Patterns of cigarette, hookah and other tobacco product consumption habits among undergraduate students of the University of Sarajevo before the COVID-19 outbreak in Bosnia and Hercegovina, a cross-sectional study
Keywords:
Cigarette, hookah, shisha, narghilè, students, tobacco products, survey, COVID-19Abstract
Background. Tobacco products represent a major health risk factor and a potent way to help transmission of COVID-19. Current data regarding consumption of these products in the region are scarce. The aim of this study was to evaluate patterns of cigarette, hookah and other tobacco products consumption among undergraduate students from the University of Sarajevo before the COVID-19 outbreak in the country.
Methods. This cross-sectional study based on a National Youth Tobacco Survey (NYTS) was conducted among undergraduate students from the University of Sarajevo in Bosnia and Hercegovina via an online questionnaire from 22nd to 26th of January 2020.
Results. Out of 605 students involved in the study, most of them were female (N=429, 70.9%); 363 (60.0%) were enrolled in medical sciences; 159 (26.3%) were attending the 3rd year of their curriculum; 224 (37%) were original from Canton Sarajevo and 514 (84.9%) were living in urban environment. Two hundred thirty five students out of 605 (38.8%) were current smokers and 117 (19.3%) hookah smokers. Being female (OR=0.539, 95% CI 0.368-0.790, p=0.002), in the 1st or 2nd year of study (OR=0.805, 95% CI 0.667-0.972, p=0.024) and living in a rural environment (OR=0.335, 95% CI 0.191-0.585, p<0.001) were associated with reduced risk of cigarette consumption, while older age (22+ years) (OR=1.287, 95% CI 1.122-1.476, p<0.001) increased the same risk. On the other side, being female (OR=0.595, 95% CI 0.380-0.930, p=0.023), of younger age (18-21 years) (OR=0.832, 95% CI 0.743-0.932, p=0.001) and medical science student (OR=0.567, 95% CI 0.328-0.978, p=0.041) were associated with decreased risk of consuming hookah.
Conclusions. This study provides an insight in prevalence of smoking among students at the University of Sarajevo. More antismoking efforts are needed, especially in urban environments; and a follow-up study, to be planned in the near future, should determine whether COVID-19 pandemic (and all the modifications of lifestyles connected with it) have eventually changed tobacco consumption patterns among undergraduate students.
References
1. Kondo T, Nakano Y, Adachi S, Murohara T. Effects of Tobacco Smoking on Cardiovascular Disease. Circ J 2019; 83(10): 1980-5. https:// doi.org/10.1253/circj.CJ-19-0323.
2. Lee W, Hwang SH, Choi H, Kim H. The association between smoking or passive smoking and cardiovascular diseases using a Bayesian hierarchical model: based on the 2008-2013 Korea Community Health Survey. Epidemiol Health 2017; 39: e2017026. doi: 10.4178/epih.
e2017026.
3. Villablanca AC, Mcdonald JM, Rutledge JC. Smoking and cardiovascular disease. Clin Chest Med 2000; 21(1): 159-72. doi: 10.1016/s02725231(05)70015-0.
4. Jones LL, Hashim A, Mckeever T, Cook DG, Britton J, Leonardi-Bee J. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respir Res 2011; 12: 5. doi: 10.1186/1465-9921-12-5.
5. Ahmed N, Maqsood A, Abduljabbar T, Vohra F. Tobacco Smoking a Potential Risk Factor in Transmission of COVID-19 Infection. Pak J Med Sci 2020; 36(COVID19-S4): S104-7.
doi:10.12669/pjms.36.covid19-s4.2739.
6. İçmeli ÖS, Türker H, Gündoğuş B, Çiftci M, Aka aktürk Ü. Behaviours and opinions of adolescent students on smoking. Tuberk Toraks 2016; 64(3): 217-22. doi: 10.5578/tt.20925.
7. Agu CF, Weaver S, Abel WD, et al. Are Adolescents likely to Start Smoking Early if Their Parents are Smokers? A Study of Jamaican High School Students. Asian Pac J Cancer Prev 2018; 19(S1): 25-31. doi: 10.22034/APJCP.2018.19.S1.25.
8. Urrutia-Pereira M, Oliano VJ, Aranda CS, Mallol J, Solé D. Prevalence and factors associated with smoking among adolescents. J Pediatr (Rio J) 2017; 93(3): 230-7. doi: 10.1016/j. jped.2016.07.003. Epub 2016 Nov 22.
9. Domić A, Tahirović H, Sajko MČ. [Cigarette smoking among school adolescents in the Brčko District of Bosnia and Herzegovina: a crosssectional study]. Croatian. Lijec Vjesn 2016; 138(7-8): 194-9.
10. Serdarevic N, Katana B, Jaganjac A, Bojicic S, Brankovic S, Mahmutovic J. The Cigarette Smoking, Coffee and Supplements Intake at Students of Sarajevo University. Med Arch 2019; 73(2): 104-8. doi: 10.5455/medarh.2019.73.104-108.
11. Aanyu C, Kadobera D, Apolot RR, et al. Prevalence, knowledge and practices of shisha smoking among youth in Kampala City, Uganda. Pan Afr Med J 2019; 32: 61. doi: 10.11604/ pamj.2019.32.61.15184.
12. Saravanan C, Attlee A, Sulaiman N. A Cross Sectional Study on Knowledge, Beliefs and Psychosocial Predictors of Shisha Smoking among University Students in Sharjah, United Arab Emirates. Asian Pac J Cancer Prev 2019; 20(3): 903-9. doi: 10.31557/APJCP.2019.20.3.903.
13. Muzammil, Al Asmari DS, Al Rethaiaa AS, et al. Prevalence and Perception of Shisha Smoking among University Students: A Cross-sectional Study. J Int Soc Prev Community Dent 2019; 9(3): 275-81. 10.4103/jispcd.JISPCD_407_18.
14. Barnett TE, Livingston MD. Hookah use among adolescents: Differential cognitions about hookah and cigarettes. Addict Behav 2017; 75: 75-8. doi: 10.1016/j.addbeh.2017.07.007. Epub 2017 Jul 9.
15. Alqahtani MM, Goodfellow LT, Zimmerman RD, Zavorsky GS. Waterpipe Smoking in Health-Care Students: Prevalence, Knowledge, Attitudes, and Motives. Respir Care 2019; 64(3): 321-7. doi: 10.4187/respcare.06263. Epub 2018 Oct 16.
16. Montazeri Z, Nyiraneza C, El-Katerji H, Little J. Waterpipe smoking and cancer: systematic review and meta-analysis. Tob Control 2017; 26(1): 92-7. doi: 10.1136/tobaccocontrol-2015052758. Epub 2016 May 10.
17. Patel MP, Khangoora VS, Marik PE. A Review of the Pulmonary and Health Impacts of Hookah Use. Ann Am Thorac Soc 2019; 16(10): 1215-9.
doi: 10.1513/AnnalsATS.201902-129CME.
18. Shekhar S, Hannah-Shmouni F. Hookah smoking and COVID-19: Call for action. CMAJ 2020; 192(17): E462. doi: 10.1503/cmaj.75332.
19. Shafagoj YA, Mohammed FI, Hadidi KA. Hubble-bubble (water pipe) smoking: levels of nicotine and cotinine in plasma, saliva and urine. Int J Clin Pharmacol Ther 2002; 40(6): 249-55. doi: 10.5414/cpp40249.
20. Jawad M, Eissenberg T, Salman R, et al. Toxicant inhalation among singleton waterpipe tobacco users in natural settings. Tob Control 2019; 28(2): 181-8. doi: 10.1136/tobaccocontrol-2017054230. Epub 2018 May 8.
21. Center for Disease Control and Prevention (CDC). National Youth Tobacco Survey. Available on: https://www.cdc.gov/tobacco/data_statistics/surveys/nyts/index.htm [Last accessed: 2021, Jan 13].
22. Center for Disease Control and Prevention (CDC). Tobacco glossary. Available on: https:// www.cdc.gov/nchs/nhis/tobacco/tobacco_glossary.htm [Last accessed: 2021, Jan 13].
23. World Health Organization (WHO). TobReg - advisory note waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators. Available from: htt ps://www.who. int/tobacco/global_interaction/tobreg/waterpipe/ en/ [Last accessed 2021, Jan 20].
24. Shihadeh A, Azar S, Antonios C, Haddad A. Towards a topographical model of narghile water-pipe café smoking: a pilot study in a high socioeconomic status neighborhood of Beirut, Lebanon. Pharmacol Biochem Behav 2004; 79(1): 75-82. doi: 10.1016/j.pbb.2004.06.005.
25. Ibisevic M, Avdic A, Osmanovic E, Kadric N, Avdic S. Cigarette smoking among students at the university of tuzla. Med Arch 2015; 69(2): 127-9. doi: 10.5455/medarh.2015.69.127-129. Epub 2015 Apr 6.
26. Rigotti NA, Lee JE, Wechsler H. US college students’ use of tobacco products: results of a national survey. JAMA 2000; 284(6): 699-705. doi: 10.1001/jama.284.6.699.
27. Memon A, Moody PM, Sugathan TN, et al. Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics, and attitudes. Bull World Health Organ 2000; 78(11): 1306-15.
28. Nouria H, Abdelaziz AB, Rouis S, et al. Comportement tabagique chez les étudiants en sciences de santé de l’université de Monastir (Tunisie). Tunisie Med 2018; 96(10-11): 557-70.
29. Cattaruzza MS, West R. Why do doctors and medical students smoke when they must know how harmful it is? Eur J Public Health 2013; 23(2): 188-9. doi: 10.1093/eurpub/ckt001. Epub 2013 Jan 18.
30. D’Egidio V, Patrissi R, De Vivo G, Chiarini M, Grassi MC, La Torre G. Global Health Professions Student Survey among Healthcare students: a cross sectional study. Ann Ig 2020; 32(4): 419-29. doi: 10.7416/ai.2020.2365.
31. Wamamili B, Wallace-bell M, Richardson A, Grace RC, Coope P. Cigarette smoking among university students aged 18-24 years in New Zealand: results of the first (baseline) of two national surveys. BMJ Open 2019; 9(12): e032590. http:// dx.doi.org/10.1136/bmjopen-2019-032590.
32. La Torre G, Kirch W, Bes-Rastrollo M, et al. Tobacco use among medical students in Europe: results of a multicentre study using the Global Health Professions Student Survey.
Public Health 2012; 126(2): 159-69. https://doi. org/10.1016/j.puhe.2011.10.009.
33. Niu L, Liu Y, Luo D, Xiao S. Current Smoking Behavior Among Medical Students in Mainland China: A Systematic Review and Meta-Analysis. Asia Pac J Public Health 2018; 30(7): 610-23. doi: 10.1177/1010539518800339.
34. Anand K, Kanishka, Marwah S. Prevalence and determinants of hookah use among college-going women of Delhi. Natl Med J India 2019; 32(5): 277-81. doi: 10.4103/0970-258X.295963.
35. Naicker N, Teare J, Albers P, Mathee A. Prevalence of hookah pipe smoking in high-school learners in Johannesburg, South Africa. S Afr Med J 2020; 110(6): 546-51. https://doi.
org/10.7196/SAMJ.2020.v110i6.14333.
36. Balogh E, Faubl N, Riemenschneider H, Balázs P, Bergmann A. Cigarette, waterpipe and ecigarette use among an international sample of medical students. Cross-sectional multicenter study in Germany and Hungary. BMC Public Health 2018; 18:591 https://doi.org/10.1186/ s12889-018-5494-6.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.