Characteristics of cigarette smoking and quitting among university students in Syria
Introduction
In the past few years, there has been increased awareness of the devastating effects of the smoking epidemic on the health and economies of developing countries [1], [2]. Future projections suggest that the wrath of the tobacco epidemic will be disproportionably distributed amongst the world's populations, with developing countries bearing most of the tobacco-related burden [3], [4]. With this dismal picture, monitoring the smoking problem and its changing patterns and trends acquires increasing importance for the efforts to face this problem in developing countries [5]. Assessment of the smoking habits of young people is particularly important as it reflects the dynamics of the smoking epidemic within societies as well as predicts future tobacco-related morbidity and mortality [6]. We have shown previously that the age period of the early twenties, the university period, is likely to be very important in terms of tobacco use, since smoking initiation most often occurs at this stage of life, as well as escalation from intermittent to regular smoking [7]. Data from a neighboring country, Lebanon, show quite a worrisome picture where about 40% of university students smoke either cigarettes or narghile (waterpipe) [8].
In Syria, studies of smoking patterns in youths are scarce. A high school study conducted in 1998 showed a male predominance of cigarette smoking with 15.9% of boys being current smokers compared to 6.6% of girls. The most important factors related to adolescents' smoking in this study were parental and peer smoking [9]. Cigarette smoking among male university students on the other hand showed an age-related pattern with about a fifth of 1st year students compared to a third of 3rd year students being current smokers [7]. Preliminary results about narghile smoking among university students in Syria show that most of such smokers practice this habit occasionally as a part of socializing with their peers [10]. However, no data to date are available on cigarette smoking among female university students as well as data about patterns of smoking and quitting in a representative sample of university students in Syria. Of particular interest to our efforts to understand the smoking problem of youths in Syria is the identification of factors related to smoking in this population as well as factors related to their interest in quitting. In this study, we try to furnish the first comprehensive data about patterns of cigarette smoking and quitting among university students in Syria.
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Subjects and methods
This study's target population is the 43,000 students (studentship in 2001) of Aleppo University, the second largest university (out of four in Syria) and the one that serves the northern part of the country. The study's methods have been described in detail elsewhere [10]. Using a cross-sectional design, an interviewer-administered questionnaire was administered in 2003 to a sample of students at Aleppo University. Four women's and four men's dorms were selected randomly from all 19 dorms at
Results
Main characteristics of the study sample in relation to their cigarette smoking are listed in Table 1. Smoking status among university students differed substantially by gender, with current cigarette smoking reported by 30.9% and 7.4% of men and women, respectively, and daily smoking reported by 24.8% and 5.2% of men and women, respectively. Narghile smoking was reported by 25.5% of men and 4.9% of women, mostly as occasional smoking (only five males smoked narghile daily) (Fig. 1). Age was
Discussion
This study presents the first use of standardized indicators to assess the reach of Syria's tobacco epidemic among university students—a population that is highly vulnerable to initiate tobacco use [7]. The same gender and age-related patterns of smoking reported in a previous study of adolescents in Syria [9] were observed among university students. Compared to women, men were more likely to smoke and initiated smoking at an earlier age. This gender difference reflects the social taboo against
Acknowledgements
This work is supported by USPHS grant R01 TW05962.
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