|Year : 2015 | Volume
| Issue : 2 | Page : 169-173
Prevalence and pattern of tobacco related habits among the college students of Satara district
Santosh Khude1, Renuka Pawar2, KM Shivakumar1, Snehal Patil1, KV Suresh3, Vidya Kadashetti4
1 Department of Public Health Dentistry, School of Dental Sciences, Krishna Institute of Medical Sciences University, Karad, Satara, Maharashtra, India
2 Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Institute of Medical Sciences University, Karad, Satara, Maharashtra, India
3 Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences University, Karad, Satara, Maharashtra, India
4 Department of Oral pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences University, Karad, Satara, Maharashtra, India
|Date of Web Publication||18-Jun-2015|
K M Shivakumar
School of Dental Sciences, Krishna Institute of Medical Sciences University, Karad - 415 110, Satara, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Tobacco use is a leading cause of preventable deaths worldwide, more so in developing countries like India. Tobacco consumption in various forms has been an integral part of Indian culture since many decades. Since few years, the vices of tobacco consumption have come to the forefront in various populations across the world. Aims: To evaluate the prevalence and pattern of tobacco related habits and also reasons for the initiation of tobacco use among the college students in Satara district. Materials and Methods: A descriptive cross-sectional study was conducted among the selected college students in Western Maharashtra. List of colleges in Western Maharashtra was obtained and permission to conduct the study was obtained from randomly selected colleges. A standardized questionnaire (Global Youth Tobacco Survey) regarding the tobacco related habits use was administered to the study subjects. Statistical analysis was performed using SPSS Ver 20.0 with P < 0.05. Results: Of the total sample of 500 subjects of age group 18-25 years, 65% were males and 35% females. The prevalence of tobacco was found to be 47.2% with 44.2% among boys and 3% among girls. Association between father's and friend's tobacco habits was observed. Conclusions: The prevalence of self-reported tobacco consumption was substantial among the college going students of Satara district.
Keywords: Adolescent, pattern of tobacco, prevalence, tobacco
|How to cite this article:|
Khude S, Pawar R, Shivakumar K M, Patil S, Suresh K V, Kadashetti V. Prevalence and pattern of tobacco related habits among the college students of Satara district. J Indian Assoc Public Health Dent 2015;13:169-73
|How to cite this URL:|
Khude S, Pawar R, Shivakumar K M, Patil S, Suresh K V, Kadashetti V. Prevalence and pattern of tobacco related habits among the college students of Satara district. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 6];13:169-73. Available from: http://www.jiaphd.org/text.asp?2015/13/2/169/159057
| Introduction|| |
Drug use, misuse or abuse is primarily due to the nature of the drug abused, the personality of the individual and the addict's immediate environment.  Of the various drugs abused, the most widely distributed and commonly used drug in the world is "tobacco." Many social, economical, and political factors have contributed to the global spread of tobacco consumption.  The fast changing social milieus, social sanctions, and other factors are mainly contributing to this proliferation and has posed a serious challenge to individuals, families, societies, and nations. 
Tobacco consumption in various forms has been an integral part of Indian culture since many centuries. In the past few years, the vices of tobacco consumption have come to the forefront in various populations across the world.  Adolescents are increasingly being exposed to tobacco and tobacco related habits. Tobacco induced diseases are growing globally.  These diseases are the leading cause of mortality and morbidity. It has been observed that the age of initiation of tobacco related habit has a direct influence on the survival and related diseases in the individuals. 
Smoking of cigarette particularly beedis and chewing tobacco (smokeless use) is an age-old practice in India. However, according to anecdotal evidence with the changes in the dynamics of societies, the prevalence of smoking among women and young children has increased many folds and present a significant public health problem. 
The tobacco situation in India is unique because of a vast spectrum of tobacco products available for smoking as well as smokeless use. The risks of tobacco use are highest among those who start early and continue its use for a long period.  The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. The most common reasons cited for children to start using tobacco are peer pressure, parental tobacco habits, and pocket money given to children.  It is seen that smoking and drinking become symbols of maturity and independence, among the young people. For them, the use of tobacco provides an opportunity for taking part in a behavior that defies established social norms.  Boys are more likely than girls to smoke, drink, and use drugs. This holds true in developing countries too, although rates for girls are increasing faster. 
The behaviors of the important people in the immediate environment of the adolescents whom they may look up to as role models are likely to influence the activities of the adolescents. Hence, this study was conducted with an aim to assess the prevalence of tobacco use (smoked and smokeless/chewable) among the college students of Satara district.
| Materials and methods|| |
A descriptive cross-sectional study was conducted among the selected college students in Western Maharashtra. As per the results of the pilot study, the sample size of 500 study subjects was determined with the probability of 90% and error of 5%. List of colleges in Western Maharashtra was obtained and colleges were selected by systematic random sampling technique. Permission to conduct the study was obtained from colleges. From these colleges, subjects were selected by simple random sampling technique. Ethical approval to conduct this study was obtained from the Ethics Committee of the University. Informed consent was obtained from the participants.
All the students in the selected classes, present on the day of the survey, were eligible to participate, allowing for anonymous and voluntary participation. A standardized questionnaire based on the Global Youth Tobacco Survey (GYTS) regarding the tobacco related habits, frequency, age of initiation and factors encouraging and discouraging tobacco use was administered on the students. The questionnaire was translated to Marathi (local language) and back translated to English by a bilingual expert. Reliability and validity of the questionnaire were assessed prior to the start of the study. "Ever use of tobacco" was defined as the use of tobacco even once including current tobacco use.  To define smoking status, students were asked if they had ever smoked a cigarette. If yes, they were classified as ever smokers. Ever smokers were those who had smoked more than 100 cigarettes in their entire life.
Statistical analysis was conducted using SPSS version 20 (SPSS Inc., Chicago, IL, U.S.A). At the time of data analysis, the forms of respondents who had stated their age to be either <18 years or more than 25 years were excluded from the analysis. Descriptive statistics was used to assess all the parameters.
| Results|| |
Of 500 subjects, 46.4% of the sample belonged to the age group of 22-23 years of age, 27.4% in the age group of 20-21 years, 16.4% in 24-25 years of age, and 9.8% in 18-19 years of age. 65% of participants were males and 35% compared to females [Table 1].
Of 500 participants, 236 were using tobacco products, of which 78 (15.6%) subjects were using smoked tobacco, 119 (23.8%) used chewable tobacco, and 59 (11.8%) subjects used both. The overall prevalence observed was (48.2%). The overall prevalence among boys was 44.2%. The highest prevalence observed among boys was in the age 22 and 23 years followed by 20-21 years. About 48.30% of subjects started using tobacco due to the influence of friends followed by 28.81% for the sake of fun. 70.7% subjects used tobacco outside with friends followed by 16.9% near the college.
Of 236 subjects, 48.30% of the sample started using tobacco due to influence of friends, 28.81% of the subjects started using tobacco for fun, 17.37% of the population started using tobacco due to others, and 5.5% of the population started using tobacco for inquisitiveness [Table 2].
Of 236, 26 (11%) of subjects used tobacco once a day/month, 151 (63.9%) majority of the subjects used 10 times a month, and 59 (25%) subjects used more than 3-5 times. 356 (71.2%), subjects reported usage of tobacco by friends.
Majority subjects used tobacco outside with friends (70.7%) and 39 (16.5%) of participants bought tobacco to their parents [Table 3].
|Table 3: Distribution of participants based on the response of the questions|
Click here to view
About 78 subjects are prone to tobacco habit were exclusive smokers (A), 119 were Exclusive tobacco chewers (B), 59 subjects used both forms of tobacco (smoking and chewing simultaneously) (C), 137 subjects were Ever smokers (A + C), 178 were Ever tobacco chewers (B + C), 236 were ever tobacco users (A + B + C). Overall, the prevalence of tobacco use in any form was significantly more in males as compared to females (P < 0.05) [Table 4].
| Discussion|| |
Majority of the tobacco related deaths occur in developing countries where the problem of tobacco is increasing in alarming proportions. A study in Gujarat State, India, showed a downward shift in age of initiation of this habit which is a matter of serious concern.  The prevalence of tobacco use among school students in different States of India has been reported to vary from 1.9% (Delhi) to 75.3% (Mizoram). ,,,,,,,
The prevalence of "ever use of tobacco" in the present study was 48.2% which is much higher than the 37.2% (boys: 39.2%, girls: 31.9%) reported by GYTS conducted in Uttar Pradesh.  Lower prevalence in Noida city may actually reflect the rates of its neighboring city of Delhi, as a large proportion of school students in Noida are residents of Delhi. Though tobacco use is on rise among girl students, we found the habit to be still a little less prevalent in girls than in boys. This observation is corroborated by other Indian studies. ,,
The overall prevalence of "exclusive smoking" (15.6%) in the present survey was also quite higher in comparison to studies done in Haryana (12.0%)  and Jamnagar (14.6%)  and Bangalore (7.3%). 
According to GYTS 1999-2001, most countries viz. AFRO, AMRO/PAHO, EMRO, EURO, WPRO, and SEARO also reported higher prevalence of "ever smoking" varying from 10.2 to 73.6% except Nepal where lower prevalence rate (6.5%) was reported.  "Ever use of tobacco," particularly the use of smokeless tobacco products, was found to be more common in boys in comparison to girls. This has considerable public health implication as it is known that people change over from smokeless form to smoking over a period of time. Our findings are in accordance with the results of Mathur et al. 
Low socioeconomic status of students may be responsible using smokeless tobacco, since being relatively inexpensive and readily available; these children often see tobacco as an alternative to food. Chewing of these products is considered less harmful than smoking. Increasing practice of tobacco use in private schools may be attributed to peer pressure, rising influence of western culture, rapid urbanization, increased disposable income in the affluent families, tobacco use by their role models, parental habits, media promotion, best friends, and easy availability. 
In the present study, prevalence of smoking was 15.6% (boys: 15% and girls: 0.6%). A study in United Arab Emirates reported that the smoking prevalence in adolescents was 14.3% among boys and 2.9% among girls.  A study among French adolescents showed the prevalence of smoking habit among males and females almost same, that is, 15.4% and 15.8%, respectively.  In Canada, a school-based survey has reported 27.8% of the school students as regular smokers and observed an increase in the smoking habit over the years, from 1991 to 2001.  Among Dutch students, 36.5% lifetime smoking prevalence among 12-14 years school students was reported by Otten et al. 
Lovato et al. reported the mean prevalence of smoking among school children in all age groups as 22.0 ± 3.37% and the mean prevalence of smoking among 15-19 years as 20.3 ± 8.30%. 
In India, a study conducted in Bangalore reported a prevalence of 6.8% smoking among 13-15 years aged students.  A 3% overall prevalence was reported in Punjab during a survey conducted by Siziya et al. and also it was noted that smoking was more prevalent among males compared to females.
A cross sectional study in Noida city reported an overall Ever smoking prevalence of 8.8% and also observed no significant difference between the genders regarding the use of other tobacco items such as hokkah, pipe, cigars and ganja, which was more prevalent among males (Narain et al). 
An interventional study conducted in Baltimore and Maryland school children reported that 46% controls were regular smokers and the treated school children for smoking was 49%. 
To the best of our knowledge, this is the first study of its kind in assessing the prevalence of tobacco related habit among college students of Western Maharashtra. In this study, an attempt was made to assess the prevalence of tobacco habits among college students. The results of this work will be instrumental in assessing the prevalence of tobacco related habits in Western Maharashtra. This will help in formulating strategies to achieve tobacco free society. This will also act as a surrogate measure to assess the effectiveness of the ban imposed by the government on sale of tobacco.
This study was carried out in rural areas of the country which can be considered as a limitation of the study. Inclusion of a urban setting will help in getting a better insight into the trends of student tobacco use among all the settings. More such surveys need to be carried out in other large cities of the country in order and to build a comprehensive database for future policy decisions on anti-tobacco campaigns.
| Conclusion|| |
This present survey indicates a high prevalence of tobacco habit by college students. The peer group influence was the reason for initiating this habit in majority of the users. It is better to prevent the initiation of the habit than trying to stop the habit, highlighting the role of primordial prevention. There is a need for college based tobacco prevention programs.
| References|| |
Ramakrishna GS, Sankara Sarma P, Thankappan KR. Tobacco use among medical students in Orissa. Natl Med J India 2005;18:285-9.
Narain R, Sardana S, Gupta S, Sehgal A. Age at initiation and prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey. Indian J Med Res 2011;133:300-7.
Reddy KS, Arora M. Tobacco use among children in India: A burgeoning epidemic. Indian Pediatr 2005;42:757-61.
Mohan S, Sankara Sarma P, Thankappan KR. Access to pocket money and low educational performance predict tobacco use among adolescent boys in Kerala, India. Prev Med 2005;41:685-92.
Deltels R, Holland WW, McEwen J, editors. Oxford Textbook of Public Health. 3 rd
ed., Vol. 3. Oxford: Oxford University Press; 1997.
World Health Organization. What about boys: A literature review on the health and development of adolescent boys. Geneva: WHO; 2002.
Bala DV, Bodiwala IN, Patel DD, Shah PM. Epidemiological determinants of tobacco use in Gujarat State, India. Indian J Community Med 2006;31:173-6.
Madan Kumar PD, Poorni S, Ramachandran S. Tobacco use among school children in Chennai city, India. Indian J Cancer 2006;43:127-31.
Bhojani UM, Chander SJ, Devadasan N. Tobacco use and related factors among pre-university students in a college in Bangalore, India. Natl Med J India 2009;22:294-7.
Sinha DN, Gupta PC, Pednekar MS. Tobacco use among students in the eight North-eastern states of India. Indian J Cancer 2003;40:43-59.
Singh V, Pal HR, Mehta M, Dwivedi SN, Kapil U. Pattern of tobacco use among school children in National Capital Territory (NCT). Indian J Pediatr 2007;74:1013-20.
Kapil U, Goindi G, Singh V, Kaur S, Singh P. Consumption of tobacco, alcohol and betel leaf amongst school children in Delhi. Indian J Pediatr 2005;72:993.
Pednekar MS, Gupta PC. Tobacco use among school students in Goa, India. Indian J Public Health 2004;48:147-52.
Gajalakshmi V, Asma S, Warren CW. Tobacco survey among youth in South India. Asian Pac J Cancer Prev 2004;5:273-8.
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.
Sinha DN. Report on the Results of the Global Youth Tobacco Survey in Uttar Pradesh, India; 2002. Available from: http://www.searo.who.int/LinkFiles/GYTSRepUttarPradesh_2002.pdf. [Last accessed on 2005 Jul 25].
Chadda R, Sengupta S. Tobacco use by Indian adolescents. Tob Induc Dis 2002;1:111-9.
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.
Sharma V, Hiremath SS, 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.
Global Youth Tabacco Survey Collaborative Group. Tobacco use among youth: A cross country comparison. Tob Control 2002;11:252-70.
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.
Saab BH. Tobacco Use Among Young People in UAE. Proceedings of the 12 th
World Conference on Tobacco or Health, Helsinki; 2003.
Botelho F, Lopes C, Barros H. Smoking and Depressive Symptoms- A Community Survey. Proceedings of the 12 th
World Conference on Tobacco or Health, Helsinki; 2003.
Murnaghan DA, Leatherdale ST, Sihvonen M, Kekki P. School-based tobacco-control programming and student smoking behaviour. Chronic Dis Can 2009;29:169-77.
Otten R, Engels RC, Prinstein MJ. A prospective study of perception in adolescent smoking. J Adolesc Health 2009;44:478-84.
Lovato CY, Zeisser C, Campbell HS, Watts AW, Halpin P, Thompson M, et al.
Adolescent smoking: Effect of school and community characteristics. Am J Prev Med 2010;39:507-14.
Shashidhar A, Harish J, Keshavamurthy SR. Adolescent Smoking- A Study of Knowledge, Attitude and Practice in High School Children, Pediatric on Call Child Health Care [serial online] 2011; 2012. Available from: http://www.pediatriconcall.com/fordoctor/Medical_original_articles/smoking.asp. [Last cited on 2012 Mar 04].
Joffe A, McNeely C, Colantuoni E, An MW, Wang W, Scharfstein D. Evaluation of school-based smoking-cessation interventions for self-described adolescent smokers. Pediatrics 2009;124:e187-94.
[Table 1], [Table 2], [Table 3], [Table 4]