Departments
Research
Jan/Feb 2009 —
Vol. 3,
Iss. 1
Tobacco Habits Among Dental Students in Northern India
Utkal Mohanty, MDS; Hari Parkash, MDS, FDS RCPS (Glas); Anil Kohli, MDS, DNBE (USA), FDS RCS (UK)
Abstract
Objectives: The aim of
the study was to assess the knowledge, attitude, and practice regarding
tobacco use among dental students. Material and Methods: A sample of 579 students was selected by random sampling
method. Students were supplied with a questionnaire containing a set of 15 close-ended questions. The completed questionnaires were
collected and subjected to analysis with SPSS 10. Results: Of 515
respondents, 94
(18.2%) were smokers, 31 (6.01%) were tobacco chewers, and 23 (4.4%) were
both chewers and smokers. Approximately 40% of the tobacco users started using tobacco before joining the professional
course and 60% started after joining. Peer pressure was found to be the
most prevalent cause (36%) of tobacco use among
the students. 77% of the students were of the opinion that tobacco products
are very easily available near the college. 87% of
the students believed that tobacco use increases the risk of heart disease.
Conclusion: Tobacco products are very easily available near the college campus, which needs to be
addressed to curb tobacco use among the students. Dental students need to
be trained regarding anti-tobacco counselling.
Introduction
Oral cancer is an important public health issue.
Cancer prevalence in India is estimated to be around 2.5 million, with over
800,000 new cases and 550,000 deaths occurring
annually.12 The oral cavity is a common site for cancer for both men and women in India. Tobacco use is a fast growing behavior which is
to be observed not only in the general
population, but also among health professionals
(medical and dental).
Therefore, there is a need to study the attitude
regarding tobacco use among the health
professionals, which can provide ideas regarding
the cause of tobacco use and the prevailing knowledge among the newcomers to the dental profession. Because oral cancer is associated with tobacco use, many cases could probably
be prevented with appropriate behavior
modification among the dental students, which
in turn will motivate the patients.
Material and Methods
A group of 579 dental students were selected,
comprised of first year to final year students,
and interns. A questionnaire consisting of 15
questions was provided to each of the selected students. The number of respondents was 515 out of 579. The completed questionnaires were subjected to analysis by using SPSS 10.
Results
A. Age distribution of the studentsin the sample
- 18 years old: 124 students
- 19 years old: 118 students
- 20 years old: 80 students
- 21 years old: 82 students
- 22 years old: 78 students
- 23 years old: 33 students
Sex-wise distribution of the students in the sample
Out of 515, 258 (50.10%) were males and 257 (49.90%)
were females (Table 1 and Figure 1 View Figure).
B. Sex-wise distribution of the students according to
tobacco use:
Of the 515 students, 94 (18.25%) smoked and 31 (6.02%)
chewed tobacco. Of
the smokers, 87 (92.55%) were men, 7 (7.45%) were women (Table 2 and Figure 2 View Figure). All the
tobacco chewers were men. There were 23 (4.47%) students who both smoked
and chewed tobacco.
C. Distribution according to start of using tobacco
products in relation to academic year
Of 125 tobacco users, 51 (40.8%) students responded
that they had begun using tobacco products
before joining the professional course. The
remaining 74 (59.2%) had begun using tobacco
after joining the professional course. It was found that 6 students (8.11%) had begun using during first year, 14 (18.92%)
had begun in second year, 22 (29.73%) during
the third year, 24 (32.43%)
during the final year, and 8 (10.81%) during the internship of their professional course (Table 3 and Figure 3 View Figure).
D. Causes of tobacco use among the students
Of 125 tobacco users, 15 (12%) started using due to
curiosity, 27 (21.6%) had started due to
pleasure, 45 (36%) had started out of peer
pressure, 17 (13.6%) had started out of stress, and 3 (2.4%) did not know the cause of starting the use. About 3 (2.4%) had responded that both curiosity and pleasure were
the cause of starting tobacco use. Another 3
(2.4%) responded that they did it out of
curiosity, pleasure, and stress as well. 12 (9.6%) responded pleasure, peer pressure, and stress as the cause of starting tobacco use (Table 4 and Figure 4 View Figure).
For 37 students (29.6%), film actors were a source of
inspiration for beginning tobacco use. 44
(35.2%) were inspired by friends, 33 (26.4%)
were inspired by family members. 11 (8.8%) did
not have any source of inspiration for starting tobacco use. Approximately 12 students (9.6%) felt fatigue after using
tobacco products, 55 (44%) felt self-rewarding,
52 (41.6%) felt refreshed, and 6 (4.8%) did not
feel anything after using tobacco.
Approximately 34 students (27.2%) spent less than
Rs100 per month on tobacco products, 27 (21.6%)
spent less than Rs200, 23 (18.4%) spent less
than Rs300, and 41 (32.8%) spent more than
Rs300.
397 (77.09%) responded that tobacco products were
easily available near the college, but 103
(19.81%) responded that they were not available
near the college. 16 (3.11%) did not respond to the question.
E. Exposure to secondhand smoke among the students
226 (43.88%) of the students have experienced
secondhand smoke in some places as compared to
289 (56.12%) who responded that they have not experienced secondhand smoke. When the location of the secondhand smoke was analyzed, 17 (7.52%)
occurred at home, 45
(19.91%) at a hostel, 154 (68.14%) at public places, and 10 (4.42%) at all the above mentioned places (Table 5 and Figure 5 View Figure).
436 students (84.66%) were of the opinion that using
tobacco products in public places should be
banned completely, whereas 79 (15.34%) were of
the opinion not to ban it in public places.
F. Effect of tobacco use on general health
Among the 515 students, 448 (86.99%) were aware that
using tobacco
products is harmful to the health of an individual. but 67 (13.01%) did not have any awareness of this issue (Table 6 and Figure 6 View Figure).
221 (42.91%) responded positively to the question
regarding smoking
during pregnancy having adverse effect on the fetus, but 189 (36.7%) responded negatively to the same question. Of the sample, 105 (20.39%) failed
to respond to the question.
G. Risk of developing cancer due to use of tobacco
When asked about the use of tobacco and risk of
cancer, 415 (80.58%) responded positively, and
43 (8.35%) responded negatively. Of the group, 57 (11.07%) did not respond
to the question (Table 7 and Figure 7 View Figure).
342 (66.4%) of the students had knowledge regarding
the harmful effect of tobacco use on the heart,
but 53 (10.3%) responded negatively to the question. 120 (23.3%) had no idea about the association between tobacco use and heart disease.
H. Risk of developing periodontal disease due to
tobacco use
The response to the question about tobacco use and
development of periodontal disease was
affirmative by 315 (61.17%) students, and
negative by 165 (32.04%) students. 35 students (6.8%) did not respond to the question
(Table 8 and Figure 8 View Figure).
I. Role of dentist in tobacco cessation program
408 (79.22%) of the students responded positively
regarding the role
of the dentist in the cessation of the tobacco habit among the patients, but 88 (17.09%) did not feel that dentists
have any role to play in this situation. 19 (3.69%) did not respond to the question (Table 9 and Figure 9 View Figure).
J. Interest of dental students regarding
anti-tobacco counselling
Most of the students, ie 416 (80.78%), were interested
in receiving training regarding anti-tobacco counselling, but 82 (15.92%) did not show any interest. Of
the students, 17 (3.3%) did not respond to
the question (Table 10 and Figure 10 View Figure).
189 (36.7%) of the students had knowledge regarding
nicotine replacement therapy, but 309 (60%) did
not have any knowledge regarding this therapy, and 17 (3.3%) did not respond to the question.
Discussion
In this study, of 515 students, 258 (50.09%) were
male, 257 (49.91%)
were female. Around 24.2% (18% smokers, 6% chewers)
of the students were tobacco users in some form or another, as compared to 13.7% in the report published by Global
Health Professional Survey (GHPS) of India
2005.12
This shows a slightly higher prevalence of tobacco use among dental
students in the present study. In another study
conducted in a Tokyo dental school, the smoking
prevalence was found to be 19.4%.2
In the present study, among the smokers, 92.6% were
male and 7.5% were female, but 100% of the
chewers were male. The GHPS report also shows
tobacco use to be a male prevalent condition.12 In a similar study
by Furukawa et al, the male–female distribution
was shown to be 91.3% and 8.7% respectively.2,4
Among all the tobacco users (n=125), 51 (40.8%) had
begun before joining the professional course
and 74 (59.2%) had started using after joining
the professional course. The study conducted at
Tokyo Dental School by Furukawa et al showed 43% of the current tobacco users started before entering the university.2,5,8
In the present study, an trend of increasing tobacco
use was found from
the first year to the final year. Similar findings were made by the Furukawa study conducted in
the Tokyo Dental School.2
The current study shows 43.9% of the students have
experienced
secondhand smoke somewhere, which is less than 60% exposure as reported by GHPS in 2005.
79% of the students agreed to receive training
regarding a tobacco
cessation program in the current study, which is similar to the findings in a study conducted by Fried et al, in which at least 70% of students from health professions programs
agreed that it was their professional
responsibility to help smokers quit.13 Similar findings
were made in a study conducted by Polychonopoulou et al6 in which more than 80% of the dental students considered tobacco cessation counselling a duty of every
dentist.
About 85% students responded to ban the use of all
kinds of tobacco products in public places, as compared to 90% response in
the 2005 GHPS of dental students in India.12
In this study, 87% of the students had awareness
regarding the harmful effects of tobacco on health, as compared to 92% reported by GHPS in dental students in India.12 However, dental students lack a
certain knowledge about the harmful effect of
tobacco on general health and well being of patients.
About 81% of the students were interested in receiving
training regarding anti-tobacco counselling as
compared to 70% in the study conducted by Fried
et al.13
Conclusion
This study shows 24.2% (125 out of 515) dental
students were tobacco users, of which more than
95% were male. Smoking is a more common form of
tobacco use than chewing is. The trend of using
tobacco products increases with the progression of academic years, which
may be correlated to increasing stress due to
the curriculum. Most of the dental students feel that it is their responsibility to promote tobacco cessation among
patients and are interested in receiving
the required training. Although the dental students have knowledge
regarding harmful effects of tobacco, a significant percentage of students
are habituated to it because of lack of motivation.
Recommendation
There is a necessity to train dental students
regarding anti-tobacco counselling during
their professional course, which will make them more confident in a tobacco cessation program.
Bibliography
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3. Victoroff KZ, Dankulich-Huryn T, Haque S.
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10. Koerber A, Crawford J, O’Connell K. The
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Table 10 |
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Figure 10 |