Risk factors for smoking behavior among university students
To identify factors associated with increased smoking risks among Kırıkkale University students using a questionnaire. Smoking is a widespread habit in Turkey and a major public health problem in the world. Materials and methods: We assessed 1734 (11.6% of 15,000 total) students (869 males and 866 females, both smokers and nonsmokers) at Kırıkkale University with the questionnaire, which included questions about age, gender, smoking status of student, smoking status and education levels of parents, income, daily sports activities, smoking history (age when started or quit smoking, daily average number of cigarettes smoked, attempts to quit smoking, the reasons for starting smoking), alcohol use, and behavioral problems. Fagerström Test for Nicotine Dependence (FTND) scores and categorical nicotine dependence variables were calculated based on individual scores. We also created dichotomous income and smoking status variables using corresponding levels. For the analyses, we used descriptive statistics, the t-test, the chi-square test, and bivariate and multivariate logistic regressions. Significant factors from the bivariate logistic regressions were included in the multivariate logistic regression analysis. Results: According to the questionnaire, 548 study participants (31.6%) were identified as smokers, smoking every day for a month or longer. The data indicated that of the 548 respondents who were smokers, 66.1% were males and only 33.9% were females. Means and standard deviations (SD) of number of cigarettes per day, age at commencement of smoking, and FTND score were 15.9 (SD = 7.8), 16.6 (SD = 3.0), and 4.4 (SD = 2.3), respectively, in males, and 13.1 (SD = 6.5), 17.4 (SD = 2.4), and 3.9 (SD = 2.4), respectively, in females. There was a significant positive correlation between FTND score and number of cigarettes per day (r = 0.612, P < 0.05) and a significant negative correlation between FTND score and age at commencement of smoking (r = -0.232, P < 0.05). The risk of smoking was 2.968 times higher in males than in females. Having a smoking sibling increased the risk of smoking 2.368 times, having a smoking mother increased the risk 1.564 times, and having a smoking father increased the risk 1.488 times. Having a high family income also increased the risk, 1.579 times. Conclusion: Our study shows that gender, the existence of a smoking person in the family, the mother's education level, and family income all play a significant role in smoking behavior among students. Increased levels of cigarette smoking and nicotine dependence in youth were observed to coincide with an increase in daily parental cigarette smoking. It is recommended that parents, along with young people, be informed about the hazards of smoking and about smoking cessation. The common assessment of both genetic and environmental factors in the development of smoking habits is of great importance.
Risk factors for smoking behavior among university students
To identify factors associated with increased smoking risks among Kırıkkale University students using a questionnaire. Smoking is a widespread habit in Turkey and a major public health problem in the world. Materials and methods: We assessed 1734 (11.6% of 15,000 total) students (869 males and 866 females, both smokers and nonsmokers) at Kırıkkale University with the questionnaire, which included questions about age, gender, smoking status of student, smoking status and education levels of parents, income, daily sports activities, smoking history (age when started or quit smoking, daily average number of cigarettes smoked, attempts to quit smoking, the reasons for starting smoking), alcohol use, and behavioral problems. Fagerström Test for Nicotine Dependence (FTND) scores and categorical nicotine dependence variables were calculated based on individual scores. We also created dichotomous income and smoking status variables using corresponding levels. For the analyses, we used descriptive statistics, the t-test, the chi-square test, and bivariate and multivariate logistic regressions. Significant factors from the bivariate logistic regressions were included in the multivariate logistic regression analysis. Results: According to the questionnaire, 548 study participants (31.6%) were identified as smokers, smoking every day for a month or longer. The data indicated that of the 548 respondents who were smokers, 66.1% were males and only 33.9% were females. Means and standard deviations (SD) of number of cigarettes per day, age at commencement of smoking, and FTND score were 15.9 (SD = 7.8), 16.6 (SD = 3.0), and 4.4 (SD = 2.3), respectively, in males, and 13.1 (SD = 6.5), 17.4 (SD = 2.4), and 3.9 (SD = 2.4), respectively, in females. There was a significant positive correlation between FTND score and number of cigarettes per day (r = 0.612, P < 0.05) and a significant negative correlation between FTND score and age at commencement of smoking (r = -0.232, P < 0.05). The risk of smoking was 2.968 times higher in males than in females. Having a smoking sibling increased the risk of smoking 2.368 times, having a smoking mother increased the risk 1.564 times, and having a smoking father increased the risk 1.488 times. Having a high family income also increased the risk, 1.579 times. Conclusion: Our study shows that gender, the existence of a smoking person in the family, the mother's education level, and family income all play a significant role in smoking behavior among students. Increased levels of cigarette smoking and nicotine dependence in youth were observed to coincide with an increase in daily parental cigarette smoking. It is recommended that parents, along with young people, be informed about the hazards of smoking and about smoking cessation. The common assessment of both genetic and environmental factors in the development of smoking habits is of great importance.
___
- Bozkurt AI, Şahinöz S, Özçırpıcı B, Özgür S, Şahinöz T, Acemoğlu H et al. Patterns of active and passive smoking, and associated factors, in the South-east Anatolian Project (SEAP) region in Turkey. BMC Public Health 2006; 6: 15.
- Doll R, Peto R, Boreham J. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519.
- Munafo MR, Johnstone EC. Genes and cigarette smoking. Addiction 2008; 103: 893-904.
- Turkish Statistical Institute. Global Adult Tobacco Survey (Küresel Yetişkin Tütün Araştırması). No. 3324; 2009. Available from: URL: http://www.tuik.gov.tr/PreHaberBultenleri. do?id=4044 (accessed 16 July 2010).
- Dube SR, Asman K, Malarcher A, Carabollo R.Cigarette smoking among adults and trends in smoking cessation – United States, 2008. JAMA 2009; 302: 2651-4.
- Fagerström KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav 1978; 3: 235-241.
- Uysal MA, Kadakal F, Karşıdağ Ç, Bayram NG, Uysal Ö, Yılmaz V. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004; 52: 15-121.
- Hosmer DW, Lemeshow S. Applied logistic regression. 2nd ed. New York (NY): Wiley; 2000.
- Akçay Ş, Dilektaşlı AG, Budakoğlu I, Yılmaz I, Erdem Ö. Attitudes and knowledge for smoking among university students. Türkiye Klinikleri Tıp Bilimleri Dergisi 2009; 29: 611- 7.
- Aslan D, Bilir N, Özcebe H, Stock C, Küçük, N. Prevalence and determinants of adolescent smoking in Ankara, Turkey. Turkish Journal of Cancer 2006; 36: 49-56.
- Erdogan N, Erdogan I. Smoking at school: views of Turkish university students. Int J Environ Res Public Health 2009; 6, 36-50.
- Celikel FC, Celikel S, Erkorkmaz U. Smoking determinants in Turkish university students. Int J Environ Res Public Health 2009; 6 2248-57.
- Erbaydar T, Lawrence S, DagliE, Hayran O, Collishaw NE. Infl uence of social environment in smoking among adolescents in Turkey. Eur J Public Health 2005; 15: 404-10.
- Rigotti NA, Lee JE, Wechsler H. US college students’ use of tobacco products: results of a national survey, JAMA2000; 284: 699-705.
- Agrawal A, Sartor C, Pergadia ML, Huizink AC, Lynskey MT. Correlates of smoking cessation in a nationally representative sample of U.S. adults. Addict Behav 2008; 33: 1223-6.
- Halperin AC, Smith SS, Heiligenstein E, Brown D, Fleming MF. Cigarette smoking and associated health risks among students at fi ve universities. Nicotine Tob Res 2010; 12: 96-104.