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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 29  |  Issue : 4  |  Page : 1092-1099

Smoking among university students in Kafr El-Sheikh Universi


1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Date of Submission13-Apr-2016
Date of Acceptance26-Jun-2016
Date of Web Publication21-Mar-2017

Correspondence Address:
Hala M. A. El Yazid Omran
Department of Family Medicine, Faculty of Medicine, Menoufia University, Desouk, Kafr El-Sheikh
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.202501

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  Abstract 

Objectives
To estimate the prevalence of smoking among university students and to identify patterns of smoking, family condition, and possible motives for smoking among the groups studied.
Background
University students are at a high risk of developing smoking habits as they become exposed to greater availability of cigarettes and close associations with smoking peers. Also, they face social, emotional, and educational challenges when they enter the university.
Participants and methods
A cross-sectional study was carried out at Kafr El-Sheikh University. All faculties at Kafr El-Sheikh University in Kafr El-Sheikh city were included in the study. The sample size was calculated using EPI-INFO program, version 7 depending on the total number of students registered in all faculties of Kafr El-Sheikh University during the year 2015–2016. All students who participated in the study were evaluated using a predesigned questionnaire through directed interviews with students.
Results
The prevalence of smoking among university students was 11%, with a higher percentage, 54.2%, at the Faculty of Commerce than other faculties of Kafr El-Sheikh University. The prevalence of smoking was higher among men than women, and other sociodemographic factors such as mother's occupation, presence of divorcing between parents, presence of smokers in the family, last year results, and working students were related significantly to the prevalence of smoking. Expression of virility 45.8% and smokers parents 12.5% were the most common motives for smoking.
Conclusion and recommendations
The prevalence of smoking among Kafr El-Sheikh University students was relatively high. Special focus should be directed toward male students and students at the Faculty of Commerce when targeting the problem of smoking.

Keywords: sociodemographic factors, tobacco smoking, university students


How to cite this article:
El-Zaher Amin SA, Shaheen HM, El Yazid Omran HM. Smoking among university students in Kafr El-Sheikh Universi. Menoufia Med J 2016;29:1092-9

How to cite this URL:
El-Zaher Amin SA, Shaheen HM, El Yazid Omran HM. Smoking among university students in Kafr El-Sheikh Universi. Menoufia Med J [serial online] 2016 [cited 2020 May 27];29:1092-9. Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1092/202501


  Introduction Top


Smoking is the most frequent cause of avoidable premature death. Annually, almost six million individuals die because of nicotine consumption [1]. Half of those deaths occur between the ages of 30 and 69 years, resulting in a loss of 20–25 years of life for smokers [2].

Early initiation of smoking increases the lifetime duration of smoking and the burden of smoking-related diseases [3]. University students are at a high risk of smoking as they become exposed to greater availability of cigarettes and have close associations with smoking peers. At the same time, they face additional social, emotional, and educational challenges when they enter the university [4].

The reported prevalence of current smoking among Egyptian university students between the ages of 17 and 25 years is 16.5%; the prevalence of smoking among male students was 28.9% compared with 1.9% among female students [5].

Exposure to passive smoking is associated with a number of health hazards such as prenatal damage to the fetus, poor growth, respiratory illness, atopy and asthma, coronary heart disease, and sudden infant death syndrome [6].

Despite the considerable focus on carrying out researches involving the evaluation of smoking-cessation interventions [7], it is much more important to prevent youth from ever developing smoking habits by continuous monitoring of risk factors for smoking, and among these, to modify the modifiable factors and target those who have nonmodifiable risk factors with health education and smoking prevention programs [8].

Most studies that have investigated the effects of family life have not focused on university students, but instead on younger age groups [9]. Therefore, this study was carried out to explore the magnitude of the problem of smoking among university students and identify personal and family-related risk factors to bridge this research gap.

The aim of this work were as follows.

  • To estimate the prevalence of smoking among university students
  • To assess the risk factors of smoking among university students.



  Participants and Methods Top


Type of study.

This was a cross-sectional study.

Study setting

All faculties at Kafr El-Sheikh University in Kafr El-Sheikh city were included in the study. They were classified into practical faculties (Medicine, Physical Education, Nursing, Engineering, Science, Agriculture, Veterinary Medicine, and Pharmacy) and theoretical faculties (Commerce, Education, Specific education, and Arts).

Sample size

The total number of students in Kafr El-Sheikh University at the time of the study was 28 596 according to the records of Kafr El-Sheikh University.

The reported prevalence of current smoking was 16.5% according to EDHS [5].

The sample size was calculated using EPI-INFO (Atlanta, Georia, USA) program, version 7 depending on the total number of students registered in all faculties of Kafr El-Sheikh University in Kafr El-Sheikh city during the year 2015–2016. The sample size was 211 students. This was increased to 255 students to account for dropout of the students because of incomplete questionnaires; the final sample size included 220 students.

The study sample was selected using the proportional allocation method from all faculties. The students were chosen according to the total number of students from each grade using the simple random method once they provided consent to participate. Students from the faculties of Veterinary, Medicine and Engineering were chosen from the first four grades to be in the same age as their peers in the other faculties.

A total of 255 structured questionnaires were distributed and 220 were completed fully. A total of 35 questionnaires were returned unfilled with missing responses for some items in the questionnaire; these were excluded from data (dropout rate 13.7%). The final sample size included in the study was 220 students.

Tools of data collection

All students who participated in the study were evaluated using a predesigned questionnaire through directed interviews with students. This questionnaire consisted of three different parts.

  • The first part included the following sociodemographic data: The faculty, age, sex, area of residence (urban or rural), number of rooms, crowding index, number of bedrooms, family size, father's occupation, mother's occupation, father's education, and mother's education for assessment of socioeconomic status
  • The second part included 13 questions for all students about the general situation encouraging smoking including questions about the presence of any family problems, working during studying, psychological or behavioral problems, bad situation, presence of any aggressive violent behavior, activities that promote quitting of smoking habits in the university, per-capita income, daily expenses, family relationship, results over the last year, and information on the use of E-cigarettes
  • The third part included 22 questions about smoking habits only for smokers: knowledge of the components of cigarettes, attending any activity about smoking, easily get on cigarettes, Is smoking facilitate taking other drugs, Is smoking was the cause of suffering a family member health, E-cigarette use, using nicotine patch, family knowing that you are smoking, why smoking, age of starting smoking, regularity of smoking, number of cigarettes per day, type of cigarettes, cigarettes mixed with other component, cost of cigarettes, longer duration of abstinence, duration of smoking, source of money of smoking, smoking in the family, who gave you the first cigarette, smoking place, teaching staff role about smoking cessation, family role about smoking cessation, knowing centers for smoking cessation.


Pilot study

A pilot study was carried out with a convenient sample that was excluded from the study (10 students) to measure the feasibility of the study setting, content and validity, and ethical considerations.

The study was carried out after a written consent from the students was obtained to answer the questionnaire.

Collection of data from the students

Data were collected in the period from 1st September 2015 to the 1st December 2015.

Statistical analysis

This included a statistical analysis of the data collected; the data were tabulated and analyzed using the statistical package of social science, 20 (IBM, Armonk, New York, USA).

Quantitative data were expressed as mean and SDs and analyzed using the Student t-test.

Qualitative data were expressed as number and percentage and analyzed using the χ2-test.

A P value greater than 0.05 was considered statistically nonsignificant.

A P value less than 0.05 was considered statistically significant.

A P value less than 0.001 was considered highly statistically significant.


  Results Top


The percentage of the current smokers among the entire population studied was 11% as shown in [Figure 1].
Figure 1: Prevalence of smoking among the groups studied.

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The frequency of smoking habits was higher among male than female students, with a statistically significant difference, 79.2 and 20.8%, respectively (χ2 = 7.6 and P = 0.005). There was a higher prevalence of current smokers at the Faculty of Commerce than other faculties of Kafr El-Sheikh University, 54.2% (χ2 = 43.4 and P = 0.000). There was a significant difference between nonsmokers and smokers in terms of mother's occupation (χ2 = 6.2 and P = 0.02) as the mothers of 64% of nonsmokers were working and the mothers of 63% of the smokers were not working. There was a nonsignificant difference between the groups studied in terms of the socioeconomic score (χ2 = 2.3 and P = 0.3) ([Table 1]).
Table 1 Comparison between the smokers and the nonsmokers in terms of the sociodemographic criteria

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There was a statistically significant difference between the groups studied in terms of the status of the parents (χ2 = 17.6 and P = 0.001) as the parents of 20.9% of smokers were separated versus 3.1% of nonsmokers. There was also a statistically significant difference between the groups studied in terms of the presence of smokers in the family (χ2 = 9.4 and P = 0.02) as the fathers of 54.2% of smokers were smokers versus 26% of nonsmokers; 46.4% of nonsmokers did not have smokers in their families. There was a statistically significant difference between the groups presence of stress factors in the family (χ2 = 6.1 and P = 0.01) as 79.2% of smokers reported a stressful family atmosphere. Also, there was significant difference in feeling bad (χ2 = 7.9 and P = 0.02) as 29.2% of smokers reported feeling bad versus 9.7% of nonsmokers. There was a significant difference in the prevalence of aggressive/violent behavior between collages (χ2 = 9.7 and P = 0.008) as 20.8% of smokers had a prevalence of aggressive/violent behavior between collages versus 7.7% of nonsmokers ([Table 2]).
Table 2 Comparison between the groups studied in terms of the status of the family condition

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There was a significant difference between nonsmokers and smokers in terms of whether they were working while studying (χ2 = 38.9 and P = 0.000) as 41.7% of smokers students reported working while studying versus 78.1% of nonsmokers. There was a statistically significant difference between the groups studied in terms of the results over the last year (χ2 = 14.2 and P = 0.001) as 70.8% of smokers students had achieved good results over the last year and 4.2% of smokers students had the least score versus 33.6% of nonsmokers who had just passed or less ([Table 3]).
Table 3 Comparison between the groups studied in terms of student status

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The possible motives for smoking among the groups of smokers were that they considered smoking as an expression of virility (45.8%), followed by the fact that their parents were smokers (12.5%) and the belief that smoking prevented weight gain (12.5%) [Figure 2].
Figure 2: Possible motives for smoking among the group of smokers.

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The mean age of starting smoking was 15.3 ± 3.2 Years, and 80% of smokers were regularly smoking nearly 20 cigarettes per day; 50% of smokers smoked both cheap or expensive cigarettes, 48.8% smoked expensive cigarettes. Only 95.8% Smoke cigarettes does not mix with other components, cost of cigarette (≤302 ± 31.1/Month), source of first cigarette was 41.7% Bought it by themselves followed by 25% from their parents, 41.7% Smoke in the university and the same percent smoke in the coffee shop and only 16.7% Smoke in the home ([Table 4]).
Table 4 Criteria of smoking habit among the group of smokers

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  Discussion Top


The prevalence of smoking habits has become a source of increasing concern because of its related impact on the health state of the individuals and the whole community. All countries worldwide have attempted to initiate efforts to tackle the issue of smoking, especially among the youth [10].

An increase in smoking habits is expected among university students and this could be related to alleviation of stress, life problems, peer pressure, social acceptance, family history of smoking, lower parents' educational level, and the desire to attain high personality profile. In contrast, religion, negative health effects, bad taste and smell, adverse physiological responses, and issues related to family are considered good reasons for not smoking [11].

The main finding of this study was that about 11% of Kafr El-Sheikh University students were current smokers. Abdelwahid et al. [2] carried out a study on the pattern of smoking among undergraduates of Suez Canal University, Egypt, and found a 17.7% prevalence of smoking, indicating that the problem increases after joining university, with decreased control over youth.

This prevalence is almost in agreement with the study of Shekidef [12]: the prevalence of smoking habits among students of Banha University was 9.9%.

These rates are particularly low compared with those reported in other Arab countries. This may be attributed to the culture of the Egyptian society as most students come from rural areas.

The higher prevalence of smoking is higher among students of theoretical faculty than students of practical faculties which in agreement with previous studies such as the study of Eid et al. [13]. Smoking problem among Helwan University students: practical versus theoretical faculty that found the higher prevalence of smoking among students of theoretical faculties (Faculty of Social Work) than among students of practical faculty (Faculty of Pharmacy). It can be explained that the students at theoretical faculties have more spare time and also have less knowledge of the risks of smoking than students at practical faculties. This is in agreement with other studies reported from medical and engineering colleges in another university in the north of Jordan (28.6%) [14].

The present study found that the frequency of smoking was more among male than female students, with a statistically significant difference, 79 and 21%, respectively. This is in agreement with the study of Eid et al. [13], which found that the prevalence of current smokers among male students was significantly higher than that among female students (28.5 vs. 0.9%), and attributed this to the culture of the Egyptian society.

This is in agreement with many studies carried out in Mediterranean and Arab countries that reported a significantly higher prevalence of smoking among men, which may be because of the social acceptability of smoking habits among men [14].

The present study found that the mean age of starting smoking was 15.3 ± 3.2 years, and it was noteworthy that 80% of smokers were regularly smoking nearly 20 cigarettes per day. This finding is in agreement with the study of Eid et al. [13] that that most current smokers used to smoke more than 20 cigarettes/day (47.1%). Also, most of them started smoking between the age of 15 and 20 years (76.5%).

El-Sharkawy [15] also found that 60% of the students started smoking over the same age range.

In contrast, Öncel et al. [16] reported that 43.3% of the students at Kirikkale University started smoking when they were younger than 14 years of age and attributed this to the gradual decrease in the mean age of smoking initiation in Egypt.

However, Musmar [17], in her study, reported that most smokers were older than 20 years of age and attributed this to family pressure against smoking during adolescence. Once students are older and gain more freedom, family pressure decreases.

The present study found that the possible motives for smoking among the group of smokers were it was considered an expression of virility (45.8%), followed by the fact that their parents were smokers (12.5%) and the belief that smoking prevented weight gain (12.5%) and finally because their friends were smokers.

This may be because of the presence of a negative role model at home such as a father or brother with smoking habits [15].

El-Sharkawy [15] found that the two main motives for smoking were encouragement by friends, followed by family-related factors such as negligence, smoker persons and sense of hopeless future. Also, Labib et al. [18], who carried out a study among female university students, found that curiosity was a significant factor for initiation of smoking.

The present study found that 50% of smokers smoked both cheap and expensive cigarettes and 48.8% smoked expensive cigarettes. The cost of cigarettes was ≤302 ± 31.1 per month.

This may be explained by the fact that 42% of smokers were working while studying; thus, the cost of cigarettes was not an issue and so the present finding that the mean Source of first cigarette was smokers themselves.

The significance of the association found in the bivariate analysis between smoking and an increase in pocket money and working status of students disappeared on carrying out a multivariate analysis. This inconsistency is in agreement with variations in the results of previous studies [19] as extra availability of money encourages spending money on cigarettes [15].

The present study found that 95.8% smoke cigarettes does not mix with other components. This finding is not in agreement with the Eid study, which found that there was a higher prevalence of drug abuse among current smokers [13]. The present study is also in agreement with the study of Abdel Hamid [20], which found that 67% of smokers may add bang to cigarettes agrees with the reported strong association between smoking and drug abuse. This is because cigarettes -which are considered legal for adults -are almost always the gateway to drug abuse. Therefore, smoking prevention may prevent other serious problems at the same time.

This contrast may be reflected the highest rate of denial about other substances abuse in the present study.

The present study found that 41.7% of students had smoking habits in the University and this is alarming as the university has no awareness programs to promote smoking cessation and does not ban smoking.

This result is in agreement with Shekidef [12] as he found that the common places where students smoke were the public places (40.6%), whereas the least common places were at home (9.9%), probably because of greater supervision at home.


  Conclusion Top


The prevalence of smoking in Kafr El-Sheikh University was 11%. There was a higher prevalence of current smokers at the Faculty of Commerce than other faculties of Kafr El-Sheikh University. The prevalence of current smokers among male smokers was significantly higher than that among female smokers. The possible motives for smoking among the group of smokers were expression of virility, followed by the fact that their parents were smokers and the belief that smoking prevented weight gain. The mean age of starting smoking was15.3 ± 3.2 years. A high percentage of smokers smoked inside the university. Smoking among university students may be linked to family-related and personal factors in addition to sociodemographic factors.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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