A tobacco use survey among university students focusing on waterpipe use and relationship between first-tried tobacco product and becoming an established smoker

Abstract

Objective: We aimed to describe tobacco use and tobacco related attitudes and perceptions among the Yeditepe University students with a special focus on waterpipe use, and to investigate the relationship between first-tried tobacco product and established smoking. Method: An anonymous questionnaire survey (a cross-sectional study) was conducted in the spring term of the 2014-15 academic year. Study subjects included all four year students (n=354) of the faculties of medicine, pharmacy, dentistry, and health sciences of the Yeditepe University (Istanbul/Turkey). The response rate was 97.5%. Results: The prevalence of current smoking was 53.5% in males, 29.7% in females. Of the male students 58.6%, among female students 32.1% smoked any tobacco product at least once in the last 30 days. While the proportion of those who have ever tried, even one puff, any tobacco product was 80.8% in males, 71.5% in females (p=0.075). The first-tried tobacco product was a cigarette among half of them, and a waterpipe product in the other half. The most tried tobacco product among females was a waterpipe product. While there was no relationship between the first-tried tobacco product and established smoking, of those who ever tried a tobacco product 74%, and 45% became established smokers in males and females respectively (p<0.001). Of the 100 current daily smokers 100%, and of the 26 non-daily current smokers 73% were cigarette smokers. Of those who were current smokers, 69% had become an established smoker during their university years in females, and 55.5% in males. A significant relationship was found between frequency of going to a café and current smoking. Mostly stated factors attracting students to use waterpipe were "taste, smell or aroma of the waterpipe smoke", and "social ambiance with friends". Conclusion: The state of the tobacco use epidemic among the students was found alarming. For the university students their university years seem to be the most important period regarding starting smoking. As a first-tried tobacco product, waterpipe appeared to be as important as cigarettes. Whether the first-tried tobacco product is cigarette or waterpipe, those who have ever tried them once, have a similar chance to become an established smoker. In the end, almost all of the smokers smoked cigarettes suggesting that waterpipe products feed cigarettes.

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