PREVALANCE OF SMOKING AMONG MALE

MEDICAL STUDENTS OF SHEIKH ZAYED

MEDICAL COLLEGE
RAHIM YAR KHAN

Submitted By
Batch B, 4th Year MBBS Session (2018-2019)
Department of Community Medicine
Sheikh Zayed Medical College, Rahim Yar Khan
Name of Student: ________________________________
Class Roll number: ______________________________
University Roll number: __________________________
Signature of Student: _____________________________
Signature of Supervisor: ___________________________

Supervisor
Prof. Dr. Hafiz Muhammad Yar Malik
HEAD OF DEPARTMENT OF COMMUNITY MEDICINE

Co supervisor
Dr. Ghulam Mustafa, Associate Professor
Dr. Imran Hanif,
DEPARTMENT OF COMMUNITY MEDICINE
SHEIKH ZAYED MEDICAL COLLEGE, RAHIM YAR KHAN
 BATCH B, 4th YEAR MBBS (2018-2019)

Name Roll No Name Roll No

Nazneen Ali Gohar 412 Atif Mumtaz 512

Shafia Saleem 413 Khizar Hayat 514

Ammara Jabbar 414 Asher Azeem 515

Zainab Ul Ghazali 417 M.Hamza Rohani 516

Ayesha Mumtaz 423 Faisal Habib 517

Zoha Arshad 424 Hafiz Hassan Hanzala 520

Kinza Kanwal 425 M.Osama Aslam 521

Ayesha Zaib Un Nisa 426 Muhammad Shahbaz 522

Rabia Rehman 430 Muhammad Uzair 523

Arfa Batool 431 M.Hassan Raza 525

Rameen Daud 432

Iqra Arif 433

Sameen Saeed 435

Hira Jabbar 436

Ushna Ali 443

Rabia Malik 607

M.Zee Waqar 511

 TABLE OF CONTENTS

Sr. No Contents Page Number

1 Abstract 7

2 Introduction 9

3 Objectives 26

4 Methodology 28

5 Results 31

6 Discussion 41

7 Conclusion 44

8 Suggestions 46

9 References 48
 PREVALANCE OF SMOKING AMONG MALE MEDICAL
STUDENTS OF SHEIKH ZAYED MEDICAL COLLEGE
RAHIM YAR KHAN

ABSTRACT
BACKGROUND: Smoking is an emerging problem among medical students. The pattern

and extent of the problem varies from place to place. OBJECTIVE: The aim of study was

to see the prevalence of smoking among male medical students of

SZMC.METHODOLOGY: Study design: Descriptive cross sectional. Study subjects:

Study was carried out among male medical students of SZMC from 1st year to final year

MBBS with sample size of 150 students, 30 from each class. Place and Duration of study:

Data was collected in a period of about 2 weeks from 20 May 2019 till 31 May 2019 in

SZMC. Performa was designed by students of Batch B with the help of our batch teacher.

Before commencing the data result informed verbal consent was taken from all study

subjects. All the data was recorded on Performa. The Performa contains class, age,

socioeconomic status, initiating factors of smoking ,number of cigarettes smoked per day,

smoking status, time period of smoking and plans to quit smoking. The data was entered

on SPSS version 22 and result was preserved as percentage, mean,±S.D. RESULTS :

According to study about 22% students are smokers. CONCLUSION: The study concluded

that 22% of male medical students are smokers. KEY WORDS: Prevalence,Descriptive

cross sectional study.

 INTRODUCTION

CIGARETTE SMOKING : Tobacco smoking is the practice of smoking tobacco and

inhaling tobacco smoke (consisting of particle and gaseous phases). (A more broad
definition may include simply taking tobacco smoke into the mouth, and then releasing it,
as is done by some with tobacco pipes and cigars.) The practice is believed to have begun
as early as 5000–3000 BC in South America. Smoking is the most common method of
consuming tobacco, and tobacco is the most common substance smoked. The agricultural
product is often mixed with additive and then combusted. The resulting smoke is then
inhaled and the active substances absorbed through the alveoli in the lungs or the oral
mucosa.Combustion was traditionally enhanced by addition of potassium or
nitrates.Cigarettes,French for "small cigar", are a product consumed through smoking and
manufactured out of cured and finely cut tobacco leaves and reconstituted tobacco, often
combined with other additives, which are then rolled or stuffed into a paper-wrapped
cylinder.Cigarettes are ignited and inhaled, usually through a cellulose acetate filter, into
the mouth and lungs.Many substances in cigarette moke trigger chemical reactions in
nerve endings, which heighten heart rate, alertness and reaction time, among other things.
STATISTICS : As of the record, tobacco is used by about 49% of men and 11% of
women aged 15 or older in low-income and middle-income countries. with about 80% of
this usage in the form of smoking. .Data from recent studies confirm the quantitative
relationship between smoking and many health hazards in the form of premature death
and serious morbidity.Unfortunately, smoking is on the rise in most developing countries,
including Pakistan, whereas in most developed countries there is a steady decline in its
prevalence. Cigarette production has been increasing worldwide at an average of 2.2%
each year, outpacing the population growth rate of 1.7%.According to a World Health
Organization (WHO) report, tobacco use is predicted to cause 10 million deaths annually
by the year 2030. Since smoking has a serious impact on public health, prevention
programs have been given high priority to WHO policies.

TRIGGERS : Many smokers begin during adolescence or early adulthood.During the

early stages, a combination of perceived pleasure acting as positive reinforcement and
desire to respond to social peer pressure may offset the unpleasant symptoms of initial
use, which typically include nausea and coughing. After an individual has smoked for some
years, the avoidance of withdrawal symptoms and negative reinforcement become the key
motivations to continue.The most common factor leading students to smoke is cigarette
advertisements. Smoking by parents, siblings and friends also encourages students to
smoke. Smoking has elements of risk-taking and rebellion, which often appeal to young
people. The presence of high-status models and peers may also encourage smoking.
Because teenagers are influenced more by their peers than by adults, attempts by parents,
schools, and health professionals at preventing people from trying cigarettes are not
always successful.

Smokers often report that cigarettes help relieve feeli

CRAVINGS : Smokers often report that cigarettes help relieve feelings of stress.
However, the stress levels of adult smokers are slightly higher than those of nonsmokers.
Adolescent smokers report increasing levels of stress as they develop regular patterns of
smoking, and smoking cessation leads to reduced stress. Far from acting as an aid for
mood control, nicotine dependency seems to exacerbate stress. This is confirmed in the
daily mood patterns described by smokers, with normal moods during smoking and
worsening moods between cigarettes. Thus, the apparent relaxant effect of smoking only
reflects the reversal of the tension and irritability that develop during nicotine depletion.
Dependent smokers need nicotine to remain feeling normal. Smoking, primarily of tobacco,
is an activity that is practiced by some 1.1 billion people, and up to 1/3 of the adult
population.The image of the smoker can vary considerably, but is very often associated,
especially in fiction, with individuality and aloofness. Even so, smoking of cigarette can be
a social activity which serves as a reinforcement of social structures and is part of the
cultural rituals of many and diverse social and ethnic groups. Many smokers begin smoking
in social settings and the offering and sharing of a cigarette is often an important rite of
initiation or simply a good excuse to start a conversation with strangers in many settings;
in bars, night clubs, at work or on the street. Lighting a cigarette is often seen as an
effective way of avoiding the appearance of idleness or mere loitering. For adolescents, it
can function as a first step out of childhood or as an act of rebellion against the adult world.
Also, smoking can be seen as a sort of camaraderie. It has been shown that even opening
a packet of cigarettes, or offering a cigarette to other people, can increase the level of
dopamine (the "happy feeling") in the brain, and it is doubtless that people who smoke form
relationships with fellow smokers, in a way that only proliferates the habit, particularly in
countries where smoking inside public places has been made illegal. Other than
recreational drug use, it can be used to construct identity and a development of self-image
by associating it with personal experiences connected with smoking. The rise of the
modern anti-smoking movement in the late 19th century did more than create awareness
of the hazards of smoking; it provoked reactions of smokers against what was, and often
still is, perceived as an assault on personal freedom and has created an identity among
smokers as rebels or outcasts, apart from non-smokers.

HARMFUL CONSEQUENCES : No matter how it is smoked,tobacco is dangerous

to the health. There are no safe substances in any tobacco products, from acetone and
tar to nicotine and carbon monoxide. The substances inhaled don’t just affect lungs,they
can affect your entire body.Smoking can lead to a variety of ongoing complications in the
body, as well as long-term effects on the body systems. While smoking can increase the
risk of a variety of problems over several years, some of the bodily effects are immediate.
Learn more about the symptoms and overall effects of smoking on the body below.In
Pakistan, the mortality rate for smokers is three times that of people who never smoked.
In fact, the institutes say that smoking is the most common "preventable cause of death"
in the Pakistan. While the effects of smoking may not be immediate, the complications
and damage can last for years. The good news is that quitting smoking can reverse many
effects.

EFFECTS OF NICOTINE : One of the ingredients in tobacco is a mood-altering

drug called nicotine. Nicotine reaches the brain in mere seconds and makes the smoking
person feel more energized for a while. But as that effect wears off, the person feel tired
and crave more. Nicotine is extremely habit-forming,which is why people find smoking
so difficult to quit.Physical withdrawal from nicotine can impair the cognitive functioning
and makes the smoker feel anxious, irritated, and depressed. Withdrawal can also cause
headaches and sleep problems.The effects of nicotine, like those of other drugs with
potential for abuse and dependence, are centrally mediated. The impact of nicotine on
the central nervous system is neuroregulatory in nature, affecting biochemical and
physiological functions in a manner that reinforces drug-taking behavior. Dose-
dependent neurotransmitter and neuroendocrine effects occur as plasma nicotine levels
rise when a cigarette is smoked. Circulating levels of norepinephrine and epinephrine
increase, and the bioavailability of dopamine is altered as well. Among the
neuroendocrine effects are release of arginine vasopressin, beta-endorphin,
adrenocorticotropic hormone, and cortisol. Notably, several of these neurochemicals are
psychoactive and/or known to modulate behavior. Thus, affective states or cognitive
demands may be favorably modified (at least temporarily) by nicotine intake. When
nicotine is inhaled, the neuroregulatory effects just described are immediately available
and the reinforcing effects of the drug are maximized.
EFFECTS ON BODY SYSTEMS : When the smoke is inhaled substance that is
taken can damage the lungs. Over time, this damage leads to a variety of problems.
Along with increased infections, people who smoke are at higher risk for chronic
nonreversible lung conditions such as emphysema, the destruction of the air sacs in
lungs, chronic bronchitis, permanent inflammation that affects the lining of the breathing
tubes of the lungs, chronic obstructive pulmonary disease (COPD), a group of lung
diseases and lung cancer. Withdrawal from tobacco products can cause temporary
congestion and respiratory discomfort as your lungs and airways begin to heal.
Increased mucus production right after quitting smoking is a positive sign that your
respiratory system is recovering.Children whose parents smoke are more prone to
coughing, wheezing, and asthma attacks than children whose parents don’t. They also
tend to have higher rates of pneumonia and bronchitis.irritation of the trachea (windpipe)
and larynx (voice box). Smoking causes reduced lung function and breathlessness due
to swelling and narrowing of the lung airways and excess mucus in the lung passages,
impairment of the lungs’ clearance system, leading to the build-up of poisonous
substances, which results in lung irritation and damage, increasedrisk of lung infection
and symptoms such as coughing and wheezing and permanent damage to the air sacs
of the lung.
Smoking damages the entire cardiovascular system. Nicotine causes blood vessels
to tighten, which restricts the flow of blood. Over time, the ongoing narrowing, along with
damage to the blood vessels, can cause peripheral artery disease.Smoking also raises
blood pressure, weakens blood vessel walls, and increases blood clots. Together, this
raises the risk of stroke.There is also the risk of worsening heart disease if someone
already had heart bypass surgery, a heart attack, or a stent placed in a blood vessel.raised
blood pressure and heart rate constriction (tightening) of blood vessels in the skin,
resulting in a drop in skin temperature. The less oxygen carried by the blood during
exercise ‘stickier’ blood, which is more prone to clotting.Cigarette smoking causes
damage to the lining of the arteries, which is thought to be a contributing factor to
atherosclerosis (the build-up of fatty deposits on the artery walls) reduced
blood flow to extremities (fingers and toes), increased risk of stroke and heart attack due
to blockages of the blood supply.greater susceptibility to infections such as pneumonia
and influenza and lowers the levels of protective antioxidants (such as vitamin C), in the
blood.
Smoking also has an effect on insulin, making it more likely that who smokes can develop
insulin resistance. That puts an increased risk of type 2 diabetes and its complications,
which tend to develop at a faster rate than in people who don’t smoke.Nicotine affects
blood flow to the genital areas of both men and women. For men, this can decrease sexual
performance. For women, this can result in sexual dissatisfaction by decreasing
lubrication and the ability to reach orgasm. Smoking may also lower sex hormone levels
in both men and women. This can possibly lead to decreased sexual desire.

Fingernails and toenails aren’t immune from the effects of smoking. Smoking increases
the likelihood of fungal nail infections.Hair is also affected by nicotine. An older study
found it increases hair loss, balding, and graying.Smoking increases the risk of mouth,
throat, larynx, and esophagus cancer. Smokers also have higher rates of pancreatic
cancer. Even people who “smoke but don’t inhale” face an increased risk of mouth cancer.
WHAT IS SECONDHAND SMOKE : Even if someone is not puffing on cigarettes in
the office (or other worksite), the colleagues can still be impacted. Smoking can decrease
productivity on the job, plus all those potential medical complications linked to smoking.
Heart disease, diabetes, and reduced immune function (to name just a few) can cause the
smoker to take more time off than a non- smoking colleagu.Secondhand smoke contains
over 7,000 chemical. Breathing in secondhand smoke—whether it’s from a neighbor’s
burning cigarette or from a cigarette outside window—has been shown to have instant
effects on the nearby individuals. Over time, secondhand smoke takes a toll on people’s
lungs and has been found to increase the risk of stroke in those exposed by 20-30%.

PASSIVE SMOKING : Passive smoking is the usually involuntary consumption of

smoked tobacco. Second-hand smoke (SHS) is the consumption where the burning end
is present, environmental tobacco smoke (ETS) or third-hand smoke is the consumption
of the smoke that remains after the burning end has been extinguished. Because of its
negative implications, this form of consumption has played a central role in the regulation
of tobacco pproducts.

EFFECTS ON FAMILY MEMEBERS : Lighting up cigarette around the family

increases their risk of developing ear infections, asthma, and other breathing
complications—like coughs, shortness of breath, and even bronchitis. Children who grow
up watching their parents smoke are also more likely to become smokers as teens. Being
an adult, of course, doesn’t protect anyone from the damaging effects of cigarettes. The
lungs and hearts of all family members in the home are put at risk by secondhand smoke,
no matter how wide someone keeps the windows open—or how many fans he make use
of.Smoking not only impact the smoker's health, but also the health of those around who
don’t smoke. Exposure to secondhand smoke carries the same risk to a nonsmoker as
someone who does smoke. Risks include stroke, heart attack, and heart disease.The
more obvious signs of smoking involve skin changes. Substances in tobacco smoke
actually change the structure of the skin. A recent study has shown that smoking
dramatically increases the risk of squamous cell carcinoma

SMOKING DECREASES EFFICIENCY IN STUDIES : College students might

want to think twice before lighting a cigarette: a new study shows that smoking during
adolescence can affect cognition and decision-making.It is found that the pre- frontal
cortex, which controls higher cognition, including the ability to make good decisions and
think about future consequences, was less active in adolescents with greater addictions
to nicotine, suggesting that smoking affects brain development and function.As the
prefrontal cortex continues to develop during the critical period of adolescence, smoking
may influence the trajectory of brain development and affect the function of the prefrontal
corex.If severely affected,students might have an impeded ability to make rational
judgments, including the choice to stop smoking.Smoking not only affects th health of
the student, but also decreases the focus an causes loss of concentration.They remain
in a state of confusion and lethargy. This decreases their efficiency in the studies and
hence compromising their future.

EFFECTS ON SOCIAL LIFE AND EXTRACURRICULAR ACTIVITIES : As

students smoke, the loose their stamina and become inactive in the sports and other
extracurricular activities.This causes a decrease in their social circle and activities that
freshen the mind.The habit of smoking ultimately drives them back and back and there is
loss of their health and studies.So their competency in their field will be compromised in
long terms.Students are also affected financially to some extent.As they put their money
for buying cigarettes, they run out of money and hence they giveup the other healthy
dietry products like fresh juices, milk etc. They may want to consume them, but they
remain no longer able to afford these products. Moreover, students usually suffer from
acute pharyngitis and fever caused by irritation due to cigarette smoke. So they need to
pay for the drugs from their pocket money and that seems to be an extra burden on them.

ROLE OF HEALTH PROFESSIONALS IN SMOKING CESSATION: Health

professionals educate their patients on the hazards of smoking. They usually serve as role
models for their patients and the public and, therefore, play an important role in
discouraging people from smoking. The participation of Health professionals in prevention
and cessation counseling could be part of the strategies to minimize tobacco-related
deaths in the future. For health professionals to convince others, they should be
nonsmokers.They counsel the smokers by addressing to them that deciding to quit
smoking is only half the battle. Knowing where to start on the path to becoming smoke-
free can help to take the leap.Quitting smoking is not a single event that happens on one
day; it is a journey. By quitting, a person will improvehis health and the quality and duration
of his life, as well as the lives of those around him. To quit smoking,a smoker not only
needs to alter his behavior and cope with the withdrawal symptoms experienced from
cutting out nicotine, buthe also need to find other ways to manage his moods.With the
right game plan,a smoker can break free from nicotine addiction and kick the habit for
good.There are several ways to stop smoking, but ultimately,the person needs to decide
whether he is going to quit abruptly, or continue smoking right up untilhis quit date and
then stop.Here are som tips that are given to a smoker to help him quit the smoking.

COUNSELLING AND INTERVENTIONS TO QUIT SMOKING : He is advised

to tell friends, family, and co-workers about his quit date, throw away all cigarettes and
ashtrays.decide whether he is going to go "cold turkey" or use nicotine replacement
therapy, set up a support system, such as a family member that has successfully quit and
is happy to help you.Breaking the association between the trigger and smoking is a good
way to help you to fight the urge to smoke.The person is asked to stay busy, begin use of
his NRT if he has chosen to use one, attend a stop-smoking group or follow a self-help
plan, drink more water and juice, drink less or no alcohol, avoid individuals who are
smoking. On the other hand, nicotine gum and most other nicotine replacement vehicles
in current use have a slower onset of action, resulting in less reinforcement value. Recent
data suggest that smoking cessation rates may be optimized by tailoring the dose of
nicotine replacement (for example, 2 or 5 mg of nicotine gum) to the individual degree of
nicotine dependence. In view of the dynamic interactions between
the neuroregulatory effects of nicotine and a host of environmental conditions, nicotine
replacement therapy is best carried out in combination with behavior modification
techniques.NRT can reduce the cravings and withdrawal symptoms that may hinderthe
attempt to give up smoking. NRTs are designed to weanthe body off cigarettes and supply
with a controlled dose of nicotine while sparing a person from exposure to other
chemicals found in tobacc. Bupropion and veriniciline are also used for this purpose.
Risks involved with using these drugs include behavioral changes, depressed mood,
aggression, hostility, and suicidal thoughts or actions.The emotional and physical
dependence on smoking makes it challenging to stay away from nicotine after quitting
the smoking. To quit, there is need to tackle this dependence. Trying counseling services,
self-help materials, and support advices can help to get through this time. As physical
symptoms get better over time, so will be emotional ones. Combining medication - such
as NRT, bupropion, and varenicline - with behavioral support has been demonstrated to
increase the chances of long-term smoking cessation by up to 25 percent.
ROLE OF MEDICAL STUDENTS : As future physicians, medical students are
considered a primary target of tobacco prevention programs. They can therefore, play a
positive role in preventing smoking among people in their community. They may deliver
health education, support anti-smoking policies and influence national and global tobacco
control efforts.Previous studies in Pakistan of medical students, in government colleges,
showed that smoking was highly prevalent among male students.This study aimed to
determine the prevalence of smoking of medical students at the Sheikh Zayed Medical
College and assess the association between smoking and sociodemographical factors,
contacts with smokers, reasons for smoking and attempts to stop smoking It is hoped
that the results would help with the planning of corrective measures, as necessary
 OBJECTIVES

The objective of this study was to see the

 Prevalence of smoking among the male medical students of sheikh Zayed medical
college Rahim Yar Khan.
 METHODOLOGY

Study Design

Cross Sectional Study

Study Setting

This study was conducted in boys hostels Sheikh Zayed Medical College R.Y.Khan.

Study Subject

Male Medical Students

Study Duration

From 18th May 2019- 31st July 2019.

Sample Size

150 male medical students were included in the study.

Sampling Technique

Convenient Sampling Technique.

Inclusion Criteria

1. Male Medical students who were willing to give data.

2. Only Male MBBS students were included.

Exclusion Criteria

1- Students not willing to participate in study.

2- The students other than MBBS students.

Data Collection Method

Data was collected on predesigned questionnaire from 20th May 2019 to 31st May 2019.
Data was collected from these students by convenient sampling technique following inclusion and
exclusion criteria. Pretesting of questionnaire was done for data collections, structured questionnaire
was designed, which comprised of different sections such as age, socioeconomic status (Poor class
having monthly income < Rs.15000, Middle Class having monthly income < Rs.50000. and upper
class having monthly income > Rs.50000) source of initiation of smoking, duration of smoking, and
impact of medical college on smoking habit were included.

Data Analysis

The data was entered and analyzed by using SPSS version -16. Numerical variables like age were
presented as mean ± SD and categorical variables like smoking status were presented as
percentages.

Ethical Approval

Ethical approval was sought from “Institutional Review Board” before starting research.
 RESULTS OF STUDY CONDUCTED IN SHEIKH ZAYED MEDICAL COLLEGE ABOUT
PREVALENCE OF SMOKING AMONG MALE MEDICAL STUDENTS

This study was conducted to assess the prevalence of smoking among male medical students.
Table 1: Age wise distribution of study subjects

Frequency Percentage
Age

18-19 years 40 26.66%

19-20 years 60 40.0%

20-21 years 30 20%

>22 years 20 13.33%

Total 150 100%

Table 1 shows That the maximum Percentage (40%) of students is between the 19 to 20 years.
Mean Age: 19.6
Median: 20
Table 2: Class wise distribution of study subjects:

Class No Percentage
1st year 30 20.0%
2nd year 30 20.0%
3rd year 30 20.0%
4th year 30 20.0%
final year 30 20.0%
Total 150 100%

Table 2 shows that 30 (20%) students were taken from each class.
 Table 3: Socio Economic class wise distribution of study subjects:

Socio-Economic Class Number Percentage

Poor class 12 8.0%
Middle class 134 89.3%%

Upper class 4 2.7%%

Total 150 100%

Table 3 shows that the highest percentage of study subjects were from middle class that is 134
(89.3%)

Table 4: Distribution of study subjects According to their initiation of smoking

Percentage
Initiation Frequency
68%
Non Smokers 102
24.6%
Friend 37
2.7%
Cousin 4
4.7%
Any other person 7
100%
Total 150

Table 4 shows that the source of majority of smokers, about 24.6%, was their friend.
 Table 5: Distribution of study subjects according to the number of cigarettes they
smoke per day

Per day distribution Frequency Percentage

Non-Smokers 102 68%
Less than 5 cigarettes per day 19 12.6%
5-10 cigarettes/day 13 8.7%
10-15 cigarettes/day 13 8.7%
20 or more 3 2.0%
Total 150 100%

Table 5 shows that about 12.6% of smokers smoked less than 5 cigarettes per day.

Table 6: Distribution of study subjects according to their smoking status:

Smoking status Frequency Percentage

Non smokers 102 68%

Daily smoker (at least 1 33 22.0%

cigarette/day)

Occasional smoker (1-2 15 10%

cigarette /week)

Total 150 100%

Table 6 shows that about 22 percent of study subjects were Daily Smokers.
 Table 7: Distribution of study subjects according to the time period of their smoking:

Time period Frequency Percentage

Non smokers 102 68%

<1 year 14 9.3%

1-2 years 13 8.7%

3-5 years 17 11.3%

5-10 years 4 2.7%

Total 150 100%

Table 7 shows that 17 (11.3%) Study subjects had been smoking for 3-5 years.

Table 8: Distribution of the study subjects according to their Effect of smoking habits
after their admission in medical college:

Effect on Smoking habit Frequency Percentage

Non Smokers 102 68%
No change 3 2.0%
Smoke 25-50% more 16 10.7%
Double smoking habit 26 17.3%
Quit smoking 3 2.0%
Total 150 100%

Table 8 shows that highest percentage of smokers that is 17.3% doubled their smoking habit after
admission in medical college.
 Table 9: Distribution Of study subjects according to their Plan to Quit Smoking:

Plan to quit smoking Frequency Percentage

Non smokers 102 68%
Yes 24 16.0%
No 24 16.0%
Total 150 100%

Table 9 shows That half of the smokers that is 16% planned to quit smoking.

Table 10: Distribution of Study Subjects According To Their Monthly Expenditure

On Smoking:

Percentage of pocket money Frequency Percentage

Non smokers 102 68%
<5% 20 13.3%
010% 9 6.0%
15% 6 4.0%
>20% 13 8.7%
Total 150 100%

Table 10 shows that majority of smokers that is 13.3% spent less than 5% of their pocket money on
smoking.
 Table 11: Distribution of Study Subjects according to Awareness about Harms of
smoking:

Awareness about harms Frequency Percentage

Non smokers 102 68%
Yes 44 29.3%
No 4 2.7%
Total 150 100%

Table 11 shows that 29.3% of smokers were aware of harmful effects of smoking.

Table 12: Distribution of study subjects according to the methods by which they can
reduce smoking:

Possible methods to reduce Frequency Percentage

smoking
Non smokers 102 68%
Placing health warning on 1 0.7%
cigarette packet
Increasing prize of cigarette 18 12%
Anti-smoking education 8 5.3%
programs
Counseling of smoker 21 14.0%
Total 150 100%

Table 12 shows that 14% (highest percentage) of smokers thought that they could reduce smoking
through counseling.
Discussion

Smoking among medical students can results in health, social and education
related issues. Our study showed that 30 (20%) study subjects were taken from each
class. mean age was 21.6±2 years and smoking prevalence among male students was
31.3%. Our study showed that 134 (89.3%) study subjects were from middle class, followed
by 12 (8%) from poor class and 4 (2.7%) from upper class.

The cross-sectional study in Lebanon reported the prevalence of tobacco use

and associated knowledge and behavior among medical students in 2009-10 from 6 medical
schools in Lebanon. The self administered questionnaire based on the global health
professional survey (GHPSS). Core questions aloes inquired about training in tobacco
cessation approaches. All enrolled students were asked to participate. The response rate
was 191/354 (54.3%). According to study in Lebanon, 191 study subjects were taken from
6 medical schools. 144 (75.3%) subjects were from middle class followed by 15 (7.85%)
were from poor class and 32 (16.75%) were from upper class. Our study showed that 103
(68.7%) study subjects were nonsmoker (never smoked), followed by 33 (22%) were daily
smokers, 11 (7.3%) were occasional smokers and 3(2%) were ex-smokers. The study
conducted in Lebanon showed that 26.3% of study subjects were smokers whereas 73.7%
of study subjects who responded were non-smokers.

The study conducted in our medical college showed that the source of
smoking of 37 (24.7%) were their friends and the sources of remaining 7 (4.7%) and 4 (2.7%)
study subjects were any other person and their cousin respectively whereas study of
Lebanon showed that 16 (33%) of the study subject had their source of smoking as friends
followed by 10 (20%) as cousins whereas remaining 24 (48%) study subjects had source
different than mentioned above. The study we conducted showed that 102 (68%) study
subjects were nonsmokers, 19 (12.7%) used to smoke not more than 5 cigarettes followed
by 13 (8.7%) used to smoke 5-10 and 10-15 cigarettes per day respectively and 3 (2%) used
to smoke 20 or more cigarettes per day. 17 (11.3%) study subjects were smoking for 3-5
years followed by 14 (9.3%) and 13 (8.7%) were smoking for < 1 year and 1-2 years
respectively and 4 (2.7%) were smoking for 5-10 years. 60 (40%) study subjects were in the
age range of 19-20 years, 40 (26.6%) were 18-19 years and remaining 30 (20%) and 20
(13.3%) study subjects were between 20-21 years and more than 22 years respectively.

According to study conducted in Lebanon, 61% of smoker smoked a pack

of cigarettes daily, whereas 34% of smokers smoked 5-10 cigarettes per day and 5% of
smokers smoke less than 5 cigarettes per day. The age range among Lebanese smokers
was between 21-26 years with the average age of 23.6 years. Our study showed that 22
(14.7%) study subjects used to smoke to relieve their tension/anxiety/stress ,14 (9.3%) used
to smoke as a fashion and remaining 8 (5.3%) and 4 (2.7%) used to smoke to enhance their
sensory stimulation and because of their peer pressure respectively. 26 (17.3%) study
subjects doubled their smoking habit, 16 (10.7%) increased their smoking habits 25-50%
more and remaining 3 (2%) quit smoking and did not change their habit respectively.
According to study in Lebanon, 34% smokers used to smoke to relieve their
tension/anxiety/stress. While 20% of smokers used to smoke as a fashion. And remaining
46% of subjects were doing it for any other reason. 30% of the smokers doubled their
smoking habit is medical school while 20% of the smokers increased their smoking habit
and remaining 50% smokers did not change their smoking habit in medical school.

Our study shows That 24 (16%) are Planning to Quit Smoking and 24 (16%)
have no plan to quit. 20 (13.3%) Study Subjects Spent <5% on smoking followed by 13
(8.7%) Spent more than 20% and 9 (6%), 6 (4%) study subjects Spent 10% and 15% of their
Money Respectively. 44 (29.3%) Study Subjects were aware of harms and dangers of
Smoking and Remaining 4 (2.7%) were not aware. 18 (12%) study subject quit smoking
because of inflation, 21 (14%) quit due to counseling and 8 (5.3%) and 1 (0.7%) quit due to
antismoking education programs and placing health warning on cigarette packet
respectively. While according to study conducted in Lebanon , 38% of smokers are planning
to quit smoking whereas remaining 62% of smokers have no plan to quit smoking. , more
than half of study subjects spent almost 200-400 US $ of their monthly expenditures on
smoking. And 94.2% of study subjects were aware of harmful effects of smoking. 38% of
study subjects were willing to quit this habit.
The research was conducted about cigarette smoking among medical students in The
Nation Ribat University, Sudan. 414 medical students responded by filling their
questionnaire out of which 240 students were from first year while 174 students were from
final year about 10% of all student smoke. Most of the students were between the age group
of 18-23 years. Mean age was 21± 2. Most of the students were living with their families and
about 13% of them live in the boarding houses. the study revealed that 16 out of 240 (6.6%)
in the first year were smokers while 25 out of 185 students in the final year (14.4%) were
smokers. 25 of all smokers had at least one family member who smoked while 116 out of
375 provided history of family smoking.

Smoking among medical students can results in health, social and

education related issues. Our study showed that 30 (20%) study subjects were taken from
each class. Mean age was 21.6±2 years and smoking prevalence among male students was
31.3%. Our study showed that 134 (89.3%) study subjects were from middle class, followed
by 12 (8%) from poor class and 4 (2.7%) from upper class. According to study conducted in
National Ribat University, 414 study subjects were taken out of which 10% smoked. Mean
age of smokers was 21± 2. Among the smokers, about 65% subjects were from middle class,
24% were from upper class and 11% were from poor class.

. Our study showed that 103 (68.7%) study subjects were nonsmoker (never
smoked), followed by 33 (22%) were daily smokers, 11 (7.3%) were occasional smokers
and 3(2%) were ex-smokers. According to study in Sudan, 90% of the study subjects were
non-smokers. Among 10% smokers, 7.5% were heavy smokers (one pack a day) and
remaining 2.5% smoked less than 10 cigarettes per day.

The study conducted in our medical college showed that the source of
smoking of 37 (24.7%) were their friends and the sources of remaining 7 (4.7%) and 4 (2.7%)
study subjects were any other person and their cousin respectively while smokers in Sudan
60% had friends as their source, 25% had cousin as their source while remaining 15% had
any other source for smoking.
 The study we conducted showed that 102 (68%) study subjects were
nonsmokers, 19 (12.7%) used to smoke not more than 5 cigarettes followed by 13 (8.7%)
used to smoke 5-10 and 10-15 cigarettes per day respectively and 3 (2%) used to smoke
20 or more cigarettes per day. 17 (11.3%) study subjects were smoking for 3-5 years
followed by 14 (9.3%) and 13 (8.7%) were smoking for < 1 year and 1-2 years respectively
and 4 (2.7%) were smoking for 5-10 years. 60 (40%) study subjects were in the age range
of 19-20 years, 40 (26.6%) were 18-19 years and remaining 30 (20%) and 20 (13.3%) study
subjects were between 20-21 years and more than 22 years respectively. According to study
conducted in Sudan, among 10% smokers, 7.5% were heavy smokers (one pack in a day)
and remaining 2.5% smoked less than 10 cigarettes per day. 19 (48%) of smokers had
history of smoking for past one year and 12 (28%) of smokers had history of smoking for
past 3-5 years and remaining 10 (24%) of smokers had history of smoking for past 5 to 10
years.

Our study showed that 22 (14.7%) study subjects used to smoke to relieve their
tension/anxiety/stress ,14 (9.3%) used to smoke as a fashion and remaining 8 (5.3%) and 4
(2.7%) used to smoke to enhance their sensory stimulation and because of their peer
pressure respectively. 26 (17.3%) study subjects doubled their smoking habit, 16 (10.7%)
increased their smoking habits 25-50% more and remaining 3 (2%) quit smoking and did not
change their habit respectively. According to study in National Ribat University, 13 (32%) of
smoker used to smoke in order to relieve their tension/anxiety/stress. And 9 (21%) of
smokers used to smoke as a fashion. And remaining 19 (47%) of smokers used to smoke
in order to enhance their sensory stimulation and because of their peer pressure.

Our study shows That 24 (16%) are planning to quit smoking and 24 (16%)
have no plan to quit. 20 (13.3%) Study Subjects Spent <5% on smoking followed by 13
(8.7%) Spent more than 20% and 9 (6%), 6 (4%) study subjects Spent 10% and 15% of their
Money Respectively. 44 (29.3%) Study Subjects were aware of harms and dangers of
smoking and remaining 4 (2.7%) were not aware. 18 (12%) study subject quit smoking
because of inflation, 21 (14%) quit due to counseling and 8 (5.3%) and 1 (0.7%) quit due to
antismoking education programs and placing health warning on cigarette packet
respectively. According to study in National Ribat University, 81% of smokers tried to quit
smoking more than 3 times because 37% of quitters thought of dangers of addiction and
40% of quitters thought of effects of smoking on health and 23% did so because of pressure
from others.

Smoking among medical students can results in health, social and education related
issues. Our study showed that 30 (20%) study subjects were taken from each class. mean
age was 21.6±2 years and smoking prevalence among male students was 31.3%. Our
study showed that 134 (89.3%) study subjects were from middle class, followed by 12 (8%)
from poor class and 4 (2.7%) from upper class. While the study conducted in Egypt, 252
subjects were taken and 12% among them were smokers. 13.1% of those smokers were
heavy smokers.

. Our study showed that 103 (68.7%) study subjects were nonsmoker (never
smoked), followed by 33 (22%) were daily smokers, 11 (7.3%) were occasional smokers
and 3(2%) were ex-smokers. Study in Egypt showed that 88% of study subjects were non-
smokers and 6.3% were ex-smokers.

The study conducted in our medical college showed that the source of
smoking of 37 (24.7%) were their friends and the sources of remaining 7 (4.7%) and 4 (2.7%)
study subjects were any other person and their cousin respectively.. The study we
conducted showed that 102 (68%) study subjects were nonsmokers, 19 (12.7%) used to
smoke less than 5 cigarettes followed by 13 (8.7%) used to smoke 5-10 and 10-15 cigarettes
per day respectively and 3 (2%) used to smoke 20 or more cigarettes per day. 17 (11.3%)
study subjects were smoking for 3-5 years followed by 14 (9.3%) and 13 (8.7%) were
smoking for < 1 year and 1-2 years respectively and 4 (2.7%) were smoking for 5-10 years.
60 (40%) study subjects were in the age range of 19-20 years, 40 (26.6%) were 18-19 years
and remaining 30 (20%) and 20 (13.3%) study subjects were between 20-21 years and more
than 22 years respectively. While according to study in Egypt, smoking habits among family
members and presence of smoking peers were significantly associated with smoking status.
Among those smokers 15 (49.66%) used to smoke less than 5 cigarettes per day, 11
(36.42%) used to smoke 5-10 cigarettes per day and 4 (13.2%) used to smoke more than
one pack a day. The mean age range of smokers of Tanta Medical College was between 21
to 25.
 Our study showed that 22 (14.7%) study subjects used to smoke to relieve their
tension/anxiety/stress ,14 (9.3%) used to smoke as a fashion and remaining 8 (5.3%) and 4
(2.7%) used to smoke to enhance their sensory stimulation and because of their peer
pressure respectively. 26 (17.3%) study subjects doubled their smoking habit, 16 (10.7%)
increased their smoking habits 25-50% more and remaining 3 (2%) quit smoking and did not
change their habit respectively. Whereas in Tanta Medical College, the most common cause
of smoking was stress (42%).

Our study shows That 24 (16%) are Planning to Quit Smoking and 24 (16%)
have no plan to quit. 20 (13.3%) Study Subjects Spent <5% on smoking followed by 13
(8.7%) Spent more than 20% and 9 (6%), 6 (4%) study subjects Spent 10% and 15% of their
Money Respectively. 44 (29.3%) Study Subjects were aware of harms and dangers of
Smoking and Remaining 4 (2.7%) were not aware. 18 (12%) study subject quit smoking
because of inflation, 21 (14%) quit due to counseling and 8 (5.3%) and 1 (0.7%) quit due to
antismoking education programs and placing health warning on cigarette packet
respectively. According to study conducted in Egypt, 37.1% of smokers were willing to quit
smoking and 64% of the smokers were aware of the harms and dangers of smoking.

Overall in the world, about 1 billion men and 250 million women are daily smokers.
In particular 35% and 50% of men and 22% and 9% of women in developed and developing
countries respectively. By 2030 it is thought that about 70% of deaths due to smoking are
expected to occur is developing countries as the negative health outcomes of the smoking
are serious and being well documented. Death at earlier age among smokers is more than
among non-smokers. About 10 years earlier as compare to non-smokers. College students
are at high risk of smoking as their might be an intimate relation with smoking peers. At the
same time, they are liable to socio-economic and educational challenges when they enter
in the universities.

In a systemic review of literature by Smit and Leggal in 2011, it was shown that
Australia and USA had lower smoking rate among their medical students by 3% whereas
study in Japan in 2012 reported much.
Conclusion

The trend of smoking among the students of low socioeconomic status was high. In contrast
the prevalence of non-smoking was high among the students of high socioeconomic status.
Moreover, many smokers had their intuition from their friends. While 29% of smokers knew
about harms of smoking. 16%of the smokers were planning to quit smoking.
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