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Patterns of Smoking Among Undergraduates of Suez Canal Abdelwahid et al., 1:12 http://dx.doi.org/10.4172/scientificreports.577 Open Access Open Access Scientific Reports Scientific Reports Research Article OpenOpen Access Access Patterns of Smoking Among Undergraduates of Suez Canal University, Egypt Hassan AE Abdelwahid*, Hend H Ali and Mohamed MA Diab Suez Canal University (SCU), Ismailia, Egypt Abstract Background: Smoking is a major international public health problem and Egypt is not an exception according to published data. Objectives: The objectives of the present study were to determine the prevalence of smoking and assess its pattern among undergraduate students of Suez Canal University in Ismailia, Egypt. Methods: In this cross sectional study, 1450 students were randomly selected and subjected to pre-designed self-administered questionnaires to collect data regarding their smoking pattern, socioeconomic status, degree of nicotine dependence, and stage of readiness to change. Results: Out of the 1450 undergraduates who were screened for smoking, 1321 responded to the questionnaire with a response rate of 91%. The total number of males was 622 (47.1%) while that of the females was 699 (52.9%). The results illustrate that 16.9% of students (n=223) were current smokers, 1.4% (n=19) ex-smoker and 81.7% (n=1079) non-smokers. Regarding the transtheoretical model of behavior change, the current smokers (n=223) were found distributed in the pre-contemplation stage (50%) with no plan to quit smoking, contemplation stage (25%) and preparation stage (25%). Age, sex, total family income and type of faculty were the, only, significant independent predictors of smoking in the present study. Males were 66 times more likely to be current smokers than females (OR=66.03; 95% CI=28.9-150.7). Conclusion: Smoking is a common health problem among Suez Canal University students, so developing and implementing an effective and comprehensive cessation program should be a high priority. Keywords: Tobacco; Smoking; Prevalence; University; Students; addition to years of potential life lost, tobacco use causes considerable Egypt economic loss through rising health costs and loss of productivity Introduction [7]. In conclusion, tobacco use has multiple health risks and adverse social and economic impacts on the lives of smokers, their families Smoking epidemic is a major international public health problem and communities, so it immensely needed to study the prevalence and [1], killing up to half the people who are addicted to it. Half of those pattern of smoking among undergraduates to collect baseline data for deaths occur between the ages of 30 and 69 years, resulting in a loss of further interventions. 20-25 years of life for smokers [2,3]. It causes significant premature mortality and morbidity that can be prevented. Out of six million Aim of the Work people who are killed yearly by tobacco, more than 600000 are non- The objectives of the present study were to determine the prevalence smokers exposed to second-hand smoke. Tobacco users who die of smoking and assess its pattern among undergraduate students of prematurely deprive their families of income, raise the cost of health Suez Canal University in Ismailia, Egypt. care and hinder economic development. Smoking is highly prevalent in low and middle-income countries where 80% of worldwide smokers Subjects and Methods (one billion) are found [1]. A cross sectional design was used. The study was conducted in Ismailia City, Egypt, that is located about 120 km from Cairo along the Current data suggest that smoking prevalence is a public health coast of Suez Canal, midway between Port Said and Suez. The target problem in Egypt. The WHO report on the global tobacco epidemic population was undergraduate students in SCU campus that included 2009 concluded that the adult daily smoking prevalence was 14 % [4]. 10 faculties, Medicine, Pharmacy, Veterinary medicine, Dentistry, The 2009 Egypt Global Adult Survey (GATS) illustrated that 19.4% Science, Commerce, Arts, Nursing Tourism and hotels, Computer and (9.7 million) of adults in Egypt currently smoked tobacco; 37.7% men informatics, Agriculture and Education. and 0.5% women. Ninety-five per cent (95%) of current smokers were daily smokers. Manufactured cigarettes were the most popular type of product smoked by men (31.7%), followed by shisha (6.2%); on the *Corresponding author: Dr. Hassan AE Abdelwahid, MD, Family Medicine, other hand 0.2% of women smoked manufactured cigarettes and 0.3% Department of Family Medicine, Faculty of Medicine, Suez Canal University, smoked shisha [5]. Ismailia, Egypt, Tel: 002 01142231059; E-mail: [email protected] Tobacco smoking has significant effects on the morbidity and Received November 07, 2012; Published November 22, 2012 mortality of the users, for example, about one third of deaths resulting Citation: Abdelwahid HAE, Ali HH, Diab MMA (2012) Patterns of Smoking from cancer are caused by tobacco. Also, tobacco cardiovascular and Among Undergraduates of Suez Canal University, Egypt. 1:577 doi:10.4172/ respiratory diseases account for about 30% each [3]. In Egypt, tobacco- scientificreports.577 related cancers as a percentage of all cancers have been significantly Copyright: © 2012 Abdelwahid HAE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which increased among men [6]. Tobacco-attributable deaths, in 2004, permits unrestricted use, distribution, and reproduction in any medium, provided increased from 8% to 11% of total deaths after 34 years of age. In the original author and source are credited. Volume 1 • Issue 12 • 2012 Citation: Abdelwahid HAE, Ali HH, Diab MMA (2012) Patterns of Smoking Among Undergraduates of Suez Canal University, Egypt. 1:577 doi:10.4172/ scientificreports.577 Page 2 of 4 A sample size of 1450 was calculated and selected from the target population with an estimated prevalence of depression to be 16% (from Current smoker a previous study) [8], 95% confidence coefficient and 5% Confidence 16.9% interval [9]. The expected non-response rate of the participants was Ex-smoker taken in consideration in sample size calculation. The sample was selected by a multi-stage stratified random sampling technique with 1.4% proportional allocation as follows. First, colleges were sub-classified by type of faculty (n=10), then by educational levels. Students were selected by systematic random sampling, choosing every tenth student from the list of registered students at each educational level, till the desired proportionate sample size was obtained. Data were collected by a pre-designed self-administered questionnaire in Arabic to collect data regarding their smoking, socioeconomic status, degree of nicotine Non smoker dependence, and stage of readiness to change. The degree of nicotine 81.7% dependence was determined brief Fagerstrom test [10] that includes 2-questions: 1) when do you smoke after walking up in the morning? 2) Figure 1: Prevalence of smoking among study group. How many cigarettes do you smoke each day? There are 3 options in the answer of the first question (less than 5 minutes, 5-30 minutes and 31- 60 minutes) that were scored 3, 2, and 1 respectively. Also the answer 60 to the second question has 3 options (more than 30, 21-30, and 11-20) that were scored 3, 2, and 1 respectively. A Fagerstrom score of 5-6 means highly dependent; 3-4=moderately dependent and 1-2=lightly, 50 minimally, dependent. The stage of readiness to quit smoking was 50 determined by the transtheoretical model of behavior change that is Percent (%) based on discrete stages along the continuum of change in cigarette smoking behavior [10]. These stages are termed precontemplation, 40 contemplation, preparation, action, maintenance and relapse. The field work was conducted from January 01, 2008 to March 10, 2008 and the study was completed in January 12, 2009. Verbal and written consents 30 were obtained from the participants who completed the questionnaires. All statistical analyses were performed using the SPSS software 25 25 package-version-10. Descriptive statistics and Measures of central 20 tendency and dispersion, as well as, appropriate significance tests were Precontemplation Contemplation Preparation applied according to the types of variables. Multiple logistic regression analysis was conducted to determine which factors were independent Figure 2: Distribution of smokers according to stage of readiness to quit. predictors for smoking among the study group. Logistic regression coefficients and estimated odds ratios for each of the independent The bivariate analysis illustrated that current smokers were variables in the model were determined. The P-value of <0.05 was significantly older than non-smokers. Out of 223 current smokers, 217 considered the significance cut-off point. (97%) were males. Out of 622 males, 217 (34.9) were current smokers Results while in females 6 out of 699 (0.9%) were smokers. The smokers were Out of the 1450 undergraduates who were screened for smoking, found to have significantly higher Per capita monthly income on 1321 responded to the questionnaire with a response rate of 91%. The comparison with non-smokers. The 10 colleges were classified into total number of males was 622 (47.1%) while that of the females was two groups, medical and non-medical colleges. The medical colleges 699 (52.9%). Their age ranged from 18-28 with a mean of 20.1 ± 1.1 included medicine, dentistry, pharmacy and veterinary. The prevalence years. All participants were single and Egyptians. Shisha smoking of smoking (17.7%) was insignificantly higher in the undergraduates of was highly prevalent (45%) among the study group, 30% smoked non-medical colleges than medical ones (14%) (Table1). waterpipes (shisha) exclusively, and 15% smoked shisha and cigarettes. The following independent variables were subjected to the multiple The smokers (n=223) started their 1st cigarette smoking at age of 14.4 logistic regression analysis with smoking as dependent variable: ± 3.4 and became regular (daily) smokers at age of 16.6 ± 2.7; on the participants’ age; gender; residency; total family income per month; other hand age of stating shisha smoking was 17.2 ± 3.1.
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