A study of habits of tobacco use among medical students and influence of various factors including medical education

Shailesh P. Parmar, Tushar R. Gosai, Krunal C. Solanki


Background: Tobacco use is a major preventable cause of morbidity and mortality. Tobacco usage among medical professionals should be reduced. It is important that they are aware regarding effects/ill effects of tobacco use, anti tobacco strategies, tobacco cessation technique to reduce tobacco usage among population. Authors undertook this study to understand tobacco use among medical students.

Methods: Authors conducted cross sectional, descriptive study by collecting anonymous data of 414 undergraduate medical students of medical college, Jamnagar in predesigned forms. Data were analysed using MS-excel and graphpad prism. Authors used Fagerstrom test for nicotine dependence to assess nicotine dependence.

Results: Tobacco users were 19.57%, among them 83.95% were smokers. Prevalence was higher in male (34.35% in male and 1.09% in female subgroup) and students with positive family history (36.81% in positive and 6.03% in negative family history subgroup). Current users were 7.73%. They were 8.20% in hosteller and 2.78% day scholar subgroups. Authors didn’t find statistical significant association of medical education with habit. Leading causes of starting tobacco use were curiosity/recreational purpose (35.8%), peer group pressure (32.10%) and stress (25.93%). Most of current user had low nicotine dependence (73.33%).

Conclusions: Tobacco use among medical students is a significant problem. Important factors affecting it are gender, family history, current living status, stress, peer group pressure, media influences. Authors recommend that special awareness programme and specific training regarding tobacco cessation should be given to medical students.


Medical students, Nicotine dependence, Smoking, Tobacco usage

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Mackay J, Eriksen M. The tobacco atlas. Geneva: World Health Organization; 2002.

GBD. Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study; 2015. Lancet 2017;389(10082):1885-906.

World Health Organization. WHO global report on trends in prevalence of tobacco smoking. Geneva: World health organization; 2015.

International Institute for Population Sciences (IIPS), Ministry of Health and Family Welfare (MoHFW), Government of India. Global Adult Tobacco Survey India report (GATS India), 2009-10. New Delhi: MoHFW, Government of India; Mumbai: IIPS; 2010.

Global Adult Tobacco Survey Collaborative Group. Tobacco Questions for Surveys: A Subset of Key Questions from the Global Adult Tobacco Survey (GATS), 2nd Edition. Atlanta, GA: Centers for Disease Control and Prevention; 2011.

Heatherton TF, Kozlowski LT, Frecker RC, Fagerström K. The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict. 1991;86:1119-27.

Kumar SG, Subba SH, Unnikrishna B, Jain A, Badiger S. Prevalence and factor associated with current smoking among medical students in coastal South India. Kathmandu Univ Med J. 2011;9(36):233-7.

Chatterjee T, Haldar D, Mallik S, Sarkar GN, Das S, Lahiri SK. Lung India. 2011;28(1):5-10.

Kumari R, Nath B. Study on the Use of Tobacco Among Male Medical Students in Lucknow, India. Indian J Community Med. 2008;33(2):100-3.

Mony PK. Is tobacco use increasing among medical students of Bengaluru city, India? Evidence from two cross-sectional studies. Natl Med J India. 2016;29(5):274-6.

Gupta AK, Mazta SR, Kumar S, Joshi I. Prevalence of use of Tobacco among Male Medical Students in IGMC Shimla, Himachal Pradesh, India. JIMSA. 2012;25(4):241-2.

Agaku IT, Ayo-Yusuf OA, Vardavas CI, Connolly G. Predictors and Patterns of Cigarette and Smokeless Tobacco Use Among Adolescents in 32 Countries, 2007–2011. J Adolesc Health. 2014;54(1):47-53.

Savitz DA, Meyer RE, Tanzer JM, Mirvish SS, Lewin F. Public Health Implications of Smokeless Tobacco Use as a Harm Reduction Strategy. American Journal of Public Health. 2006;96(11):1934-9.

Patel DR, Greydanus DE. Substance abuse: A paediatric concern. Indian J Pediatr. 1999;66:557-67.

Rami K, Makvana BJ, Thakor NC. Knowledge, attitude and practices of hookah smoking among medical students in Gujarat, India: a cross sectional study. Int J Adv Med. 2015;2(4):397-400.

Venkataraman S, Mukhopadhya A, Muliyil J. Trends of smoking among medical students. Indian J Med Res. 1996;104:316-20.

Singh SK, Narang RK, Chandra S, Chaturvedi PK, Dubey AL. Smoking habits of the medical students. Indian J Chest Dis Allied Sci. 1989;31:99-103.

Nawaz H, Imam SZ, Zubairi AB, Pabaney AH, Sepah YJ, Islam M, et al. Smoking habits and beliefs of future physicians of Pakistan, section of pulmonary and critical care medicine, Aga Khan University Hospital, Karachi, Pakistan. Int J Tuberculosis and Lung Diseases. 2007;11:915-9.

Ramakrishna GS, Sarma SP, Thankappan KR. Tobacco use among medical students in Orissa. Natl Med J India. 2005;18:285-9.