@2024 Afarand., IRAN
ISSN: 2383-2150 Journal of Education and Community Health 2015;2(1):10-18
ISSN: 2383-2150 Journal of Education and Community Health 2015;2(1):10-18
Predictors of Tobacco Use among Medical Students of Ahvaz University: A Study Based on Theory of Planned Behavior
ARTICLE INFO
Article Type
Original ResearchAuthors
Araban M. (1)Karimy M. (2*)
Taher M. (3)
Baiati S. (3)
Bakhtiari A. (3)
Abrehdari H. (3)
Fayazi N. (3)
Abedi A. (4)
(1) Department of Public Health, School of Health, Ahvaz University of Medical Sciences, Ahvaz, Iran
(2*) Department of Public Health, School of Health, Saveh University of Medical Sciences, Saveh, Iran
(3) Department of Nursing, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran
(4) Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
Correspondence
Article History
Received: March 1, 2015Accepted: May 26, 2015
ePublished: September 17, 2015
ABSTRACT
Aims
Tobacco use among medical students is important for the health of the general population since medical groups are important role models in terms of health related behaviors. Therefore, the objective of this study was to investigate tobacco use and its predictors among medical students of Ahavaz University based on the theory of planned behavior (TPB).
Materials & Methods A cross-sectional study using a self-administered questionnaire was conducted in 2014 among 170 medical students (56 males, 114 females), at Ahvaz University of Medical Sciences. Data were analyzed using SPSS version 18 software program. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) and to determine the effect of demographic factors and theory of planned behavior (TPB) constructs on students’ smoking behaviors.
Findings From all subjects, 36% of boys and 3.5% of girls were current smokers. Using multiple logistic regression models, being male, having friends who smoke, smoking parents and smoking brother were strongly associated with tobacco use. Furthermore, all component of TPB, sub-jective norms, perceived behavioral control and intention were found to predict student’s smoking.
Conclusion The present study propose that subjective norms and selection of friends need to be consid-ered as the most important factors explaining smoking behavior among medical students be-sides the TPB constructs.
Materials & Methods A cross-sectional study using a self-administered questionnaire was conducted in 2014 among 170 medical students (56 males, 114 females), at Ahvaz University of Medical Sciences. Data were analyzed using SPSS version 18 software program. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) and to determine the effect of demographic factors and theory of planned behavior (TPB) constructs on students’ smoking behaviors.
Findings From all subjects, 36% of boys and 3.5% of girls were current smokers. Using multiple logistic regression models, being male, having friends who smoke, smoking parents and smoking brother were strongly associated with tobacco use. Furthermore, all component of TPB, sub-jective norms, perceived behavioral control and intention were found to predict student’s smoking.
Conclusion The present study propose that subjective norms and selection of friends need to be consid-ered as the most important factors explaining smoking behavior among medical students be-sides the TPB constructs.
CITATION LINKS
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[16]Taremian F, Bolhari J, Peyravi H, Asgari A. [Drug use prevalence among students of universities of medical sciences in Tehran]. Journal of Research on Addiction.2014; 7(28):9-21. (Persian)
[17]Cote F, Godin G, Gagné C. Identification of factors promoting abstinence from smoking in a cohort of elementary schoolchildren. Prev Med.2004; 39(4):695-703.
[18]Karimy M, Niknami S, Heidarnia AR, Hajizadeh I. [Measuring constructs of Theory of Planned Behavior (TPB) regarding cigarette use among adolescents]. Journal of Kermanshah University of Medical Sciences.2013; 16(8):617-25. (Persian)
[19]Karimy M, Niknami S, Hidarnia AR, Hajizadeh E, Shamsi M. Evaluation of intrapersonal and interpersonal factors of male adolescent smoking. Journal of Research & Health.2013; 3(3):445-51.
[20]Tavousi M, Montazeri A, Hidarnia A, Hajizadeh E, Taremian F, Haerimehrizi A. Substance use avoidance among Iranian male adolescents: a comparison of three versions of the theory of reasoned action. Int J Adolesc Med Health.2015; 27(3):329-34.
[21]Homa Z, Kiomars N, Moosa K, Maryam S. Substance use among students of Guilan University of Medical Sciences in Iran in 2005-2006. Acta Med Iran.2009; 47(6):473-8.
[22]Sahraian A, Sharifian M, Omidvar B, Javadpour A. Prevalence of substance abuse among the medical students in Southern Iran. Shiraz E Med J.2010; 11(4):198-202.
[23]Kebede Y. Cigarette smoking and khat chewing among college students in North West Ethiopia. East Afr Med J.2002; 79(5):274-8.
[24]Al-Kaabba AF, Saeed AA, Abdalla AM, Hassan HA, Mustafa AA. Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia. J Family Community Med.2011; 18(1):8-12.
[25]Siziya S, Rudatsikira E, Muula AS, Ntata PR. Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross sectional study from Chongwe district. Rural Remote Health.2007; 7(3):728.
[26]Alexopoulos EC, Jelastopulu E, Aronis K, Dougenis D. Cigarette smoking among university students in Greece: a comparison between medical and other students. Environ Health Prev Med.2010; 15(2):115-20.
[27]Eticha T, Kidane F. The prevalence of and factors associated with current smoking among College of Health Sciences students, Mekelle University in northern Ethiopia. PloS One.2014; 9(10):e111033.
[28]Hassan HM, Mahmoud SS, Katasha MK, Isaa LF, Abdel-Wahed A, Kandil S, et al. Tobacco smoking among students of Al-Ghad college for applied medical sciences for male in Riyadh, Saudi Arabia. Int J Med Sci Public Health.2014; 3(10):1196-200.
[29]Cooke R, Dahdah M, Norman P, French DP. How well does the theory of planned behaviour predict alcohol consumption? A systematic review and meta-analysis. Health Psychol Rev.2014; 1-20.
[30]Van De Ven MO, Engels RC, Otten R, Van Den Eijnden RJ. A longitudinal test of the theory of planned behavior predicting smoking onset among asthmatic and non-asthmatic adolescents. J Behav Med.2007; 30(5):435-45.
[31]Wilkinson D, Abraham C. Constructing an integrated model of the antecedents of adolescent smoking. Br J Health Psychol.2004; 9(3):315-33.
[32]van Lettow B, de Vries H, Burdorf A, Conner M, van Empelen P. Explaining young adults' drinking behaviour within an augmented Theory of Planned Behaviour: temporal stability of drinker prototypes. Br J Health Psychol.2015; 20(2):305-23.
[33]Higgins A, Conner M. Understanding adolescent smoking: The role of the Theory of Planned Behaviour and implementation intention. Psychol Health Med.2003; 8(2):173-86.
[34]Karimy M, Niknami S, Hidarnia A, Hajizadeh E, Shamsi M. Personal attitudes, risk perception and perceived vulnerability toward water pipe smoking among male students in Zarandieh. Health Education & Health Promotion.2013; 1(2):47-59.
[35]Jradi H, Wewers ME, Pirie PP, Binkley PF, Ferketich AK. Lebanese medical students' intention to deliver smoking cessation advice. J Epidemiol Glob Health.2015; 5(2):117-23.
[36]Eisenberg ME, Forster JL. Adolescent smoking behavior: measures of social norms. Am J Prev Med.2003; 25(2):122-8.
[37]Nazari M, Hosseini MR, Kaveh MH. The impact of education on smoking refrain based on the theory of planned behavior on Shiraz high school students’ attitudes. J Health Sci Surveillance Sys.2013; 1(2):83-8.
[38]Smit ES, de Vries H, Hoving C. Determinants of practice nurses' intention to implement a new smoking cessation intervention: the importance of attitude and innovation characteristics. J Adv Nurs.2013; 69(12):2665-74.
[2]Deressa W, Azazh A. Substance use and its predictors among undergraduate medical students of Addis Ababa University in Ethiopia. BMC Public Health.2011; 11(1):660.
[3]Harakeh Z, Scholte RH, Vermulst AA, de Vries H, Engels RC. Parental factors and adolescents' smoking behavior: an extension of The theory of planned behavior. Prev Med.2004; 39(5):951-61.
[4]AlSwuailem AS, AlShehri MK, Al-Sadhan S. Smoking among dental students at King Saud University: Consumption patterns and risk factors. Saudi Dent J.2014; 26(3):88-95.
[5]Karimy M, Niknami S, Hidarnia AR, Hajizadeh I. Intention to start cigarette smoking among Iranian male adolescents: usefulness of an extended version of the theory of planned behaviour. Heart Asia.2012; 4(1):120-4.
[6]Ebadi M, Vahedian M, Azin A, Aeenparast A, Omidvari S, Jahangiri K, et al. [Prevalence of tobacco consumption: Iranian health perception survey]. Payesh.2011; 10(3):365-72.
[7]Karimy M, Niknami S, Heidarnia AR, Hajizadeh I, Montazeri A. Prevalence and determinants of male adolescents’ smoking in Iran: An explanation based on the theory of planned behavior. Iran Red Crescent Med J.2013; 15(3):187-93.
[8]Karimy M, Niknami S, Heidarnia AR, Hajizadeh E, Shamsi M. Refusal self efficacy, self esteem, smoking refusal skills and water pipe (Hookah) smoking among Iranian male adolescents. Asian Pac J Cancer Prev.2013; 14(12):7283-8.
[9]Morean ME, Camenga DR, Kong G, Cavallo DA, Schepis TS, Krishnan-Sarin S. Predictors of middle school students’ interest in participating in an incentive-based tobacco prevention and cessation program in connecticut. J Addict.2014; 2014:915652.
[10]Shojaa M, Jouybari L, Qorbani M, Sanagoo A, Shojaee H, Kajoori ZK, and et al. [Prevalence and cause of smoking among the dormitories students in Gorgan University of Medical Sciences]. Pajoohandeh.2010; 15(3):123-8. (Persian)
[11]Nazemi S, Chaman R. Prevalence of smoking among universities students of Shahroud in 2010. Open J Prev Med.2012; 2(2):235-9.
[12]Zareipour M, Sadeghi R, Sadeghi Tabatabaei S, Seyedi S. [Effective factors smoking based on BASNEF model in male student in Tehran medical sciences university in 2009]. Journal of Urmia Nursing and Midwifery Faculty.2011; 9(1):23-9. (Persian)
[13]Saulle R, Bontempi C, Baldo V, Boccia G, Bonaccorsi G, Brusaferro S, and et al. GHPSS multicenter Italian survey: smoking prevalenc, knowledge and attitudes, and tobacco cessation training among third-year medical students. Tumori.2013; 99(1):17-22.
[14]Anders S, Strobel L, Krampe H, Raupach T. [Do final-year medical students know enough about the treatment of alcohol use disorders and smoking?]. Dtsch Med Wochenschr.2013; 138(1-2):23-7.
[15]Sinha DN, Rinchen S, Palipudi KM, Naing Shein N, de Silva P, Khadka BB, and et al. Tobacco use, exposure to second-hand smoke, and cessation training among the third-year medical anddental students in selected Member States of South-East Asia region: A trend analysis on data from the Global Health Professions Student Survey, 2005-2011. Indian J Cancer.2012; 49(4):379-86.
[16]Taremian F, Bolhari J, Peyravi H, Asgari A. [Drug use prevalence among students of universities of medical sciences in Tehran]. Journal of Research on Addiction.2014; 7(28):9-21. (Persian)
[17]Cote F, Godin G, Gagné C. Identification of factors promoting abstinence from smoking in a cohort of elementary schoolchildren. Prev Med.2004; 39(4):695-703.
[18]Karimy M, Niknami S, Heidarnia AR, Hajizadeh I. [Measuring constructs of Theory of Planned Behavior (TPB) regarding cigarette use among adolescents]. Journal of Kermanshah University of Medical Sciences.2013; 16(8):617-25. (Persian)
[19]Karimy M, Niknami S, Hidarnia AR, Hajizadeh E, Shamsi M. Evaluation of intrapersonal and interpersonal factors of male adolescent smoking. Journal of Research & Health.2013; 3(3):445-51.
[20]Tavousi M, Montazeri A, Hidarnia A, Hajizadeh E, Taremian F, Haerimehrizi A. Substance use avoidance among Iranian male adolescents: a comparison of three versions of the theory of reasoned action. Int J Adolesc Med Health.2015; 27(3):329-34.
[21]Homa Z, Kiomars N, Moosa K, Maryam S. Substance use among students of Guilan University of Medical Sciences in Iran in 2005-2006. Acta Med Iran.2009; 47(6):473-8.
[22]Sahraian A, Sharifian M, Omidvar B, Javadpour A. Prevalence of substance abuse among the medical students in Southern Iran. Shiraz E Med J.2010; 11(4):198-202.
[23]Kebede Y. Cigarette smoking and khat chewing among college students in North West Ethiopia. East Afr Med J.2002; 79(5):274-8.
[24]Al-Kaabba AF, Saeed AA, Abdalla AM, Hassan HA, Mustafa AA. Prevalence and associated factors of cigarette smoking among medical students at King Fahad Medical City in Riyadh of Saudi Arabia. J Family Community Med.2011; 18(1):8-12.
[25]Siziya S, Rudatsikira E, Muula AS, Ntata PR. Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross sectional study from Chongwe district. Rural Remote Health.2007; 7(3):728.
[26]Alexopoulos EC, Jelastopulu E, Aronis K, Dougenis D. Cigarette smoking among university students in Greece: a comparison between medical and other students. Environ Health Prev Med.2010; 15(2):115-20.
[27]Eticha T, Kidane F. The prevalence of and factors associated with current smoking among College of Health Sciences students, Mekelle University in northern Ethiopia. PloS One.2014; 9(10):e111033.
[28]Hassan HM, Mahmoud SS, Katasha MK, Isaa LF, Abdel-Wahed A, Kandil S, et al. Tobacco smoking among students of Al-Ghad college for applied medical sciences for male in Riyadh, Saudi Arabia. Int J Med Sci Public Health.2014; 3(10):1196-200.
[29]Cooke R, Dahdah M, Norman P, French DP. How well does the theory of planned behaviour predict alcohol consumption? A systematic review and meta-analysis. Health Psychol Rev.2014; 1-20.
[30]Van De Ven MO, Engels RC, Otten R, Van Den Eijnden RJ. A longitudinal test of the theory of planned behavior predicting smoking onset among asthmatic and non-asthmatic adolescents. J Behav Med.2007; 30(5):435-45.
[31]Wilkinson D, Abraham C. Constructing an integrated model of the antecedents of adolescent smoking. Br J Health Psychol.2004; 9(3):315-33.
[32]van Lettow B, de Vries H, Burdorf A, Conner M, van Empelen P. Explaining young adults' drinking behaviour within an augmented Theory of Planned Behaviour: temporal stability of drinker prototypes. Br J Health Psychol.2015; 20(2):305-23.
[33]Higgins A, Conner M. Understanding adolescent smoking: The role of the Theory of Planned Behaviour and implementation intention. Psychol Health Med.2003; 8(2):173-86.
[34]Karimy M, Niknami S, Hidarnia A, Hajizadeh E, Shamsi M. Personal attitudes, risk perception and perceived vulnerability toward water pipe smoking among male students in Zarandieh. Health Education & Health Promotion.2013; 1(2):47-59.
[35]Jradi H, Wewers ME, Pirie PP, Binkley PF, Ferketich AK. Lebanese medical students' intention to deliver smoking cessation advice. J Epidemiol Glob Health.2015; 5(2):117-23.
[36]Eisenberg ME, Forster JL. Adolescent smoking behavior: measures of social norms. Am J Prev Med.2003; 25(2):122-8.
[37]Nazari M, Hosseini MR, Kaveh MH. The impact of education on smoking refrain based on the theory of planned behavior on Shiraz high school students’ attitudes. J Health Sci Surveillance Sys.2013; 1(2):83-8.
[38]Smit ES, de Vries H, Hoving C. Determinants of practice nurses' intention to implement a new smoking cessation intervention: the importance of attitude and innovation characteristics. J Adv Nurs.2013; 69(12):2665-74.