Uncovering the Smoking Habits of Undergraduate University Students: A Comprehensive Assessment of different varieties Tobacco Use

Main Article Content

Sawsan S. Al- Rawi
Ahmad H. Ibrahim

Keywords

Tobacco, Hookah, Vape, E-cigarette, Waterpipe, Students

Abstract

Tobacco use is a prevalent and serious global health issue, causing significant morbidity and mortality. Every year, over 5 million people worldwide die due to tobacco use. This research aims to comprehensively assess tobacco use, including the types of smoking, such as hookah and other varieties, among undergraduate students. A cross-sectional study was conducted using a questionnaire survey to investigate students' attitudes towards different types of smoking. The questionnaire included demographic information in the first section, while the second section consisted of questions related to students' smoking behaviors. The data revealed that 59.33% of students smoked tobacco daily and started smoking at a young age. The most common tobacco products consumed were manufactured cigarettes (64.66%) and hookah (50%), while vaping or electronic cigarette use was 26%. A total of 70% of students noticed health warnings on cigarette packages, with 50.66% of them attempting to quit smoking, while 64% never considered quitting. Males were found to smoke more than females, with a ratio of 6:1 (85.3% and 14.7%, respectively), possibly influenced by various social, cultural, environmental, and developmental factors. The results also indicated that the majority of students who smoked lived in urban areas with their families, suggesting a significant association between family smoking and students' smoking behavior. Despite health warnings on cigarette packages, students did not seriously consider quitting smoking, indicating an increasing trend of smoking varieties and a significant public health concern, particularly among university students. More effective policies are needed to control smoking and raise awareness about its detrimental health effects among the public.

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References

1. Aboaziza, E., & Eissenberg, T. Waterpipe tobacco smoking: what is the evidence that it supports nicotine/tobacco dependence? Tobacco control, 2015, 24(Suppl 1), i44-i53.
2. Lancet. Tobacco Collaborators. Global health metrics: Tobacco level 2 risk. 2020. Available from: https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/risks/tobacco-smoke.pdf
3. O’Keeffe, L. M., Taylor, G., Huxley, R. R., Mitchell, P., Woodward, M., & Peters, S. A. Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis. BMJ open, 2018, 8(10), e021611.
4. Sanchez-Ramirez, D. C., & Mackey, D. Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: a systematic review and meta-analysis. Respiratory medicine, 2020; 171, 106096.
5. Ding, N., Sang, Y., Chen, J., Ballew, S. H., Kalbaugh, C. A., Salameh, M. J., ... & Matsushita, K. Cigarette smoking, smoking cessation, and long-term risk of 3 major atherosclerotic diseases. Journal of the American College of Cardiology, 2019. 74(4), 498-507.
6. Islami, F., Stoklosa, M., Drope, J., & Jemal, A. Global and regional patterns of tobacco smoking and tobacco control policies. European urology focus, 2015;1(1), 3-16.
7. Nădăşan, V., Chirvăsuţă, R., Ábrám, Z., & Mihăicuţă, Ş. Types of interventions for smoking prevention and cessation in children and adolescents. Pneumologia, 2015; 64(3), 58-62.
8. Maiti, M., & Samanta, G. C. Relationship between physical activity and smoking behavior among college students. Int. J. Exp. Res. Rev, 2018;15, 39-43.
9. Hagmeyer, L., & Randerath, W. Smoking-related interstitial lung disease. Deutsches Ärzteblatt International, 2015; 112(4), 43.
10. Thiruppathy, M., Kumar, S. K., Amaladas, J., & Pavani, D. Tobacco: An overview. Drug Invention Today, 2019;12(3).
11. Vallès, Y., Inman, C. K., Peters, B. A., Ali, R., Wareth, L. A., Abdulle, A., . . . Galani, D. (2018). Types of tobacco consumption and the oral microbiome in the United Arab Emirates Healthy Future (UAEHFS) Pilot Study. Scientific reports, 8(1), 1-11.
12. Schubert J, Müller FD, Schmidt R, Luch A, Schulz TG. Waterpipe smoke: source of toxic and carcinogenic VOCs, phenols and heavy metals?. Archives of toxicology. 2015 Nov;89:2129-39.
13. Muzammil, D. S., Al Rethaiaa, A. S., Al Mutairi, A. S., Al Rashidi, T. H., Al Rasheedi, H. A., & Al Rasheedi, S. A. (). Prevalence and perception of shisha smoking among university students: A cross-sectional study. Journal of International Society of Preventive & Community Dentistry, 2019; 9(3), 275.
14. Hallingberg, B., Angel, L., Brown, R., Copeland, L., Gray, L., Van Godwin, J., & Moore, G. Changes in childhood experimentation with, and exposure to, tobacco and e-cigarettes and perceived smoking norms: a repeated cross-sectional study of 10–11 year olds’ in Wales. BMC Public Health, 2021; 21(1), 1-17.
15. Erinoso, O., Oyapero, A., Amure, M., Osoba, M., Osibogun, O., Wright, K., & Osibogun, A. Electronic cigarette use among adolescents and young adults in Nigeria: Prevalence, associated factors and patterns of use. PloS one, 2021; 16(10), e0258850.
16. Marques, P., Piqueras, L., & Sanz, M. J. An updated overview of e-cigarette impact on human health. Respiratory research, 2021; 22(1), 1-14.
17. Buckner, J. D., Abarno, C. N., Zvolensky, M. J., Morris, P. E., Walukevich-Dienst, K., Garey, L., & Mayorga, N. A. (). E-cigarettes use prior to smoking combustible cigarettes among dual users: The roles of social anxiety and E-cigarette outcome expectancies. Addictive Behaviors, 2021; 117, 106854.
18. Al-Rawi S, H Ibrahim A, Ali Hama H, Abdulrahman MD. Depression, Anxiety and Stress Level among University Students of Class Reentry Post Covid-19 Pandemic. International Journal of Social Sciences & Educational Studies. 2022;9(2).
19. Al-Rawi SS, Ibrahim AH. The Overlooked Risk Behaviors of Hepatitis B Virus among Medical and Nonmedical Undergraduate Students. Acta Biomed. 2023;94(2): e2023040
20. Ibrahim AH, Dahham SS, Al-Muffti SA, Al-Rawi SS. Obesity Study among Secondary School Students at Duhok City. InIOP Conference Series: Materials Science and Engineering 2018 (Vol. 454, No. 1, p. 012165). IOP Publishing.
21. Bonnie, Richard J., Kathleen Stratton, and Leslie Y. Kwan. "The Developmental and Environmental Context of Adolescent and Young Adult Tobacco Use." Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. National Academies Press (US), 2015.
22. Neuberger, M. Tobacco and alternative nicotine products and their regulation. Regulatory Toxicology, 2021; 1127-1151.
23. Pazo, D. Y., Moliere, F., Sampson, M. M., Reese, C. M., Agnew-Heard, K. A., Walters, M. J., . . . Chambers, D. M. Mainstream smoke levels of volatile organic compounds in 50 US domestic cigarette brands smoked with the ISO and Canadian intense protocols. Nicotine & tobacco research, 2016;18(9), 1886-1894.
24. Martin, R. S., & Khader, A. Particulate matter pollution in Hookah lounges in Palestine. Journal of Aerosol Science, 2022; 159, 105892.
25. Galaria, K. K., Younus, N., Zubair, R., Khan, M. B., Rehman, S. A., Shahab, S., & Ishaque, S. M. Early Respiratory Symptoms of Water-Pipe (Shisha) Smoking in Medical Students ofKarachi. Annals Of Abbasi Shaheed Hospital and Karachi Medical & Dental College, 2021; 26(4), 225-231.
26. Othman N, Kasem AO, Salih FA. Waterpipe smoking among university students in Sulaimaniyah, Iraqi Kurdistan: prevalence, attitudes, and associated factors. Tanaffos. 2017;16(3):225.
27. Kanmodi, K. K., Buowari, D. Y., & Kelishadi, R. Shisha Smoking—Behaviour with Health and Social Implications, Affecting All Ages Healthy Lifestyle, 2022; pp. 199-213: Springer.
28. Redhwan Ahmed, A., & Saghir, F. S. (2011). Water pipe (shisha) smoking and associated factors among Malaysian university students. Asian Pacific Journal of Cancer Prevention, 12, 3041-3047.
29. Pan, L., Morton, J., Mbulo, L., Dean, A., & Ahluwalia, I. B. (). Electronic cigarette uses among adults in 14 countries: A cross-sectional study. EClinicalMedicine, 2022; 47, 101401.
30. Vankhuma, C., Basu, S., Sharma, N., & Kumar, S. (). Tobacco use patterns and tobacco-related awareness in medical students of Delhi. Clinical Epidemiology and Global Health, 2020; 8(1), 83-86.
31. Chavan, S., Bray, F., Lortet-Tieulent, J., Goodman, M., & Jemal, A. (2014). International
variations in bladder cancer incidence and mortality. European urology, 66(1), 59-73.
32. Getachew, S., Lewis, S., Britton, J., Deressa, W., & Fogarty, A. W. (2019). Prevalence and risk factors for initiating tobacco and alcohol consumption in adolescents living in urban and rural Ethiopia. Public health, 174, 118-126.
33. Moodie, C., & Stead, M. (2020). The importance of loose tobacco when considering capping pack size. Addiction, 115(5), 812-814.
34. Qasim H, Alarabi AB, Alzoubi KH, Karim ZA, Alshbool FZ, Khasawneh FT. The effects of hookah/waterpipe smoking on general health and the cardiovascular system. Environmental health and preventive medicine. 2019 Dec;24:1-7.
35. Cohn, A. M., Blount, B. C., & Hashibe, M. (2021). Nonmedical Cannabis Use: Patterns and Correlates of Use, Exposure, and Harm, and Cancer Risk. JNCI Monographs, 2021(58), 53-67.
36. Sanchez-Ramirez, D. C., & Mackey, D. (2020). Underlying respiratory diseases, specifically COPD, and smoking are associated with severe COVID-19 outcomes: a systematic review and meta-analysis. Respiratory medicine, 171, 106096.