Tobacco use, beliefs and risk awareness in university students from 24 low, middle and emerging economy countries

Prevalence of cardiometabolic risk factors according to urbanization level, gender and age, in apparently healthy adults living in Gabon, Central Africa

BACKGROUND

The prevalence of cardiometabolic risk factors (CMRFs) is increasing in sub-Saharan Africa and represents a serious public health issue. Accurate data are required to implement adapted prevention programs and healthcare strategies. Thus, the aim of this study was to estimate the prevalence rates of CMRFs according to the level of urbanization, age and gender in Gabon.

METHODS

A cross-sectional study was conducted in northern (Bitam), western coast (Libreville, Melen) and southeast (Koulamoutou) areas of Gabon using the World Health Organization's (WHO) stepwise approach for the surveillance of chronic disease risk factors. Participants over 18 years of age, without known underlying disease, living in rural and urban areas of Gabon were included. Sociodemographic, biological, and behavioral data were collected. Univariate and multivariate analysis were used to identify the CMRFs.

RESULTS

Of the 978 participants, 499 lived in urban and 479 in rural areas. Their median age was 38[28-50] years. Tobacco (26.1% vs 6.2%; p < 0.01) and excessive alcohol consumption (19.4% vs 9.6%; p < 0.01) predominated in rural than in urban areas, respectively. Urban dwellers had more often insufficient physical activity than rural people (29.5% vs 16.3%; p < 0.01). In total, 79.9% of participants aged under 54 years had a high blood pressure;10.6% of the younger participants had pre-hypertension. Metabolic syndrome was more frequent in women (21.7%) than in men (10.0%) (p < 0.01); 6.4% of men and 2.5% of women had a high Framingham score (p = 0.03). Finally, 54.0% of the participants had three or four CMRFs. The multivariate analysis showed that men were more likely to be smokers and to be at risk of pre-hypertension or high blood pressure (p < 0.01). Women were more likely to be obese or to have a metabolic syndrome (p < 0.01). Living in urban areas was also a risk factor for hypertension, diabetes, metabolic syndrome and high LDL cholesterol level.

CONCLUSION

The prevalence of CMRFs was high in the study population. Disparities were observed according to urban and rural areas, gender and age. National prevention and healthcare strategies for cardiometabolic diseases in Gabon should consider these observed differences.

The Impact of COVID-19 on the Lifestyles of University Students: A Spanish Online Survey

The present study aimed to investigate the perceived changes in lifestyle behaviors among Spanish university students during COVID-19-related confinement. An observational, descriptive, and cross-sectional survey study was conducted during April 2020. Sociodemographic and anthropometric data were then obtained. The FANTASTIC questionnaire was used to assess the lifestyles of the 488 participants who took part in the study. Of the participants, 76.3% were female. Overall, the lifestyles of university students significantly deteriorated during the period of confinement caused by the COVID-19 pandemic in Spain. University female students were especially affected compared to their male fellows (p = 0.010). For women, social and family relationships (p < 0.001), personality (p < 0.001), interior (p < 0.001), and career (p < 0.001) were the aspects that worsened during confinement. For men, lack of physical exercise (p < 0.001), social and family relationships (p < 0.001), and career (p = 0.002) were affected to a greater extent. In both cases, confinement was a protective factor against the consumption of tobacco, toxins (p < 0.001), and alcohol (p < 0.001). Gender (p = 0.008) and obesity (p = 0.044) were the two factors that most affected the change in the score of the FANTASTIC questionnaire. Spanish university students’ lifestyles worsened during the lockdown caused by the COVID-19 pandemic, especially those of women, who were the most affected. Some aspects, such as those related to social and emotional behaviors, were deeply affected, while confinement could be a protective factor against previous toxic habits.

Tobacco Use Among College Students Across Various Disciplines in Kerala, India

Background

Tobacco use is a major public health concern in India. Its use in young people is linked to increased severity, longer duration, and reduced efforts to seek treatment for tobacco use. A significant proportion of young people are enrolled in colleges, and early prevention during this period has better effectiveness. There is preliminary evidence that prevalence may vary across courses even among students of the same sociocultural background. Hence, we compared the prevalence and correlates of tobacco use among college students enrolled in five common streams of collegiate education (medical, nursing, engineering, arts/science and others, law/fisheries) in Kerala, India.

Methods

5784 college students from 58 colleges (medical, nursing, engineering, arts, and law and fisheries) selected by cluster random sampling in the district of Ernakulum, Kerala, completed a self-administered questionnaire incorporating standardized instruments. R software was used for analyses. Lifetime prevalence and severity of tobacco use were determined. Sociodemographic variables of tobacco users and nonusers enrolled in various courses were compared using chi-square test and two-way ANOVA. Furthermore, for each course, factors influencing tobacco use were identified using multivariable logistic regression analysis.

Results

The mean age of the sample was 19.5 ± 1.9 years, with the majority being female (65.3%). Lifetime prevalence of tobacco use varied from 0.5% in nursing students, 4.2% in medical students, 8.2% in students of arts and science, 12.5% in engineering students, and 22.8% among other students (law/fisheries). Approximately two-thirds of all tobacco users across courses showed signs of nicotine dependence. Dependent users also showed variance with none in nursing, 2.6% among medicine, 1.6% among arts and science, 1.9% among engineering, and 6.3% among others. Male gender and alcohol use were consistently associated with tobacco use across courses, whereas other examined psychosocial correlates showed variance.

Conclusions

To conclude, it appears that among college students, course-level characteristics may influence risk of tobacco use. This has public health importance as it suggests that interventions need to be tailored bearing this in mind. Future research needs to examine campus-level characteristics that may explain variance.

Alcohol and tobacco consumption associated factors among college students: A review

Aim

Alcohol and tobacco consumption, common among college students, may lead to future health and social problems. We aim to identify the factors associated with those consumptions among college students.

Method

A literature review was performed using PRISMA recommendations. Records were selected through PubMed and Scopus. Through inclusion and exclusion criteria, data from the selected studies were analysed through meta-syntheses.

Results

Twenty studies were included in the analysis. Tobacco consumption was associated with having smoker friends, sedentary behaviours and male sex. Drinking was associated with having parents/friends who drink, having smoker friends and male sex.

Conclusion

This review contributes to identify the consumption factors, allowing health care workers to develop and improve the effectiveness of possible interventions for this population, such as health education programs or psycho-educational interventions, aiming to decrease consumptions behaviours, by targeting the students who are at risk.

Prevalence of major cardiovascular disease risk factors among a group of sub-Saharan African young adults: a population-based cross-sectional study in Yaoundé, Cameroon

OBJECTIVE

To determine the prevalence estimates of some major risk factors for cardiovascular disease (CVD) in a young adult-aged population living in Yaoundé, Cameroon.

DESIGN

A cross-sectional study held from May to July 2017.

SETTING

PARTICIPANTS: Students aged 18-35 years, with no known history of CVD, found at the campus during recruitment and who voluntarily agreed to be included in the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data were collected on personal and family history as well as lifestyle and nutritional habits; anthropometric parameters and blood pressure were also measured. Prevalence rates were calculated with their respective 95% CI.

RESULTS

Overall, 931 participants (53.8% males) were included, with a median age of 23 years (IQR 21-25). The prevalence estimates for some major CVD risk factors were: 3.1% (95% CI 2.0 to 4.2) for family history of heart attack, 6.3% (95% CI 4.7 to 7.9) for family history of stroke, 26.7% (95% CI 23.9 to 29.5) for hazardous alcohol consumption, 0.9% (95% 0.3 to 1.5) for current tobacco smoking, 27.6% (95% CI 24.7 to 30.5) for secondhand smoking, 88.9% (95% CI 86.9 to 90.9) for physical inactivity, 99.0% (95% CI 98.4 to 99.6) for inadequate fruits and/or vegetables consumption, 39.8% (95% CI 36.7 to 42.9) for self-reported anxiety, 49.2% (95% CI 46.0 to 52.4) for self-reported depression, 22.1% (95% CI 19.4 to 24.8) for overweight, 3.9% (95% CI 2.7 to 5.1) for obesity, 14.4% (95% CI 12.1 to 16.7) for abdominal obesity, 14.5% (95% CI 12.2 to 16.8) for excess body fat mass, 30.0% (95% CI 27.1 to 32.9) for suspected prehypertension and 2.8% (95% CI 1.7 to 3.9) for suspected hypertension.

CONCLUSION

The prevalence of some major CVD risk factors is high among young adults living in Yaoundé, Cameroon. Therefore, specific actions should be undertaken in this population to mitigate the upcoming burden of CVD. Accordingly, younger-aged adult populations should be encouraged and accompanied to practice physical activity, eat healthily, and stop or avoid smoking and/or hazardous alcohol consumption.

Population insight of the relationship between lifestyle and cancer: A population-based survey

Background

There is a substantial rise in the incidence of cancer in Saudi Arabia. Life style models and lack of awareness are the prime suspect in this substantial increase. Therefore, the objective of the present study was to assess the relationship between lifestyle and cancer in a population-based Survey in Northern Saudi Arabia.

Methodology

This cross-sectional study was conducted in North Saudi Arabia (Hail Region). Data was collected as a part of a community based cancer's awareness movement that covered an area inhibited with approximately 500,000 individuals.

Results

In this study, about 2558/3227 (79.3%) and 641/794 (80.7%) believed that tobacco smoking and smokeless are not a risk of cancer development. In this study large section (87.2%) of the study population believe that exposure to diverse occupational or non-occupational chemicals has no role in cancer development. Furthermore, around 59% of the study subjects in the current study believed that repeated exposure to insecticidal chemicals doesn't influence the risk of cancer.

Conclusion

The present study point to the urgent need for awareness educational programs and preventive measures towards may lifestyle factors that can increase or decrease the overall risk of cancer among Saudi population.

Educational Intervention on Undergraduate Cancer Awareness and Self-Directed Learning

Traditional lecture-based learning (LBL) can increase cancer awareness in undergraduates. However, because of the rapidly changing knowledge base in medicine, undergraduates must develop skills required for lifelong self-directed learning (SDL). Problem-based learning (PBL) has been suggested as an SDL approach. This study used a nonequivalent control group with a pretest-posttest design for comparing PBL and LBL for their effectiveness in increasing cancer awareness and SDL among nonmedicine or nonnursing major undergraduates in a health-related general education course. Experimental groups 1 and 2 were instructed using PBL while the control group was instructed using LBL. Cancer educational programs were offered to experimental group 1 and the control group but not to experimental group 2. Among the 325 undergraduates who completed a questionnaire regarding cancer awareness and SDL in the pretest, 223 completed the 12-week follow-up survey of the posttest. Cancer awareness significantly improved between the pretest and posttest in the control group (P < 0.001). No significant difference in cancer awareness improvement was observed between experimental group 1 and the control group (P = 0.934). Cancer awareness improvement in experimental group 2 was significantly less than in the control group (P = 0.010). No statistically significant change in SDL was observed in the control group during the study (P = 0.897). However, the SDL of experimental groups 1 and 2 improved more significantly than that of the control group (P = 0.049 and 0.023, respectively). Therefore, PBL is an effective method of increasing cancer awareness and SDL in undergraduates.

Level of Awareness of Various Aspects of Lung Cancer Among College Teachers in India: Impact of Cancer Awareness Programmes in Prevention and Early Detection

Lung cancer is one of the most common causes of cancer mortality among men in India and incidence is increasing, but actually, they are largely preventable diseases. In India, advanced stage at the time of presentation is responsible for high mortality and morbidity and early detection is the only way to reduce it. The purpose of this study is to know the level of awareness of various aspects of lung cancer among college teachers and impact of awareness programmes in its prevention and early detection. This assessment was part of Pink Chain Campaign-a campaign on cancer awareness. During the cancer awareness events in 2011-2013 at various women colleges in different parts in India, pre-test related to lung cancer was followed by awareness programme. Post-test using the same questionnaire was conducted at the end of interactive session, at 6 months and 1 year. A total of 872 out of 985 teachers participated in the study (overall response rate was 88.5 %). Mean age of the study population was 41.6 years (range 26-59 years). There was a significant increase in the level of knowledge regarding lung cancer at 6 months, and this was sustained at 1 year. Among teachers who were just asked yes or no question, 117 teachers (13.4 %) were smokers and 241 teachers (27.6 %) were alcoholics. Magazines and newspapers were sources for knowledge in 50-60 % of teachers, whereas approximately 30 % of teachers were educated by TV and Internet regarding various aspects of lung cancer. Post awareness at 6 months and 1 year, Pink Chain Campaign was the major source of knowledge related to lung cancer in more than 90 % of teachers by continuous and timely update on subject. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not going for check-up were ignorance (83.1 %), fear (30.1 %) and lethargic attitude (29.3 %) initially, but over time, lack of time, lethargic attitude and hesitation became important factors after knowing various aspects of lung cancer. Knowledge of lung cancer was very low among teachers. Overall awareness of risk factors, sign and symptoms, screening modalities of lung cancer has improved in a year along with practices related to smoking and alcohol, but there was not much improvement in people undergoing regular check-ups. To inculcate safe practices in the lifestyle of people, awareness programmes such as the Pink Chain Campaign should be conducted more widely and frequently.

Ethnic Variation in Consumption of Traditional Tobacco Products and Lung Cancer Risk in Nepal

Lung cancer is the leading contributor to cancer deaths in the developing world. Within countries, significant variability exists in the prevalence of lung cancer risk, yet limited information is available whether some of the observed variability is associated with differences in the consumption pattern of local tobacco products with differing potency. We recruited 606 lung cancer cases and 606 controls from the B.P. Koirala Memorial Cancer Hospital in Nepal from 2009-2012. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for lung cancer risk associated with different tobacco products, using unconditional logistic regression. Unfiltered cigarettes tended to be the most frequently used products across ethnic subgroup with about 53.7% of Brahmins, 60.1% of Chettris, and 52.3% of Rai/Limbu/Magar/others. In contrast, about 39.9% of Madishe/Tharu smokers reported using bidi compared with only 27.7% who smoked unfiltered cigarettes. Among those who only smoked one type of product, choor/kankat smokers had the highest lung cancer risk (OR 10.2; 95% CI 6.2-16.6), followed by bidi smokers (OR 5.6; 95% CI 3.6-8.7), unfiltered cigarettes (OR 4.9; 95% CI 3.4-7.2), and filtered cigarettes (OR 3.4; 95% CI 2.2-5.3). A clear dose-response relationship was observed between increased frequency of smoking and lung cancer risk across all ethnic subgroups. These results highlight the important role of traditional tobacco products on lung cancer risk in the low income countries.

Assessment of perception of medical students in regard to links between tobacco or alcohol use and cancer

BACKGROUND

The aim of this study was to assess cancer awareness among medical students in Saudi Arabia toward tobacco and alcohol use as risk factors.

MATERIALS AND METHODS

A cross-sectional survey from October to December 2014, covering 1200 medical students, was performed.

RESULTS

Of the total, 975 (81.25%) responded. The male to female ratio was 1.00:7.125. 96/975 (9.8%) had smoked tobacco in their lifetime, and 51/975 (5.23%) were alcoholic beverage consumers. On asking them whether tobacco smoking and alcohol consumption can cause cancer, only 4/975 (0.4%) and 14/975 (1.43%) answered no for smoking and alcohol, respectively.

CONCLUSIONS

The prevalence of smoking and alcohol use is very low among medical students, which might be due to high female contribution besides social stigma. The prevalence of second-hand smoke (SHS) was found to be very high in Hail region.

Women and Tobacco Use: Discrepancy in the Knowledge, Belief and Behavior towards Tobacco Consumption among Urban and Rural Women in Chhattisgarh, Central India

BACKGROUND

Tobacco consumption has become pandemic, and is estimated to have killed 100 million people in the 20th century worldwide. Some 700,000 out of 5.4 million deaths due to tobacco use were from India. The era of global modernization has led to an increase in the involvement of women in tobacco consumption in the low income and middle-income countries. Tobacco consumption by females is known to have grave consequences.

OBJECTIVES

To assess: (1) the tobacco use among urban and rural women; (2) the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural women in Durg-Bhilai Metropolitan, Chhattisgarh, Central India.

MATERIALS AND METHODS

The study population consisted of 2,000 18-25 year old young women from Durg-Bhilai Metropolitan, Chhattisgarh, Central India, from both urban and rural areas. Data were collected using a pretested, anonymous, extensive face to face interview by a female investigator to assess the tobacco use among women and the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural individuals.

RESULTS

The prevalence of tobacco use was found to be 47.2%. Tobacco consumption among rural women was 54.4% and in urban women was 40%. The majority of the women from urban areas (62.8%) were smokers whilst rural women (77.4%) showed preponderance toward smokeless tobacco use. Urban women had a better knowledge and attitude towards harms from tobacco and its use than the rural women. Women in rural areas had higher odds (1.335) of developing tobacco habit than the urban women.

CONCLUSIONS

Increased tobacco use by women poses very severe hazards to their health, maternal and child health, and their family health and economic well-being. Due to the remarkably complex Indian picture of female tobacco use, an immediate and compulsory implementation of tobacco control policies laid down by the WHO FCTC is the need of the hour.

Association of Cigarette Prices with the Prevalence of Smoking in Korean University Students: Analysis of Effects of the Tobacco Control Policy

BACKGROUND

Increased pricing of cigarettes might be one of the most effective approaches for reducing the prevalence of smoking. This study aimed to investigate the effects of increasing cigarette prices through taxation by a tobacco intervention policy on the changes in smoking prevalence in Korean university students.

MATERIALS AND METHODS

The participants in this study were 23,047 healthy university students aged 18-29 years from a health examination in 2011-2015. We investigated the adjusted prevalence of daily and occasional smoking before and after increasing cigarette prices through taxation.

RESULTS

The prevalence of occasional smoking was significantly decreased in 2015 from 2014 in both male (from 10.7% in 2014 to 5.4%) and female (from 3.6% to 1.1%) students, but the prevalence of daily smoking did not decrease significantly. The frequency of individuals who had attempted smoking cessation during the past year was significantly higher among occasional smokers in male students (90.2%) compared with daily smokers (64.9%). For female students, there were no differences in experience of smoking cessation, willingness for smoking cessation, or E-cigarette experience between daily and occasional smokers.

CONCLUSIONS

We found that a policy of increasing cigarette prices through taxation is associated with decreases in the prevalence of occasional smokers, who have relatively lower nicotine dependence compared with individuals who smoke daily. The results of our study suggest that social support and direct intervention for smoking cessation at the community level are needed for university students alongside the pricing policy.