Menon Priya G, George Sanju, Nair B Sivasankaran, Rani Anjana, Thennarasu K, Jaisoorya T S
Department of Psychiatry, Government Medical College, Ernakulam, India.
Department of Psychology, Rajagiri School of Behavioural Sciences and Research, Ernakulam, India.
Tob Use Insights. 2020 Jul 10;13:1179173X20938773. doi: 10.1177/1179173X20938773. eCollection 2020.
Tobacco use is a major public health concern in India. Its use in young people is linked to increased severity, longer duration, and reduced efforts to seek treatment for tobacco use. A significant proportion of young people are enrolled in colleges, and early prevention during this period has better effectiveness. There is preliminary evidence that prevalence may vary across courses even among students of the same sociocultural background. Hence, we compared the prevalence and correlates of tobacco use among college students enrolled in five common streams of collegiate education (medical, nursing, engineering, arts/science and others, law/fisheries) in Kerala, India.
5784 college students from 58 colleges (medical, nursing, engineering, arts, and law and fisheries) selected by cluster random sampling in the district of Ernakulum, Kerala, completed a self-administered questionnaire incorporating standardized instruments. R software was used for analyses. Lifetime prevalence and severity of tobacco use were determined. Sociodemographic variables of tobacco users and nonusers enrolled in various courses were compared using chi-square test and two-way ANOVA. Furthermore, for each course, factors influencing tobacco use were identified using multivariable logistic regression analysis.
The mean age of the sample was 19.5 ± 1.9 years, with the majority being female (65.3%). Lifetime prevalence of tobacco use varied from 0.5% in nursing students, 4.2% in medical students, 8.2% in students of arts and science, 12.5% in engineering students, and 22.8% among other students (law/fisheries). Approximately two-thirds of all tobacco users across courses showed signs of nicotine dependence. Dependent users also showed variance with none in nursing, 2.6% among medicine, 1.6% among arts and science, 1.9% among engineering, and 6.3% among others. Male gender and alcohol use were consistently associated with tobacco use across courses, whereas other examined psychosocial correlates showed variance.
To conclude, it appears that among college students, course-level characteristics may influence risk of tobacco use. This has public health importance as it suggests that interventions need to be tailored bearing this in mind. Future research needs to examine campus-level characteristics that may explain variance.
烟草使用是印度主要的公共卫生问题。年轻人使用烟草与病情加重、病程延长以及减少寻求烟草使用治疗的努力有关。很大一部分年轻人进入了大学，在此期间进行早期预防效果更佳。有初步证据表明，即使在具有相同社会文化背景的学生中，不同课程的烟草使用率也可能有所不同。因此，我们比较了印度喀拉拉邦五门常见大学教育课程（医学、护理、工程、文科/理科及其他、法律/渔业）的大学生中烟草使用的患病率及其相关因素。
通过整群随机抽样从喀拉拉邦埃纳库卢姆区的58所学院（医学、护理、工程、文科以及法律和渔业学院）选取5784名大学生，他们完成了一份包含标准化工具的自填式问卷。使用R软件进行分析。确定烟草使用的终生患病率和严重程度。使用卡方检验和双向方差分析比较各课程中烟草使用者和非使用者的社会人口统计学变量。此外，对于每门课程，使用多变量逻辑回归分析确定影响烟草使用的因素。
样本的平均年龄为19.5±1.9岁，大多数为女性（65.3%）。烟草使用的终生患病率在护理专业学生中为0.5%，医学专业学生中为4.2%，文科和理科专业学生中为8.2%，工程专业学生中为12.5%，其他专业（法律/渔业）学生中为22.8%。所有课程中约三分之二的烟草使用者表现出尼古丁依赖迹象。依赖使用者也存在差异，护理专业中无依赖使用者，医学专业中有2.6%，文科和理科专业中有1.6%，工程专业中有1.9%，其他专业中有6.3%。男性性别和饮酒在所有课程中均与烟草使用持续相关，而其他经检查的心理社会相关因素则存在差异。
总之，在大学生中，课程层面的特征可能会影响烟草使用风险。这具有公共卫生重要性，因为这表明干预措施需要考虑到这一点进行调整。未来的研究需要考察可能解释差异的校园层面特征。
