Elsevier

Preventive Medicine

Volume 39, Issue 2, August 2004, Pages 330-336
Preventive Medicine

Characteristics of cigarette smoking and quitting among university students in Syria

https://doi.org/10.1016/j.ypmed.2004.01.024Get rights and content

Abstract

Background. No study to date in Syria has documented the smoking and quitting characteristics in a representative sample of university students, and this study aims to fill this void.

Design. In 2003, a cross-sectional survey was carried out among students at Aleppo University using an interviewer-administered questionnaire. Overall, 587 students participated in the study (278 males, 309 females; mean age, 21.8 ± 2.1 years; response rate, 98.8%). Experiences and attitudes related to smoking and quitting were assessed for two popular forms of tobacco use in Syria-cigarettes and narghile (waterpipe).

Results. Current cigarette smoking was reported by 30.9% of male and 7.4% of female students and daily smoking by 24.8% of male and 5.2% of female students. Narghile smoking was seen among 25.5% of men and 4.9% of women, mostly on an occasional basis. More than half of current smokers (56%) believed they could quit cigarettes, 75.2% were interested in quitting, and 78% of those had made a quit attempt in the past year. Important correlates of cigarette smoking among students were being older, male, and smoking narghile, while being older and from a poorer family were associated with increased interest in quitting. Interestingly, peers' smoking was associated with current smoking among students, but inversely with their willingness to quit.

Conclusions. Cigarette smoking is mainly a problem of male students, whose narghile smoking is likely to be dramatically increasing as well, sometimes practiced as a substitute for cigarettes. The findings that most smokers in this sample are interested in quitting smoking and have tried unsuccessfully to do so indicate that cessation support for youths in this country is urgently needed.

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.

Section snippets

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.

References (22)

  • W Maziak et al.

    Smoking among adolescents in Muenster-Germany (1995–2000): increase in prevalence and relation to tobacco advertising

    Prev. Med.

    (2003)
  • H Tamim et al.

    Smoking among adolescents in a developing country

    N. Z. J. Public Health

    (2001)
  • M Ezzati et al.

    Measuring the accumulated hazards of smoking: global and regional estimates for 2003

    Tob. Control

    (2003)
  • P Jha et al.

    The economics of global tobacco control

    BMJ

    (2000)
  • J Mackay et al.

    The tobacco atlas

    (2002)
  • C.J.L Murray et al.

    The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020

    (1996)
  • E Baris et al.

    Research priorities for tobacco control in developing countries: a regional approach to a global consultative process

    Tob. Control

    (2000)
  • W Maziak et al.

    The dynamics of tobacco smoking among educated youths in Aleppo-Syria

    Eur. J. Epidemiol.

    (2000)
  • H Tamim et al.

    Tobacco use by university students, Lebanon 2001

    Addiction

    (2003)
  • W Maziak et al.

    Characterization of the smoking habit among high school students in Syria

    Eur. J. Epidemiol.

    (2000)
  • W Maziak et al.

    Prevalence and characteristics of narghile smoking among university students in Syria

    Int. J. Tuberc. Lung Dis.

    (2004)
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