Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2015  |  Volume : 13  |  Issue : 1  |  Page : 24-29

Prevalence of tobacco use among 15-20 years old college students in Bengaluru city


1 Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
2 Department of Public Health Dentistry, Oxford Dental College and Hospital, Bengaluru, Karnataka, India
3 Department of Public Health Dentistry, Government Dental College and Research Institute Dental College and Hospital, Bengaluru, Karnataka, India

Date of Web Publication19-Mar-2015

Correspondence Address:
Dr. Vasudha Sharma
Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, No. 207, Kambipura, Kumbal Godu, Mysore Road, Bengaluru, Karnataka
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.153560

Rights and Permissions
  Abstract 

Introduction: Tobacco use in children and adolescents is reaching pandemic levels. The World Health Organization predicts that India will have the fastest rate of rise in deaths attributable to tobacco in the productive years of adult life, as a consequence of an addiction acquired in youth. Materials and Methods: A cross-sectional questionnaire study based on global youth tobacco survey was undertaken to study the prevalence of tobacco use among 15-20 years old college students. A simple random sampling method was used to select the students from Government and Private schools and Colleges in Bengaluru city. Results: In the study population of 2399 in the age group of 15-20 years, 307 (12.8%) subjects reported use of cigarettes among whom 176 (7.3%) reported current use and 240 (10%) reported ever use of smokeless tobacco. Majority 226 (73.6%) belonged to private institutions and 81 (26.4%) to government institutions. About 41 (1.7%) were daily smokers. Conclusion: Prevalence of smoking was much higher among the private institution students as opposed to students of government institutions; also, it was observed that the percentage of smokeless tobacco users were higher in this age group when compared to cigarette smokers.

Keywords: Global youth tobacco survey, smokeless tobacco use, tobacco use


How to cite this article:
Sharma V, Hiremath S S, Puranik M, Somasundara S. Prevalence of tobacco use among 15-20 years old college students in Bengaluru city. J Indian Assoc Public Health Dent 2015;13:24-9

How to cite this URL:
Sharma V, Hiremath S S, Puranik M, Somasundara S. Prevalence of tobacco use among 15-20 years old college students in Bengaluru city. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2019 Dec 6];13:24-9. Available from: http://www.jiaphd.org/text.asp?2015/13/1/24/153560


  Introduction Top


Tobacco use is a serious public health challenge in several regions of the world. According to estimates made by the World Health Organization (WHO), currently about 5 million people die prematurely every year in the world due to the use of tobacco, mostly cigarette smoking. By 2030, it would double to 10 million deaths every year, with about 7 million of the deaths taking place in developing countries. India will have the fastest rate of rise in deaths attributable to tobacco and many of these will occur in the productive years of adult life, as a consequence of an addiction acquired in youth. [1]

The global literature is only of limited help in assessing the problem of tobacco use in India since the dominant and the most researched form of tobacco use globally is cigarette smoking. In India, cigarette smoking comprises a small part of the tobacco smoking problem and a minor part of the overall tobacco problem, a major problem being beedi smoking, and the oral use of smokeless tobacco products. Adolescents are the most vulnerable population to initiate tobacco use. However, it is now well established that most of the adult users of tobacco start tobacco use in childhood or adolescence. [2]

Many studies across the world and in the country have focused on 13-15 years age group using global youth tobacco survey (GYTS) while global adult tobacco survey has been used for adult population. The present study was an attempt to specifically study the pattern tobacco use both smoking and smokeless forms among the 15-20 years old as 15 years is a transition age group from school to college, which offers more freedom than rigid school systems and 17 years is transition from junior college to senior college in our country. However, very few studies have been conducted with respect to prevalence of use of tobacco in any form among especially college going students in our country. Hence, the aim of the study was to assess the prevalence of smoking and smokeless tobacco use among 15-20 years old college students in Bengaluru city.


  Materials and Methods Top


This was a cross-sectional questionnaire-based study conducted on 15-20 years old college students in Bengaluru city. List of colleges was obtained from The Directorate of Pre University Education Bengaluru and collegiate education.

Colleges in Bengaluru are divided into north and south zones with 306 colleges in south and 236 colleges in north zone respectively. From north Zone, 4 Government and 1 Private College and from south zone, 3 Government and 3 Private Colleges offering pre university and degree courses were selected randomly until the required sample size was satisfied. The study participants were selected using simple random sampling from I st year, II nd year pre university and I st , II nd and III rd year degree students to suit the age group of the study.

A pilot study was conducted, and the population proportion of tobacco use was estimated at 40%. Based on this, sample size was estimated at 2304 subjects. It was then rounded off to 2400 study subjects.

Ethical clearance was obtained by the institutional ethical committee. Necessary permissions were obtained from Board of Pre-University and collegiate education and the study and colleges. The required permissions to conduct the study were taken from the college authorities.

The study participants were allotted a number and were asked not to disclose their name to protect the confidentiality of the information provided. Demographic information regarding the age, sex, education, parental education level, occupation and socioeconomic status was collected. Information regarding smoking and use of smokeless tobacco among students were ascertained using a questionnaire derived from the GYTS [3] and modified to suit the present study. The students were asked to assemble in a classroom and explained the purpose of the study. The questionnaire was then administered and was collected after they had completed answering all questions.

Ascertainment of tobacco exposure was done using the terminologies suggested by GYTS. Ever users of cigarettes or ever smokers were defined as those who reported having smoked >100 cigarettes during their lifetime. Current smokers were defined as those who reported having smoked >100 cigarettes during their lifetime and who currently smoked every day or some days. Never smokers were defined as those who reported not having smoked >100 cigarettes during their lifetime. Ever use of tobacco products other than cigarette was defined as having used these products at least 20 times in their life. The category of current smokers in this study included those who reported to be occasional smokers, frequent smoker and daily smokers.

Descriptive statistics was used to analyze the data. Statistical analysis was performed using SPSS version 14 (spss inc. Chicago, USA).


  Results Top


Demographic profile

[Table 1] shows the distribution of participants in different age groups. Of 2400 students, one student did not respond and hence statistical analysis and result reporting was done using the final sample of 2399 students: 1391 (57.9%) belonged to private institution and 1009 (42.04%) to government institutions. About 1366 (57%) were males, and 1033 (43%) were females.
Table 1: Demographic profile


Click here to view


Prevalence of smoking in various groups

Prevalence of ever use


In the study population of 2399, 307 (12.8%) subjects reported ever use of cigarette, 262 (85.3%) were males and 45 (14.9%) were females, 226 (73.6%) belonged to private institutions and 81 (26.4%) to government institutions

Prevalence of current use of cigarettes

In the present study, 176 (7.3%) reported current use of cigarette. Among the 176 students who reported current use, 123 (5.1%) were ex-smokers, 112 (4.7%) were occasional smokers, 23 (1%) were frequent smokers and a total of 41 (1.7%) reported to be daily smokers. Among the 1367 males, 16% reported ever use of cigarette and among the 1033 females, 4.5% reported ever use of cigarette. [Table 2] shows the distribution of current smokers with respect to gender.
Table 2: Distribution of current smokers with respect to gender


Click here to view


Distribution of study population with respect to current use of cigarettes and age

Out of 176 current users of cigarette, 2 (1.1%) students were of the age 15 years; 20 (11.3%) were 16 years old; about 41 (23.2%) were 17 years of age; 48 (27.2%) were 18 years of age; 30 (17%) students were 19 years of age and 35 (19.8%) were 20 years old. Of the 41 subjects who were daily smokers, 1 (2.4%) student was of the age 15 years; 1 (2.4%) was 16 years old; 7 (17.1%) were 17 years of age; 16 (39%) subjects were 18 years of age and 12 (29.3%) were 20 years of age.

Distribution of study population with respect to age, gender and current use of cigarettes

Out of 147 males who were current users of cigarette, 2 (1.3%) students were of the age 15 years, 15 (10.2%) were 16 years old, about 36 (24.4%) were 17 years of age, 37 (24.5%) were 18 years of age, 26 (17.6%) students were 19 years of age and 31 (21%) were 20 years old.

Out of 29 females who were current users of cigarette, 5 (17.2%) were 16 years old, about 5 (17.2%) were 17 years of age, 11 (37.9%) were 18 years of age, 4 (13.7%) students were 19 years of age and 4 (13.7%) were 20 years old.

Distribution of study population with respect to age of initiation of the habit among pre university and degree groups

Among the 307 ever smokers, 89 (28.9%) reported smoking before the age of 15 and 218 (71.1%) reported smoking after the age of 15 years. [Table 3] shows the age of initiation among ever smokers.
Table 3: Distribution of ever users of cigarettes with respect to age of initiation of the habit and education category


Click here to view


Prevalence of use of tobacco products other than cigarettes

Distribution of users of tobacco products other than cigarettes among the pre university and degree group


Among the total population of 2399 students, 240 (10%) of the students have reported ever use of tobacco products like guthka, khaini, snuff, hookah. Among the 240 students who reported ever use, 106 (44.1%) belonged to the pre university category and 134 (55.8%) were degree students.

Among the 176 who reported current use of cigarettes, 51 (28.9%) reported ever use of tobacco products like guthka, khaini, snuff, hookah Furthermore, it was observed that 14 (34%) of the daily smokers reported concurrent ever use of smokeless tobacco and among the students who reported no use of cigarettes, 153 (6.3%) reported use of only smokeless tobacco. [Table 4] shows the distribution of ever users of tobacco products other than cigarettes among students in different college categories. [Table 5] shows the ever use of tobacco products other than cigarettes among students who reported to be current smokers.
Table 4: Distribution of students reporting ever use of tobacco products other than cigarettes with and education category and college category


Click here to view
Table 5: Distribution of current users of cigarette reporting ever use of tobacco products other than cigarettes with education category and college category


Click here to view



  Discussion Top


Tobacco use is one of the major preventable causes of premature death and disease in the world. The WHO estimated that the proportion of deaths that result from tobacco-related diseases will rise in India, from 1.4% of all deaths in 1990 to 13.3% of all deaths in 2020. In India's case, the population is expected to grow by about 300 million between 2000 and 2020. [1] Most of the expansion will occur in the age group of 15-20 years.

Prevalence of ever users and current users

In the present study, among the total population, 176 (7.3%) reported current use of cigarettes, 147 (6.1%) males and 29 (1.2%) females reported current cigarette use. A study in Haryana in 1995 among adolescents [4] and 2002 among college students [2] reported 7.1%, which is similar to the present study. Whereas, according to GYTS - India 2002-2004, [1] prevalence of current smoking among students was 8.3%, study among college students in Andhra Pradesh, [5] prevalence of current smokers was 8.2%, CDC-MMWR [6] reported 9.2%, Western Nepal 2007 [7] reported 9.4% and in a study in Greece [8] in 2007, 10.4% students were current smokers. Study in Maharashtra 1998 [9] reported 10.6%, country wide study in 2004 [10] reported 19.4%, Youth tobacco surveillance New York [11] reported 16.3% and Georgia youth tobacco survey [12] reported 14% which is much higher, this can be attributed to sociocultural and geographic differences.

Among the 307 ever users, the majority 226 (73.6%) belonged to private institutions and 81 (26.4%) to government institutions, whereas in a study in Chennai in 2006 [13] reported that smoking was more in the corporation students which is not in line with the present study. Similarly, a study in Delhi and Chennai 2004 [14] has reported that the prevalence of ever smoking was 18.9% in government sector when compared to 12.2% in private sector which is again, not in line with this study. Among the 176 current smokers, 132 (72%) belong to private institutions and 44 (18%) belong to government institutions. Of the 41 daily smokers, 25 (60.9%) are from private institutions and 16 (39.9%) are from government institutions. Whereas in a study in Bombay in 1991 [15] reported that 22.5% of the smokers belonged to private English institution when compared to 13.8% in the municipal sector, which is less than the present study.

Age of initiation

In the present study, nearly 29% reported initiation of ever use of cigarette before the age of 15 similar to other studies, however, the age range of initiation spans from as low as 10 years in certain studies to as high as 18. Among the 307 ever users 89 (28.9%) reported smoking before the age of 15 and 218 (71.1%) reported smoking after the age of 15 years whereas in the study in Western Nepal 2007 [7] 89.6% of ever smokers had initiated smoking between the ages 12 and 18 years with a median age of 16 years and 30.2% of ever smokers initiated before the age of 15 years. In a study in Uganda 2004, [16] 37.8% had smoked before the age of 10 years. Whereas a study in Harayana in 1995 among adolescents [4] reported that the majority of smokers had started at the age of 10-15 years and almost 36% had smoked before the age of 10 years. Whereas study in 2002 among college students, [2] reported that 40% of students, majority males had started the habit between the ages of 10 and 15 years. However, in a study in Karachi 2007 [17] reported that the mean age of starting cigarette in males was 13.1 years.

There has been reporting of different ages with respect to age of initiation in various studies. This may be on account of the various age groups used in these studies and also to the cultural differences in the study populations of these studies. There may be differences also due to the fact that the age of initiation again is self-reported by the participant.

Age of current smokers

Out of 176 current users of cigarette, 2 (1.1%) students were of the age 15 years, 20 (11.3%) were 16 years old, about 41 (23.2%) were 17 years of age, 48 (27.2%) were 18 years of age, 30 (17%) students were 19 years of age and 35 (19.8%) were 20 years old.

On the whole, among the current users, use of cigarettes was seen more in the age group of 17-20 years. However, a study in Alaska 2004 [18] reported than cigarette smoking seems to peak at the ages from 18 to 24 years.

Prevalence of use of tobacco products other than cigarettes

In the present study, the overall prevalence of smokeless tobacco use is about 10%, there was a wide variation of percentage of tobacco products other than cigarettes use, ranging from 10% to as high as 55.6%. According to the GYTS - India 2002-2004, [1] 14.6% were the current smokeless tobacco users ranging from 2% in Himachal Pradesh to 55.6% in Bihar. In the GYTS 2002 in Uttaranchal, [19] the prevalence was 17.6%, higher than the present study; in a study in Jamnagar 2007, [20] the prevalence of smokeless tobacco use among 17-19 years age group was 36.26%, much higher than the present study. Maharashtra 1998 [9] study reported 6.7%, A study in Mumbai 2006 [21] reported overall smokeless tobacco use as 10% which is comparable to the present study. In a study in Greece [8] in 2007, the prevalence of smokeless tobacco use was 10.9%.Whereas, the prevalence of smokeless tobacco in Canada 2004 [22] was 14%. Tobacco use survey in high school students in US [6] showed the prevalence to be 12.8%, Karachi 2007 [17] was 16.1%. According to Florida youth tobacco survey-2006, [23] current smokeless tobacco use among high school students is about 6%, Youth Tobacco Surveillance, New York [11] reported 3.2%, CTUMS Ontario [24] reported use among 15-19 years old youth as 7%, Western Nepal 2007 [7] study reported 6.5%, which is lower than the present study.

It was also observed that the percentage of smokeless tobacco users was slightly higher in the students from the private institution when compared to government, also was higher among the degree students than pre-university students.

The prevalence of smokeless tobacco use among these students was much higher than use of cigarettes. Some of the reasons for this trend may be that smokeless tobacco consumption can be done more discreetly as there is no associated smoke or odor, can be used inside classrooms. Comparatively more economical compared with cigarettes as a single packet can be used over an entire day. The small pouches can be concealed easily and also easier to hide the habit from family members.

Limitations

Global youth tobacco survey is limited to students especially in the ages 13-15 years and most of the data are available from sporadic surveys is in this age group. The present study was conducted on age groups 15 through 20 years and hence comparability was limited. Furthermore, in India, there is a huge dropout rate in education after schooling, it is important that tobacco use survey must be extended to those youth who do not attend schools or colleges.

Second, these data apply only to youths who were in college on the day of the survey and who completed the survey. However, student response rates were high suggesting that bias attributable to absence or nonresponse was limited. Finally, data were based on the self-report of students, who might underreport or overreport their behaviors or attitudes. The extent of this bias cannot be determined from these data.


  Conclusion Top


The gloomy predictions about the growing magnitude of tobacco threat to India relate to a rise both in the proportion of deaths attributable to tobacco and in the absolute number of persons who consume tobacco. The age group of 15-20 encompasses most of the high school/pre university and degree students, which is most vulnerable to acquiring and continuing the tobacco addiction. It was observed in this study among the 176 current smokers, 72% belong to private institutions and 18% belong to government institutions. Of the 41 daily smokers, 60.9% are from private institutions and 39.9% are from government institutions. The prevalence of smoking was much higher in the private institution as opposed to government institutions; this may be attributed to greater financial independence of students in private institutions, prevalent peer pressure. Also, it was observed that the percentage of smokeless tobacco users were higher in this age group as compared to cigarette smokers.

Therefore, it is necessary to monitor the trends in age of initiation as well as the prevalence of tobacco usage patterns in this age group of college going students at the national level. Measures to curb the increasing use of tobacco among the youth have to be enforced more strictly.

 
  References Top

1.
Reddy KS. Report on Tobacco Control in India (New Delhi, India); 25 November, 2004. Available from: http://www.who.int/.Annex6_Report_on_Tobacco_Control_in_India_2004. [Last accessed on 2008 Oct 02].  Back to cited text no. 1
    
2.
Chadda R, Sengupta S. Tobacco use by Indian adolescents. Tob Induc Dis 2002;1:111-9.  Back to cited text no. 2
    
3.
Global Youth Tobacco Survey Collaborative Group. Global Youth Tobacco Survey (GYTS). Geneva: WORLD HEALTH ORGANISATION, Core Questionnaire with Optional Questions; 2007.  Back to cited text no. 3
    
4.
Kapoor SK, Anand K, Kumar G. Prevalence of tobacco use among school and college going adolescents of Haryana. Indian J Pediatr 1995;62:461-6.  Back to cited text no. 4
    
5.
Gavarasana S, Doddi VP, Prasad GV, Allam A, Murthy BS. A smoking survey of college students in India: Implications for designing an antismoking policy. Jpn J Cancer Res 1991;82:142-5.  Back to cited text no. 5
    
6.
From the Centers for Disease Control and Prevention. Tobacco use among middle and high school students - United States, 1999. JAMA 2000;283:1134-6.  Back to cited text no. 6
[PUBMED]    
7.
Sreeramareddy CT, Kishore P, Paudel J, Menezes RG. Prevalence and correlates of tobacco use amongst junior collegiates in twin cities of western Nepal: A cross-sectional, questionnaire-based survey. BMC Public Health 2008;8:97.  Back to cited text no. 7
    
8.
Kyrlesi A, Soteriades ES, Warren CW, Kremastinou J, Papastergiou P, Jones NR, et al. Tobacco use among students aged 13-15 years in Greece: The GYTS project. BMC Public Health 2007;7:3.  Back to cited text no. 8
    
9.
Hans G, Tobacco Use Survey India. Tobacco/Panmasala Use Survey. Prevention of Cancer in Youth with Particular Reference to Intake of Paan Masala and Gutkha. NSS Unit, TISS, Mumbai, India; 1998.  Back to cited text no. 9
    
10.
Sinha DN, Gupta PC, Pednekar M. Tobacco use among students in Bihar (India). Indian J Public Health 2004;48:111-7.  Back to cited text no. 10
[PUBMED]  Medknow Journal  
11.
Youth Tobacco Surveillance New York State, 2006. Available from: https://www.health.ny.gov/../tobacco_control/youth_tobacco_survey. [Last accessed on 2008 Nov 13].  Back to cited text no. 11
    
12.
Georgia Youth Tobacco Survey was Conducted in 1999, the Report was Published as a Compilation of Tobacco Use Surveillance Summary Report Across us From 1998 to 1999, Department of Health MMWR Report in 2012.  Back to cited text no. 12
    
13.
Madan Kumar PD, Poorni S, Ramachandran S. Tobacco use among school children in Chennai city, India. Indian J Cancer 2006;43:127-31.  Back to cited text no. 13
[PUBMED]  Medknow Journal  
14.
Mathur C, Stigler MH, Perry CL, Arora M, Reddy KS. Differences in prevalence of tobacco use among Indian urban youth: The role of socioeconomic status. Nicotine Tob Res 2008;10:109-16.  Back to cited text no. 14
    
15.
Jayant K, Notani PN, Gulati SS, Gadre VV. Tobacco usage in school children in Bombay, India. A study of knowledge, attitude and practise. Indian J Cancer 1991;28:139-47.  Back to cited text no. 15
[PUBMED]    
16.
Mpabulungi L, Muula AS. Tobacco use among high school students in Kampala, Uganda: Questionnaire study University of Malawi College of Medicine, Malawi. Stud Croat Med J 2004;45:80-3.  Back to cited text no. 16
    
17.
Rozi S, Akhtar S. Prevalence and predictors of smokeless tobacco use among high-school males in Karachi, Pakistan. East Mediterr Health J 2007;13:916-24.  Back to cited text no. 17
    
18.
Gilbertson J, Mandsager R, Middaugh J. Smokeless Tobacco Use in Alaska. Vol. 8. USA: Department of Health and Social Services, Division of Public Health, Section of Epidemiology Bulletin; 2004.  Back to cited text no. 18
    
19.
Sinha DN. Report on GYTS Uttaranchal 2002. p. 132-7. Available from: http://www.researchgate.net/.../228720208_Report_on_Global_Youth_Tobacco.  Back to cited text no. 19
    
20.
Makwana NR, Shah VR, Yadav S. A study on prevalence of smoking and tobacco chewing among adolescents in rural areas of Jamnagar District, Gujarat State. J Med Sci Res 2007;1:47-9.  Back to cited text no. 20
    
21.
Mukherjee K, Hadaye RS. Gutkha consumption and its determinants among secondary school male students . Indian J Pediatr 2006: 31:177.  Back to cited text no. 21
    
22.
Wyckham RG. Smokeless tobacco in Canada: Deterring market development. Tob Control 1999;8:411-20.  Back to cited text no. 22
    
23.
Youth Smokeless Tobacco Use, 2006 Florida Youth Tobacco Survey. Available from: http://www.edocs.dlis.state.fl.us/.../tobacco/.../Fact_Sheet_3_Smokeless_Tobacco_Us. [Last accessed on 2008 Nov 13].  Back to cited text no. 23
    
24.
What Population Surveys Say about Smokeless Tobacco Use. Canadian Tobacco Use Monitoring Survey (CTUMS) Ontario Tobacco Research Unit, Canada; October, 2006.  Back to cited text no. 24
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]


This article has been cited by
1 Potential roles of school administrators and community-residing adults in tobacco use prevention in Nigerian college students: a viewpoint
Anthonia U. Nwobi,Chiedu Eseadi,Mathias U Agboeze,Onyinyechi E Okoye,Felicia Ukamaka Iremeka,Felicia Mbagwu,Nkiru Christiana Ohia,Okechukwu O. Nwaubani,Angie I. Oboegbulem,Immaculata N. Akaneme
Journal of International Medical Research. 2018; 46(11): 4412
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed2255    
    Printed37    
    Emailed0    
    PDF Downloaded328    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]