Perceptions of Lung Cancer and Smoking Among College Students in Jordan

Prevalence of cigarette smoking among college students in Iran: An updated systematic review and meta-analysis of observational studies

Background: Cigarette smoking is known as a gateway drug for illicit drug use in youth. The objective of this study is to assess the prevalence of cigarette smoking in the college students in Iran.

Methods: We searched electronic databases including Scopus, Medline/PubMed, Google Scholar and Web of Science, and national databases such as Magiran, Scientific Information Database, Iranmedex, Medlib, Irandoc, and IranPsych from 1946 to 21st July 2018 without any language restriction using a proper search strategy. We used a random effect model to calculate the pooled prevalence of cigarette smoking in college students in Iran. Chi-square test and I2 index were used to evaluate the heterogeneity between the studies. We used the meta-regression and subgroup analysis to assess the potential source of heterogeneity. Stata software, version 11 (StataCorp, TX) was used for all statistical analysis.

Results: We included 60 eligible articles in our study. The pooled prevalence of cigarette smoking at least once in the lifetime was 19% (95%CI: 17-22). The I2 index indicated considerable between-study heterogeneity (I2 =98%, p<0.001). The pooled prevalence of cigarette smoking at least once in the lifetime in males and females was 28% (95% CI: 23-34) and 9% (95% CI: 6-13), respectively. In multivariable meta-regression, a significant association was shown between the year of study (β=-13.1, p=0.011) and sampling method (β=-12.8 p=0.017) and daily use in the last month.

Conclusions: Increasing prevalence of smoking among Iranian university students is an important health priority. Increasing preventive and health education programs are recommended.

Smoking behavior and secondhand smoke exposure among university students in northern Portugal: Relations with knowledge on tobacco use and attitudes toward smoking

OBJECTIVES

To assess the prevalence of active smoking and secondhand smoke (SHS) exposure among college students in the north of Portugal, and analyze the relationship between knowledge about tobacco use and attitudes toward smoking.

MATERIALS AND METHODS

This a cross-sectional study with a representative sample of college students (n=840) in one university in Portugal. A validated self-reported questionnaire was administered to a proportional stratified random sample during the academic year of 2018/2019. We evaluated associations between smoking status, SHS exposure, smokers peers, knowledge and attitudes toward smoking and sociodemographic variables.

RESULTS

The results showed that 20.1% of the students surveyed were current smokers (7.3% occasional smokers, 2.9% regular smokers and 9.9% daily smokers). Most current smokers started smoking before the age of 17 (61.4%) and reported never having tried to quit smoking (59.7%). Only 34.4% of students reported (almost) not having been in enclosed spaces with smokers in the past 7 days. Exposure to SHS and having smoker friends contributes to the prevalence of tobacco use. In general, students showed favorable attitudes toward smoking, especially those who are smokers, have smoking friends and are more exposed to SHS. The level of knowledge about tobacco was moderate, with a higher number of correct responses by former smokers.

CONCLUSIONS

These results suggests an urgent need for socio-educational programs for counseling on smoking cessation. In addition, is also strongly recommended that, throughout academic training, students develop personal and social skills for dealing with the tobacco epidemic.

Subgrouping of risky behaviors among Iranian college students: a latent class analysis

BACKGROUND

Risky behaviors may interrupt development or cause considerable morbidity or mortality. This study's purpose was to determine subgroups of students based on risky behaviors and assess the prevalence of risky behaviors in each of the subgroups.

PARTICIPANTS AND METHODS

This anonymous cross-sectional study was carried out in October 2015 and November 2015, with 1,777 students from Tabriz University of Medical Sciences, through multistage random sampling method. The data were analyzed by latent class analysis.

RESULTS

The prevalence rates of cigarette smoking (more than or equal to ten cigarettes), hookah use (≥1 time/month), and alcohol consumption (≥1 time/month) during the last year were 12.4% (95% confidence interval [CI]: 10.9-14.0), 11.6% (95% CI: 10.0-13.1), and 4.9% (95% CI: 3.8-5.9), respectively. The prevalence rates of illicit opioids (1.8%, 95% CI: 1.2-2.5), cannabis (1.2%, 95% CI: 0.7-1.7), methamphetamine (1.1%, 95% CI: 0.6-1.6), methylphenidate (2.5%, 95% CI: 1.7-3.2), and extramarital sex (5.5%, 95% CI: 4.5-6.6) over the last year were also estimated. Three latent classes were determined: 1) low risk; 2) cigarette and hookah smoker; and 3) high risk. It is worth mentioning that 3.7% of males and 0.4% of females were in the high risk group.

CONCLUSION

Subgrouping of college students showed that a considerable percentage of them, especially males, were classified into the high risk and cigarette and hookah smoker groups. Appropriate preventive measures that consider multiple different risky behaviors simultaneously are needed for this part of the population.

Psychosocial determinants of cigarette smoking among university students in Jordan

The objectives of this study were to describe the prevalence of cigarette use and water pipe smoking in Jordanian university students and to analyze differences in determinants between cigarette smokers and non-smokers. A cross-sectional questionnaire was administered to a random sample of 400 students (18-24 years, 51% males). Smokers were compared with non-smokers on several smoking-related determinants. Data were analyzed using descriptive statistics, t-test, χ 2 test and binary logistic regression analysis. The prevalence rates of cigarette use and water pipe smoking were 25.9% and 23.3%, respectively. Cigarette smokers differed significantly from non-smokers on almost all of the assessed determinants. The I-Change model explained 85% of the total variance of cigarette-smoking behavior. Cigarette smoking was determined by being male and older, having more depressive symptoms, having less Muslim identity, being more emancipated, perceiving more pros of smoking, having more modeling from peers and having lower self-efficacy. The popularity of cigarette use and water pipe smoking among Jordanian students necessitates health promotion interventions that motivate students not to engage in smoking behaviors by clearly outlining the outcomes of smoking and the healthier alternatives, how to cope with social influences and difficult situations in order to increase self-efficacy.

Knowledge and beliefs about smoking and goals for smoking cessation in hospitalized men with cardiovascular disease

OBJECTIVES

To describe perceptions of smoking in men hospitalized with cardiovascular disease (CVD).

BACKGROUND

Smoking is a major risk factor and associated with the high prevalence of CVD in Jordan.

METHODS

The study design was cross-sectional with a convenience sample. A structured interview was conducted in 112 men who were hospitalized with CVD.

RESULTS

The study showed that 91% of men hospitalized with CVD smoked daily. The majority (83%) had attempted to quit smoking in the past without help from others, and intended to quit in the future using the same previously unsuccessful method. They were unaware of the hazards of smoking such as stroke; or the long term health benefits of quitting smoking. Logistic regressions showed that men were more confident in quitting smoking if they had a high income (OR: 7.7; 95% CI: 2.7, 22.3), longer hospitalizations (OR: 2.6; 95% CI: 1.3, 5.3), or were hospitalized in acute cardiac settings (OR: 3.9; 95% CI: 1.2, 12.7), and admitted with a diagnosis of MI or angina (OR: 3.0; 95% CI: 1.1, 8.3).

CONCLUSION

Assessment of smoking status with smoking cessation counseling is paramount in hospitalized men with CVD who smoke.

Cigarette smoking among Jordanian adults

The objectives were to determine the rate of cigarette smoking and correlates of its use among a sample of Jordanian adults (N = 600). A survey-based, cross-sectional study was conducted with a convenient sample. Logistic regression was used to determine predictors of being a cigarette smoker. Approximately half of the population (45%) had smoked a cigarette in the past month, 40% in the past week, and 36% in past 24 hours. These findings underscore the magnitude of the smoking problem in the Jordanian population and the urgent need for effective interventions. Future research should focus on developing interventions that incorporate the predictors identified.

Article Commentary: Secondhand Smoking in Jordan: Clearing the Air for One of the Highest Tobacco Prevalence Countries in the Middle East

As the rate of tobacco consumption in Jordan increases, Jordanian policy makers are urged to develop guidelines on smoking exposures. This paper is concerned with the magnitude of exposure and harm caused by secondhand smoke (SHS) on childbearing women and young children. Despite a strict policy that limits tobacco advertising and efforts by the Ministry of Health, which include cessation programs and education on the adverse effect of smoking, the country sustains its high smoking rate, especially among men. According to the data gathered in this paper, special concern should be directed toward children's SHS exposure. Only four recent studies on SHS exposure among Jordanian women and children were encountered. Moreover, Jordan has legislation that bans smoking in public institutions; however, the enforcement of the law is extremely poor in most locations. Recommendations are presented to aid policy makers and law enforcement agencies in addressing this issue.

Knowledge of substance abuse among high school students in Jordan

OBJECTIVES

The purpose a descriptive design was employed using a self-administrated questionnaire to collect the data from 400 high school students.

METHODS

A multistage, random sample was generated in selecting schools from the educational directorate located in a large urban city located in the north of Jordan. This city district contains 23 public secondary schools and serves 56.8% of the adolescents in the entire province.

RESULTS

The results revealed the following: Students of both sexes were knowledgeable about aspects of substance abuse, including its harmful effects on the body and society and reported that even occasional or frequent use of cigarettes, alcohol, and other drugs was extremely harmful. A majority of the students perceived substance abuse as a problem, although the older students were more acutely aware than the younger group. However, the results revealed that the students lack in-depth knowledge of substance abuse. In addition, the adolescents consistently refer to Islamic principles forbidding use of intoxicants but mistakenly presume that mosques are sources for assistance regarding substance abuse.

CONCLUSIONS

Policy makers, health workers, and religious leaders must collaborate to build structured educational programs and readily accessible, evidence-based treatment programs for adolescents. Given that young people constitute the majority of the Jordanian population and that drug trafficking is prevalent in the region, the implications of prevention programs are critical to maintaining gains in public health outcomes as well as economic progress and development in Jordan.

Predictors of intention to quit smoking among Jordanian university students

PURPOSE

To identify predictors that influence tobacco smoking cessation among Jordanian college students and to test the utility of the Trans-Theoretical Model for future cessation programs in this population.

METHOD

A cross-sectional survey of randomly selected college students (18 to 22 years of age) who were smokers was conducted at two Jordanian universities. The surveys included the: Tobacco Use Questionnaire; Tobacco Use Self-Efficacy; Rosenberg Self-Esteem Scale; Barriers to Cessation; and the Fagerstrom Tobacco Nicotine Dependency Scale. Due to the complex nature of the contextual and individual factors related to smoking behaviour, a structural equation modeling approach was used to identify variables that may influence participation in tobacco smoking cessation programs.

RESULTS

There was a 75% response rate with a total of 800 students (90% male) completing the survey. Three factors were identified as major contributors toward quitting smoking: a) a high stage of readiness, b) previous experience with barriers to smoking cessation, and c) past experience with quitting.

CONCLUSIONS

The findings suggest that the value of smoking cessation programs should not be measured on recidivism rates alone. The implications are that such programs should make return to treatment easy and as guilt free as possible to improve ultimate long-term smoking abstinence.