Jurnal 1
Jurnal 1
Jurnal 1
Abstract
Background: Tobacco surveillance among medical students offers an opportunity to assess the preparedness for tobacco control
among future healthcare professionals in India. The purpose of the present study was to evaluate the use of tobacco in the
undergraduate medical students and to assess the factors influencing medical students to indulge in tobacco use.
Objective: To assess the prevalence of tobacco use among undergraduate students and to assess the attitude and awareness towards
participating in tobacco cessation.
Material and methods: A cross-sectional questionnaire-based study to assess the prevalence of tobacco use among undergraduate
students of Himalayan Institute of Medical Sciences, Dehradun (Uttarakhand State) was conducted from January 2010 to January
2011. A pre-designed structured questionnaire was used to study various correlates of the tobacco use. Data was collected and
analysed. Global Health Professional Students Survey (GHPSS), questionnaire given by the Centers for Disease Control (CDC),
Atlanta, USA, which is a standard pre-tested questionnaire for assessing prevalence of tobacco use among health care professionals
around the world was used.
Results: Overall, 386 of 400 eligible students (97%) participated in the survey. The mean age and standard deviation of the study
group was 21.47 3.70 years. The rates of smoking among male medical and female medical students were 38.6% and 6.5%,
respectively (p < 0.001). A 6-times higher tobacco use was found among male medical students as compared to females. Out of the
386 participants, current tobacco use (last 30 days) was reported by 11.1% of students. About 21.7% of students had never used
tobacco. More than 80% favoured a ban on tobacco sales to adolescents, tobacco advertising, and tobacco use in public places.
Over 90% reported interest in further training in tobacco control. There was a familial aggregation of the use of tobacco. The
factor initiating the use of tobacco was peer pressure in most of the cases.
Conclusion: This study reflects an alarming situation and demands urgent measures to be adopted by health professionals, who
happen to be health promoters and health role models for the society.
Key words: Tobacco, smoking, medical student, undergraduate.
Introduction
Tobacco is the leading preventable cause of death and
more than five million people die globally from the effects
of tobacco every year more than that of HIV/AIDS,
malaria, and tuberculosis1. Tobacco is a serious threat to
health2 and a proven killer3 and ranks second as a cause
of death in the world4. Evidences accumulating since early
1950s indicate that more than 25 diseases are now known
or strongly suspected to be causally related to smoking5.
WHO estimates that unless the current smoking pattern
is reversed, tobacco will be responsible for 10 million
deaths per year in the next decade, with 70% of them
occurring in developing countries. In India tobacco kills
0.8 - 1.0 million people each year and many of these
deaths occur in people who are very young6. Currently,
about one-fifth of all worldwide deaths attributed to
tobacco occur in India. More than 8,00,000 people die and
12 million people become ill as a result of tobacco use
* Assistant Professor, ** Professor and Head, Department of ENT,*** Professor and Head,
Department of Community Medicine, **** Professor and Head, Department of Microbiology,
Himalayan Institute of Medical Sciences, Jolly Grant, Doiwala, Dehradun-248 140, Uttarakhand.
Results
Inclusion criteria
General
190
Male
(n = 184)
Female
(n = 202)
Number %
Total
(n = 386)
Number % Number %
65
43.9
83
56
148 38.4
30
45.5
36
54.5
66
17.0
50
54.3
42
45.7
92
23.8
39
48.8
41
51.2
80
20.8
Age-wise (years)
Minimum
Maximum
Mean SD
17
36
21.47 3.709
July-September, 2012
Male
(n = 71)
Number %
Female
(n = 13)
Total
Number % Number %
Smoke tobacco
10
14.1
23.1
13
3.3
Smokeless tobacco
59
83.1
69.2
68
17.6
Ever user
No response
2.8
7.7
0.7
Male
Female
Total
Number
Number % Number %
Yes
71
38.5
13
6.5
84
No
113
61.5
189
93.5
302 78.3
21.7
X2 = 58.461, df = 1, pd 0.001.
Table III shows an increasing trend in the consumption of
tobacco among the ever users with an increase in MB,BS
professionals.
Table III: Distribution of ever users according to year
of MB,BS.
Ever user
Professional Wise
Male
Female
Number %
Total
Number % Number %
Male
Female
Total
23
15.5
1.3
25
16.9
(last 30 days)
7.5
4.5
12.1
Yes
41
10.6
0.5
43
11.1
23
25
3.2
26
28.2
No
27
6.9
2.1
35
9.1
20
25
6.3
25
31.3
No response
0.7
0.8
1.6
Male
(n = 71)
Number %
Female
(n = 13)
Total
Number % Number %
Number %
Number % Number %
X = 4.372, df = 1, p = 0.0365
10 years
10.7
2.3
11
13.0
11 - 15 years
12
14.2
3.5
15
17.9
16 - 20 years
45
53.5
9.5
53
63.0
21 - 25 years
5.9
5.9
12
48
13
52
Total
71
100
13
100
84
100
50
50
Male
Female
Number %
Total
Number % Number %
Male
Female
Overall
12
46.1
3.9
13
50
Mean SD
Mean SD
Mean SD
13
52
13
52
Total
41
48.8
2.3
43
51.1
July-September, 2012
191
Male
Female
Number %
Total
Number % Number %
Smoke tobacco
0.75
0.25
1.00
Smokeless tobacco
38
9.8
0.25
39 10.10
Awareness
14.2% of the medical students were not aware about the
NHP related to tobacco use and 17.1% were also not
aware about any law related to tobacco use. 31.3% were
able to answer correctly the year in which law was
implemented.
It was also observed when the non-consumers were
inquired whether they would like to ever take up tobacco
use in future. Surprisingly, about 10% responded that they
were interested to take up tobacco use in future.
Table XI: Distribution of study subjects according to
their habits and beliefs pertaining to tobacco use.
Is there any National health programme related to
tobacco? (n = 386)
Responses
No
Yes
259
67.1
No
55
14.2
No Response
72
18.7
Number
Yes
30
9.9
No
272
90.1
Responses
No
Yes
288
74.6
No
66
17.1
No Response
32
8.3
No
2005
65
16.8
121
31.3
Responses
2009
83
21.5
Total
Quitting
Number
2010
13
3.4
Yes
35
41.6
No response
104
26.9
No
9.5
Current non-users
41
48.8
Total
84
100
Responses
No
27
7.0
Head of Institution or HR
12
3.1
46
11.9
204
52.8
No response
97
25.1
Current users
192
Discussion
The median age of the study subjects in the present study
July-September, 2012
Recommendations
1. Develop and promote effective cessation programme
July-September, 2012
193
5.
6.
7.
Conclusion
8.
9.
Acknowledgement
The authors sincerely acknowledge the permission and
financial assistance granted by the Himalayan Institute
Hospital Trust (HIHT) University to conduct this study.
References
1.
Leung CM, Leung AK, Hon KL, Kong AY. Fighting tobacco smoking
a difficult but not impossible battle. International Journal of
Environmental Research and Public Health 2009; 6 (1): 69-83. Epub
2009/05/15.
2.
Ball K. Smoking spells death for millions. World Health Forum. World
Health Organization 1986; p. 211-6.
3.
4.
194
July-September, 2012