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Zahedi H, Sajjadi SL, Sahebihagh MH, Sarbakhsh P. Association between loneliness and cigarette smoking attitudes among university students in Iran: a cross-sectional study. BMJ Open 2024; 14:e079593. [PMID: 38806432 PMCID: PMC11138298 DOI: 10.1136/bmjopen-2023-079593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/21/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVES During the last two decades, cigarette smoking witnessed a global increase in use, especially among youth. Loneliness is one of the possible psychosocial determinants of smoking. This study examined the association between loneliness and attitudes towards cigarette smoking among university students of Iran. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS This study was conducted among 538 university students, who were recruited using the cluster random sampling method. Loneliness and smoking attitudes of the samples were assessed using the revised version of the University of California Los Angeles Loneliness Scale and the Scale of Cigarette Smoking Attitude (CSA). Descriptive statistics, Pearson's correlation coefficient and multivariable regression analysis were used to analyse the data. RESULTS From a total of 538 participants, 301 (59.9%) students were young women. The mean age of the students was 22.2±2.9 years. Only 56 (10.4%) of the students were married and 370 (87.9%) of them were lived with their families. 131 (24.3%) students experienced cigarette smoking. In terms of university-related characteristics, 205 (38.1%) of the students studied in the faculty of medicine. Also, 30% of the students had a positive or indifferent attitude towards smoking, while 26.4% of the students reported feeling lonely. The mean scores for loneliness and CSA were 41.42±11.29 and 48.64±11.2, respectively. Statistically, a significant positive correlation was found between loneliness and CSA (r=0.289; p<0.001). After controlling for potential confounders by regression analysis, loneliness scores were also positively associated with CSA scores (B: 0.14; 95% CI 0.097 to 0.18). CONCLUSIONS According to the positive association between loneliness and students' CSA, paying more attention to the state of loneliness in college students, examining situations and reasons that increase it and identifying the interventions that might reduce it are necessary. Reducing loneliness among college students can correct their attitudes towards smoking.
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Affiliation(s)
- Hamideh Zahedi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyyede Leila Sajjadi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical Surgical Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasan Sahebihagh
- Professor of Nursing Education, Tabriz Health Services Management Research Center and Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Ph.D in Biostatistics, Department of Statistics and Epidemiology, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Gupta H, Gupta S, Rozatkar AR. Magnitude of Substance Use and Its Associated Factors Among the Medical Students in India and Implications for Medical Education: A Narrative Review. Indian J Psychol Med 2022; 44:218-226. [PMID: 35656413 PMCID: PMC9125464 DOI: 10.1177/02537176211032366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Medical students are at an increased risk of developing substance use and related problems (SURP) because of the inherent stress associated with the professional medical course apart from the developmental risk factors. However, this is under-researched. Moreover, a comprehensive review on the prevalence of SURP among the medical undergraduates (UGs) and associated factors is lacking from India. To fill this gap, the current research work is aimed to review the existing literature on the magnitude of the SURP among UGs of India and its determinants. METHODS PubMed, Medline, and Google Scholar databases were searched for the original articles studying the prevalence of SURP among medical UGs of India, published from inception till date. Non-original articles, studies on behavioral addictions, and those not directly assessing the prevalence of SURP among the medical UGs were excluded. RESULTS A total of 39 studies were found eligible for the review. Alcohol (current use: 3.2%-43.8%), followed by tobacco (3.7%-28.8%) and cannabis (1.6%-15%), were the common substances used by the medical students. Among the females, an increasing trend of substance use, particularly of nonprescription sedatives (even higher than males), alcohol, and smoking, was seen. Family history, peer pressure, transition from school to college life, and progression in the medical course were important associated factors. CONCLUSION Sensitizing medical students and college authorities, increasing the duration of training on SURP in medical curricula, and providing psychological support for the students with SURP could address this issue.
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Affiliation(s)
- Himank Gupta
- All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
| | - Snehil Gupta
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
| | - Abhijit R Rozatkar
- Dept. of Psychiatry, All India Institute of Medical Sciences, Bhopal, Bhopal, Madhya Pradesh 462020, India
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Kachwaha P, Singhal DK, Singh N. Perceptions Regarding Tobacco Cessation Counselling among Dental Students and Graduates: A Cross-Sectional Study. Asian Pac J Cancer Prev 2019; 20:2589-2593. [PMID: 31554350 PMCID: PMC6976852 DOI: 10.31557/apjcp.2019.20.9.2589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Tobacco usage is a global concern and it is essential to curb its usage and increase awareness among patients. Dental professionals’ contribution in tobacco cessation will definitely make a stark difference. Thus it is important to assess dental students’ and graduates’ knowledge, attitude and practice towards Tobacco cessation counselling (TCC). Materials and Methods: The descriptive, cross-sectional survey was carried out among 286 students of a dental college in South India. A well-structured, pretested, self-administered questionnaire consisting of 17 close-ended questions was employed to assess knowledge, attitude and practice towards TCC. Results: Almost all study participants agreed that tobacco cessation counselling is under the scope of dental practice and admitted that it is the responsibility of dental professionals to educate patients for the same. Majority of graduates responded that they have done tobacco cessation counselling whereas less than two-third of undergraduates have done the same and difference between two groups was statistically significant (p<0.001). A significantly higher number of graduates (79%) were aware of 5A’s and 5R’s protocol for TCC as compared to undergraduates (50%). But less than one-fifth of study population have actually applied this protocol for TCC in clinical practice. Conclusion: There is a need to modify the dental curriculum and motivate young graduates and students about TCC. This will develop a more professional competence and helps to encourage the dental professionals in developing a preventive mind set about tobacco use. Thus, it will help in enhancing the long-term rates of quitting tobacco among patients, which will prove beneficial in controlling tobacco related diseases in near future.
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Affiliation(s)
- Priyanka Kachwaha
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Deepak Kumar Singhal
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India.
| | - Nishtha Singh
- Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Karnataka, India
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Nyi Latt N, Saw YM, Myat Cho S, Kariya T, Yamamoto E, Hamajima N. Tobacco Control Law awareness, enforcement, and compliance among high school students in Myanmar. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:379-389. [PMID: 30214087 PMCID: PMC6125651 DOI: 10.18999/nagjms.80.3.379] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
In Myanmar, the Control of Smoking and Consumption of Tobacco Products Law (Tobacco Control Law; TCL), which covers the prohibition of sale of tobacco to minors and all forms of tobacco advertisement, was enacted in 2006. This study aimed to examine the awareness of the TCL among high school students. A cross-sectional study was conducted in November 2015. Participants were 1,339 high school students (554 boys and 785 girls) from two regions and two states of Myanmar. Data were collected using anonymous self-administered questionnaires and revealed that 78.0% of boys and 86.5% of girls responded the sale of tobacco products in or within 100 feet from school, and 83.4% of boys had ever seen someone selling tobacco products to minors. More than half of the students had ever seen minors selling or distributing tobacco products, and had knowledge about the TCL, while only 9.7% knew about the penalties. The adjusted odds ratio (95% confidence interval) of awareness of the TCL was 2.12 (1.35-3.31) for students who had ever received tobacco products free of charge, or seen/heard about their distribution free of charge, 1.86 (1.20-2.89) for current smokeless tobacco users, and 0.58 (0.43-0.77) for students who had ever seen someone selling tobacco products to minors. The majority of high school students did not know that the violation of the TCL could be punished with a fine and/or imprisonment. These findings suggest that awareness of the TCL was very low among high school students, highlighting that TCL enforcement and compliance, and tobacco-related health education programs are not satisfactory in Myanmar.
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Affiliation(s)
- Nyi Nyi Latt
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Aung Myin Myint Mo Hospital, Gyobingauk, Myanmar
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Alagiyawanna AMAAP, Rajapaksa-Hewageegana N, Gunawardena N. The impact of multiple interventions to reduce household exposure to second-hand tobacco smoke among women: a cluster randomized controlled trial in Kalutara district, Sri Lanka. BMC Public Health 2017; 17:810. [PMID: 29037230 PMCID: PMC5644088 DOI: 10.1186/s12889-017-4820-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 10/04/2017] [Indexed: 11/29/2022] Open
Abstract
Background Second-hand smoke (SHS) in households remains a serious public health problem in Sri Lanka, partly due to a lack of voluntary prohibitions of tobacco smoking inside houses. Women are especially at risk of being exposed. Effective community based interventions to reduce the SHS in households targeting women is scarce. The objective of this study was to examine the impact of a multi-component intervention on household SHS exposure among Sri Lankan women. Methods Thirty clusters of 25 women (aged 18–65) from 750 households were randomized into the intervention and control groups. Women in the intervention group were exposed to activities which focused on improving knowledge on the health effects of SHS, attitudes towards SHS exposure, right to a smoke-free living and women empowerment against smoking. The duration of the intervention was six months. The comparison group received no intervention. The primary outcome of interest was self-reported SHS exposure in the household within 7 days prior to data collection. The secondary outcomes were exposure in the past 30 days, knowledge of the health risks of exposure, attitudes towards exposure, right to smoke-free living, women empowerment against smoking, and smoking inside the homes. Results Final assessment was in 329 (89.6%) in the intervention group and 309 (85.8%) in the comparison group. Following the intervention, significantly lower proportion of women in the intervention group as compared to the control group reported SHS exposure in their households within 7-days (9.2% vs. 15.3%, p = 0.02) and 30-days (13.6% vs. 21.6%, p = 0.008) prior to the post survey. As compared to the control group, significantly higher median scores were observed in the intervention group on the knowledge of the health risks of exposure to SHS (p < 0.001), attitudes on exposure to SHS (p = 0.004), right to smoke free living (p = 0.001) and women empowerment (p < 0.001). Conclusion Multi-component intervention activities were effective in reducing household exposure to SHS among women. Trial registration Sri Lanka Clinical Trials Registry SLCTR/2014/033. Electronic supplementary material The online version of this article (10.1186/s12889-017-4820-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A M A A P Alagiyawanna
- Ministry of Healthcare and Indigenous Medicine, Health Promotion Bureau, No 02, Kynsey Road, Colombo, 08, Sri Lanka.
| | - N Rajapaksa-Hewageegana
- Ministry of Healthcare and Indigenous Medicine, Health Promotion Bureau, No 02, Kynsey Road, Colombo, 08, Sri Lanka
| | - N Gunawardena
- Department of Community Medicine, University of Colombo, No.25, PO Box, 271 Kynsey Road, Colombo-08, Colombo, Western Province, Sri Lanka
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Boopathirajan R, Muthunarayanan L. Awareness, Attitude and Use of Tobacco among Medical Students in Chennai. J Lifestyle Med 2017; 7:27-34. [PMID: 28261558 PMCID: PMC5332118 DOI: 10.15280/jlm.2017.7.1.27] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/27/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Health professionals have an important role to play in the fight against tobacco. As individuals, health professionals can help educate the population; as community members, they can support anti-smoking policies; and, at a societal level, they can influence national and global tobacco control efforts. The objectives of the study was to estimate the prevalence of tobacco use among medical students in Chennai and to measure the extent of attitude toward, behavior around and knowledge of tobacco use among medical students. METHODS This cross-sectional study was conducted among 400 medical students from 4 randomly selected medical colleges, comprised of 1 government and 3 private medical colleges in and around Chennai, India. The Global Health Professional Students Survey (GHPSS), a standardized college-based tool, was administered to students in the four medical colleges. RESULTS The proportion of students who ever tried cigarette smoking was found to be 10.9% (males, 23.5% and females, 1.8%). The prevalence of exposure to tobacco smoke at home was found to be 34.2%. A majority of students agreed that smoking should be banned. The proportion of students who wanted to quit smoking cigarettes and who ever tried to stop smoking were 29.8% and 34.6% respectively. Only 23.6% of the students said they have received formal training in smoking cessation techniques. CONCLUSION As indicated by the majority of the medical students queried, there is a need for formal training in smoking cessation techniques, and this training should be included in the medical curriculum, such that students can instruct or counsel their patients.
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Affiliation(s)
- Ramkumar Boopathirajan
- Department of Community Medicine, SRM Medical College Hospital & Research Centre, Kattankulathur, Kanchipuram District, Tamil Nadu,
India
| | - Logaraj Muthunarayanan
- Department of Community Medicine, SRM Medical College Hospital & Research Centre, Kattankulathur, Kanchipuram District, Tamil Nadu,
India
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Abstract
BACKGROUND Tobacco control needs in India are large and complex. Evaluation of outcomes to date has been limited. AIM To review the extent of tobacco control measures, and the outcomes of associated trialled interventions, in India. METHODS Information was identified via database searches, journal hand-searches, reference and citation searching, and contact with experts. Studies of any population resident in India were included. Studies where outcomes were not yet available, not directly related to tobacco use, or not specific to India, were excluded. Pre-tested proformas were used for data extraction and quality assessment. Studies with reliability concerns were excluded from some aspects of analysis. The Framework Convention on Tobacco Control (FCTC) was use as a framework for synthesis. Heterogeneity limited meta-analysis options. Synthesis was therefore predominantly narrative. RESULTS Additional to the Global Tobacco Surveillance System data, 80 studies were identified, 45 without reliability concerns. Most related to education (FCTC Article 12) and tobacco-use cessation (Article 14). They indicated widespread understanding of tobacco-related harm, but less knowledge about specific consequences of use. Healthcare professionals reported low confidence in cessation assistance, in keeping with low levels of training. Training for schoolteachers also appeared suboptimal. Educational and cessation assistance interventions demonstrated positive impact on tobacco use. Studies relating to smoke-free policies (Article 8), tobacco advertisements and availability (Articles 13 and 16) indicated increasingly widespread smoke-free policies, but persistence of high levels of SHS exposure, tobacco promotions and availability-including to minors. Data relating to taxation/pricing and packaging (Articles 6 and 11) were limited. We did not identify any studies of product regulation, alternative employment strategies, or illicit trade (Articles 9, 10, 15 and 17). CONCLUSIONS Tobacco-use outcomes could be improved by school/community-based and adult education interventions, and cessation assistance, facilitated by training for health professionals and schoolteachers. Additional tobacco control measures should be assessed.
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McKay AJ, Patel RKK, Majeed A. Strategies for tobacco control in India: a systematic review. PLoS One 2015; 10:e0122610. [PMID: 25856462 PMCID: PMC4391913 DOI: 10.1371/journal.pone.0122610] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 02/21/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tobacco control needs in India are large and complex. Evaluation of outcomes to date has been limited. AIM To review the extent of tobacco control measures, and the outcomes of associated trialled interventions, in India. METHODS Information was identified via database searches, journal hand-searches, reference and citation searching, and contact with experts. Studies of any population resident in India were included. Studies where outcomes were not yet available, not directly related to tobacco use, or not specific to India, were excluded. Pre-tested proformas were used for data extraction and quality assessment. Studies with reliability concerns were excluded from some aspects of analysis. The Framework Convention on Tobacco Control (FCTC) was use as a framework for synthesis. Heterogeneity limited meta-analysis options. Synthesis was therefore predominantly narrative. RESULTS Additional to the Global Tobacco Surveillance System data, 80 studies were identified, 45 without reliability concerns. Most related to education (FCTC Article 12) and tobacco-use cessation (Article 14). They indicated widespread understanding of tobacco-related harm, but less knowledge about specific consequences of use. Healthcare professionals reported low confidence in cessation assistance, in keeping with low levels of training. Training for schoolteachers also appeared suboptimal. Educational and cessation assistance interventions demonstrated positive impact on tobacco use. Studies relating to smoke-free policies (Article 8), tobacco advertisements and availability (Articles 13 and 16) indicated increasingly widespread smoke-free policies, but persistence of high levels of SHS exposure, tobacco promotions and availability-including to minors. Data relating to taxation/pricing and packaging (Articles 6 and 11) were limited. We did not identify any studies of product regulation, alternative employment strategies, or illicit trade (Articles 9, 10, 15 and 17). CONCLUSIONS Tobacco-use outcomes could be improved by school/community-based and adult education interventions, and cessation assistance, facilitated by training for health professionals and schoolteachers. Additional tobacco control measures should be assessed.
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Affiliation(s)
- Ailsa J. McKay
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Dable RA, Wasnik PB, Pawar BR, Bopardikar SS, Nagmode SN. Assessment of professional competency and need of smoking cessation counseling for dental students. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2014; 11:26. [PMID: 25284069 PMCID: PMC4309932 DOI: 10.3352/jeehp.2014.11.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 10/05/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of this study was to analyze the smoking prevalence among dental students and to assess the need for promoting tobacco education and intervention by exploring their knowledge about smoking related risk factors. The study also examined the attitudes and practices of the students toward tobacco consumption, and their responsibilities toward the community. METHODS In total, 53 male students participated in the study (21 juniors and 32 seniors). The training program was divided into three modules, and the questionnaire was administered before and after the counseling sessions, which provided the comparative data on the students' views about smoking cessation. RESULTS The most commonly practiced mode of tobacco consumption was found to be cigarette smoking (90.6 %), while a few consumed Gutkha (9.4%). All the junior students (100%) reported to have been benefitted by the counseling program, while 68.8% of the students from the senior group reported the same. Bivariate statistical analysis was conducted using the Pearson's chi-square test for testing the difference across the age groups. P-values less than 0.05 were considered statistically significant. CONCLUSION Curbing tobacco influence on dental students in their initial days can ensure a smoke-free life for them, as well as prevents them from feeling embarrassed or experiencing a lack of confidence while seeing their patients. Thus, tobacco education and intervention programs can motivate the students and increase their potential to be credible advisors regarding smoking cessation.
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Affiliation(s)
- Rajani A. Dable
- Department of Prosthodontics, Guardian College of Dental Sciences and Research Centre, Ambernath, India
| | - Pradnya B. Wasnik
- Department of Endodontics, SMBT Dental College and Hospital Amrutnagar, Sangamner, India
| | - Babita R. Pawar
- Department of Periodontics, Pravara Rural Dental College and Hospital Loni, Loni, India
| | | | - Sunilkumar N. Nagmode
- Department of Orthodontics, SMBT Dental College and Hospital Amrutnagar, Sangamner, India
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