft Excel (Microsoft Corporation, Redmond, Washington) and IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). A p-value less than 0.5 is considered to be statistically significant. Results Of the 200 participants, 64(32%) had some oral lesions linked to tobacco use. A significant correlation was observed between the oral lesions and TTM stages (OR=2.81, p<0.05). Among the participants, most were aware only of tobacco (68%) and quid chewing (58%) practices as risk reasons for developing oral cancer. Conclusion The study participants' awareness of OPMDs, their health risks, and clinical signs and symptoms could ber higher. A significant relationship was seen between OPMDs and TTM behavioural stages.
... Young people and adolescents are most likely to use tobacco products [13][14][15][16][17]. The typical age of tobacco initiation in the current research was 25.4 ± 6.3 years. ...
Article
Full-text available
Objectives There is a lack of knowledge on oral cancer and oral potentially malignant disorders (OPMDs) among the local communities of Northeast India. Since the habit of tobacco is linked to the culture and oral cancer is a widespread epidemic here, it is pertinent to assess the knowledge about risk factors and readiness to quit the habit among the study population. Methods The present research was done in the Tobacco Cessation Centre (TCC), Department of Public Health Dentistry (PHD) of Regional Dental College (RDC), Guwahati, Assam, from Jan 2023 to June 2023. This cross-sectional research was done among 200 patients aged 15-65 years. We have utilised the transtheoretical model (TTM) for assessing behaviour change. Oral inspection using a mouth mirror and explorer with adequate illumination was used to visualise the lesions. Data was collected through a self-administered questionnaire. Chi-square and odds ratio (OR) tests were used to see the association among the variables. The data was analysed with Microsoft Excel (Microsoft Corporation, Redmond, Washington) and IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). A p-value less than 0.5 is considered to be statistically significant. Results Of the 200 participants, 64(32%) had some oral lesions linked to tobacco use. A significant correlation was observed between the oral lesions and TTM stages (OR=2.81, p<0.05). Among the participants, most were aware only of tobacco (68%) and quid chewing (58%) practices as risk reasons for developing oral cancer. Conclusion The study participants' awareness of OPMDs, their health risks, and clinical signs and symptoms could be higher. A significant relationship was seen between OPMDs and TTM behavioural stages.
... According to Indian literature very few studies have been conducted to assess the patterns and cessation of smoking perceptions in student population in India especially in college going students. Therefore this suggested a need to carry out a study to learn the pattern of smoking in student population that may further help to create awareness of health hazards related to cigarette smoking [12]. Hence, the objective of the presence study aimed to assess the patterns of cigarette smoking and cessation perception in college students in India. ...
Article
Background and objectives: Cigarette smoking is one of the major types of tobacco consumption seen worldwide. It contains the highest number of carcinogens and is associated with various forms of cancer. The early initiation of smoking is a cause of addiction and causing greater harm in younger population. Hence, this study aimed to evaluate the patterns of cigarette smoking and cessation perception in college students in India. Methods: 1009 participants between the ages of 18 to 30 years were recruited in the study. Self-designed questionnaire was prepared in the form of Google forms and links were posted on social media (including E-mails, Whatsapp, Instagram and Facebook). Results: Out of 1009 participants 54.2% (n=547) 72.22% males and 24.27% females smoked cigarettes. 68.55% smokers were between the ages of 22 to 26 years. 67.1% smoked for the first time when they were in the age group of 18 to 21 years. More than 60% were daily smokers consuming 1 to 5 cigarettes/day. 38.19 of the participants wished to stop smoking and around 62% of the participants had never made and attempt to quit. Conclusion: The present study demonstrated that more than half of Indian college students who participated in the study smoked cigarettes with the number of males being significantly higher than females. The study suggests for more tobacco prevention and cessation programs to be undertaken targeting the Indian student population leading to cancer prevention in later years of life. KEY WORDS: Cigarette Smoking, Cessation, Students.
... This finding is lower than a study conducted among students in South Africa which reported a prevalence of 16.9% [50]. Conversely, the current reported pooled prevalence of cigarette smoking was higher than a study conducted among government and private schools and college students in Bengaluru, India (12.8%) [54] and amongst university students in Iran (13.8%) [55]. ...
Article
Full-text available
Background Cigarettes and their by-products (i.e., smoke; ash) are a complex, dynamic, and reactive mixture of around 5,000 chemicals. Cigarette smoking potentially harms nearly every organ of the human body, causes innumerable diseases, and impacts the health of smokers and those interacting with the smokers. Smoking brings greater health problems in the long-term like increased risk of stroke and brain damage. For students, peer pressure is one of the key factors contributing to cigarette smoking. Therefore, this systematic review and meta-analysis assessed the impact of peer pressure on cigarette smoking among high school and university students in Ethiopia
... This finding is lower than a study conducted among students in South Africa which reported a prevalence of 16.9% [50]. Conversely, the current reported pooled prevalence of cigarette smoking was higher than a study conducted among government and private schools and college students in Bengaluru, India (12.8%) [54] and amongst university students in Iran (13.8%) [55]. ...
Article
Full-text available
Background Cigarettes and their by-products (i.e., smoke; ash) are a complex, dynamic, and reactive mixture of around 5,000 chemicals. Cigarette smoking potentially harms nearly every organ of the human body, causes innumerable diseases, and impacts the health of smokers and those interacting with the smokers. Smoking brings greater health problems in the long-term like increased risk of stroke and brain damage. For students, peer pressure is one of the key factors contributing to cigarette smoking. Therefore, this systematic review and meta-analysis assessed the impact of peer pressure on cigarette smoking among high school and university students in Ethiopia. Methods An extensive search of key databases including Cochrane Library, PubMed, Google Scholar, Hinari, Embase and Science Direct was conducted to identify and access articles published on the prevalence of cigarette smoking by high school and university students in Ethiopia. The search period for articles was conducted from 21st September, 2018 to 25th December 25, 2018. All necessary data were extracted using a standardized data extraction checklist. Quality and risk of bias of studies were assessed using standardized tools. Heterogeneity between the included studies was assessed using Cochrane Q-test statistic and I² test. To estimate the pooled prevalence of cigarette smoking, a random effects model was fitted. The impact of peer pressure on cigarette smoking was determined and was reported in Odds Ratio (OR) with 95% Confidence Interval (CI). Meta-analysis was conducted using Stata software. Results From 175 searched articles, 19 studies fulfilled the eligibility criteria and were included in this study. The pooled prevalence of cigarette smoking among Ethiopian high school and university students was 15.9% (95% CI: 12.21, 19.63). Slightly higher prevalence of cigarette smoking was noted among university students [17.35% (95% CI: 13.21, 21.49)] as compared to high school students [12.77% (95% CI: 6.72%, 18.82%)]. The current aggregated meta-analysis revealed that peer pressure had a significant influence on cigarette smoking (OR: 2.68 (95% CI: 2.37, 3.03). Conclusion More than one sixth of the high school and university students in Ethiopia smoke cigarette. Students who had peer pressure from their friends were more likely to smoke cigarette. Therefore, school-based intervention programs are needed to reduce the high prevalence of cigarette smoking among students in Ethiopia.
... When compared to study done by Hirani et al [6] municipal school of rural areas were found with similar number of school children that is 222 (13.4%) and Rashmi et al [11] 18%. School children aged 16 years were found to be more involved 355(95%) followed by 15y years of age in tobacco consumption 319(65%). While study done by Rashmi et al [11] and Vasudha et al [12] 12.8%, age group 15-16 years were found to be more involved in tobacco consumption. Among total school children involved in the present study males were found to be more in number 1760 as compare to females and more involved in tobacco consumption 14.7 which was very less when compared to study done by Rashmi et al [11] 38.5%. ...
Article
Full-text available
Aim: The objective of this study is to assess the knowledge, attitude and prevalence of tobacco consumption among rural and urban school children aged 12-17years. Material&Methods: A descriptive questionnaire cross-sectional study was performed in rural and urban schools from March to June 2018. Total 2790 school children were included in study of both genders. The study was then conducted by enrolling the students, and collected data were analyzed by using appropriate statistical software. Results: Of the 2790 students, 740 students were aware that tobacco is hazardous to health and 810 students were aware about passive smoking exposure outside home.1040 students were aware of anti-tobacco warnings on tobacco packets and 430 students were ready to start consuming tobacco if it is provided free to them. Total number of tobacco non-consumer students was more than those who were consuming tobacco and female students were less in number. Out of 2790 students, aged 15-16 years students were found more in number of tobacco consumption, mainly in rural schools. Conclusion: The present study suggests the need for school based educational programs regarding harmful effects of tobacco and make students and their families more aware and motivate them to stop and eradicate the use of tobacco among all age groups.
... 16 A study on college students in Bangalore showed that the use of cigarettes was more in the age group 17-20 years. 17 In this study, majority of cigarette smokers reside in urban areas (56.7%). Similar to this finding, a study in Lucknow showed majority of tobacco users come belong to urban residential areas compared to rural. ...
Article
Background: Tobacco use is a major public health problem worldwide. It is estimated that 7 million people die each year from tobacco use. The prevalence of tobacco use is rising in adolescents and young adults. Teenagers easily get influenced by their peers and media to experiment substances like tobacco. Due to lack of awareness on the harmful nature, addictive potential and long-term effects of tobacco use, college students tend to start tobacco consumption. Hence, the present study was done to assess the prevalence, determinants and attitudes of tobacco use among college students in Visakhapatnam. Methods: A cross-sectional descriptive study was conducted in two randomly selected colleges in Visakhapatnam for one month in November 2017. 300 male college students in their first, second and third years of degree were selected for the study. Data on socio-demographic profile and perspectives of tobacco use was recorded using a self-administered, pre-designed, pre-tested and semi-structured questionnaire. Data was analysed by entering it in MS excel worksheet. Results: The prevalence of tobacco use is 17.3% of which 57.7% smoke cigarette, 26.9% use smokeless tobacco and 15.4% smoke beedi. 66.6% of cigarette smokers are < 20 years in age. 56.7% of cigarette smokers belong to urban areas of residence and 63.3% belong to Hindu religion. 60% of current cigarette smokers want to stop smoking. 17.6% are exposed to secondhand smoking at home and 46.6% at enclosed public places. 88.6% noticed tobacco advertisements on television or movies. 72.6% definitely believe that it is difficult to quit smoking once started. 20.3% thought smoking helps them feel comfortable at parties and gatherings. 89% are in favor of banning smoking inside enclosed areas and 85% for banning smoking in outdoor public places. Conclusions: Implementing anti-tobacco awareness programmes, educating students in schools and colleges on the harmful nature of tobacco and developing effective laws is crucial. Providing adequate support and counselling to those willing to quit tobacco is pivotal. Regular surveillance and assessment of disease burden through periodical surveys can help determine the prevalence and attitudes of people, thus allowing for development of more comprehensive and targeted approaches to effectively handle the problem. Keywords: Attitudes, Cigarette smoking, College students, Cross-sectional descriptive study, Prevalence, Socio-demographic profile, Tobacco use.
Article
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AIMS: The present study was done to build a database on prevalence of tobacco use among students of grade 8 to 10 in Chennai city, for the purpose of advocacy of tobacco control and planning tobacco control interventions and evaluation. MATERIALS AND METHODS: A two-stage stratified probability sample of students in grades 8-10 corresponding to 13 to 15 years of age were selected from private/government aided private schools and purely government aided corporation schools. Data was collected by a pretested, closed-ended self-administered questionnaire. RESULTS: A total of 1255 students participated in this survey. Among them 64.4 boys and 35.6% were girls. Ever tobacco use was reported by 37.6% of the students (41.6 males and 30.2% females). Current users of tobacco (any products) were reported by 41.1% of the students. Prevalence was more among boy students (46.3%) when compared to that of girl students (31.6%). There existed no significant difference between current users of tobacco based on the zones of the school. Tobacco users prevalence was found more in corporation schools when compared to that of private schools. Parental and friends tobacco use was reported more often by tobacco users compared to never users. Purchasing tobacco products in a store was reported by 82.5% and almost no one was refused because of age. Almost everyone reported watching a lot of cigarette advertisements on TV, whereas about half reported watching advertisements on other medias like outdoor hoardings (45.7%), newspapers (65.3%) and social events (67.4%). CONCLUSION: This study demonstrates that among the 13 to 15-year old school going children (corresponding to grades 8 to 10) in Chennai city, the current tobacco use is high.
Article
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Background: Adolescent tobacco use and the subsequent health problems are a major concern today. Tobacco con-sumption has been identified as the single most preventable cause of death and disease in India. Approximately 90% of the Oral Cancers in South East Asia Region are linked to to-bacco chewing and tobacco smoking. In view of above, present study was carried out with an aim to find out the prevalence of tobacco chewing among ado-lescents in four villages namely Alia, bada, Vijarakhi and Theba, rural field practicing areas of Jamnagar district and influencing factors associated with it. Methods: Present Study is a cross-sectional study, con-ducted amongst 930 adolescents of 10 – 19 years age group. Results: The main observations of the study are, 33.12% of the adolescents were addicted with one or other type of to-bacco chewing, majority of addicted adolescents were in the age group of 17-19 years (36.26%). Tobacco chewing is the most frequent form of using tobacco by adolescents than smoking. Majority of the adolescents were addicted for more than 12 months (57.47%). Main inducing factor for addiction was found to be friends (61.69%).
Article
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Adolescents are the most vulnerable population to initiate tobacco use. It is now well established that most of the adult users of tobacco start tobacco use in childhood or adolescence. There has been a perceptible fall in smoking in the developed countries after realization of harmful effects of tobacco. The tobacco companies are now aggressively targeting their advertising strategies in the developing countries like India. Adolescents often get attracted to tobacco products because of such propaganda. There has been a rapid increase in trade and use of smokeless tobacco products in recent years in the country, which is a matter of serious concern to the health planners. It is important to understand various factors that influence and encourage young teenagers to start smoking or to use other tobacco products. The age at first use of tobacco has been reduced considerably. However, law enforcing agencies have also taken some punitive measures in recent years to curtail the use of tobacco products. This paper focuses on various tobacco products available in India, the extent of their use in adolescents, factors leading to initiation of their use, and the preventive strategies, which could be used to deal with this menace.
Article
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A study of knowledge, attitude and practice with regard to tobacco usage was conducted in 1278 boys and 353 girls studying in the final year in various schools in Bombay. The proportion of boys given to one or the other form of tobacco usage (including experimenters/triers) was significantly higher in private English median schools (22.5%) compared to private Indian language schools (6.9%) or municipal Indian language schools (13.8%). There was also a significant difference between the two types of Indian schools. Girls from only Indian language schools were entered into the study and the proportion of tobacco users in them was very low (1.1%). Most (86%) boys who used tobacco were smokers. Hence the detailed analysis is restricted to smokers. Several probable factors influencing smoking behavior were studied. It was found that significantly higher proportion of boys smoked if their father or best friend smoked. Generally boys were more sensitive to best friend's or elder brother's disapproval than to parental. They were well informed about harmfulness of smoking but knowledge about specific health hazards was limited. Most of them had a positive attitude towards nonsmoking and smoking control programmes. Tobacco use has been proven to be a major health hazard. Although its use in adults in India is common, prevalence in adolescents in urban schools is not yet high. Before the situation changes we need to mount anti-tobacco educational programmes and work towards a non-tobacco generation to contain the harmful consequences of tobacco usage.
Article
A survey of 599 college students was conducted in Andhra Pradesh, India, to formulate an anti-smoking policy for youth. There were 64.6% boys and 35.4% girls between 15 and 22 years, and 8.2% of students (n = 49, 48M + 1F) were smokers. It is a taboo for girls to smoke. There is no current anti-smoking policy and one is proposed based on the smoking survey results. The policy includes parental pressure to curb smoking, and a ban on (1) advertising of tobacco products, (2) smoking in public places and (3) teachers smoking in school. An increase in the price of cigarettes was approved by a majority of the students. The survey revealed a gap in the knowledge of students about the ill effects of smoking, which can be rectified by health education programs.
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A review of the literature identified demographic, cultural, and marketing variables related to the uptake and continuation of smokeless tobacco use. Government and industry data on production, marketing, and consumption of smokeless tobacco products are presented. The Canadian and American markets are compared in terms of prevalence, consumption per capita, and marketing practices. Lessons to be learned from the well-orchestrated development of the American market in the past 30 years are examined. Canadian tobacco regulations are described. Strategies by which the increased exploitation of the Canadian smokeless tobacco market can be deterred are discussed. A long-term, independently financed strategy built around a national smokeless tobacco de-marketing organisation with a constellation of private local institutions is suggested as a means of combating smokeless tobacco marketing efforts.
Article
The prevalence of tobacco use among the school and college going adolescents of Haryana, a state in northern India was studied. 1130 male and 256 female students were given a self administered questionnaire regarding tobacco use. 160 (14.2%) male and 6 (2.3%) female students reported to have smoked at any time in the past. The prevalence of current smoking (defined as smoked in last one week) was only 7.1%. Of the 166 ever smokers, 44% had started this habit between 10 to 15 years of age. There was no rural-urban difference. Univariate analysis showed, male sex, age > 15 years, smoking by father, mother, sister, and friends to be significantly associated with smoking by the adolescent children. By logistic regression, only smoking by friend (O.R. 6.14), brother (O.R. 1.74) and male sex (O.R. 4.67) were found to be significantly associated with smoking by adolescent children. About 8% of the smokers were spending more than Rs. 10 per week on this habit. Both the smokers and non smokers were well aware of the adverse health effects of smoking indicating that mere provision of information on hazards of smoking may not be enough to reduce the prevalence of smoking. A more concerted effort for inducing behavioural change including legislation, communication is called for the fight against smoking.