Tobacco dependence among medical students and their attempts for cessation: Obstacles and factors that affect the success

Introduction and Purpose Tobacco use is a serious public health problem in terms of both mortality and morbidity. Studies that have been carried out in our country show that the rate of tobacco use is 27,1%. In our country the rates for starting smoking under the age of 15 and under the age of 18 are 16,1% and 58,7% respectively. For this reason, it is important to investigate the tobacco dependence in early adulthood and to fight against tobacco use. In our study, we aimed to determine the status of tobacco use, the reasons of starting smoking, attempts to quit, the rate and reasons of success in their attempts, the obstacles and reasons of failure, and physician inquiry about their smoking habit, in a group of students studying in fields of health occupations. Material and Methods Our study was designed as a cross-sectional analytic survey, and 869 of 965 students studying at Adnan Menderes University Faculty of Medicine in 2014-2015 academic year participated in this study. A questionnaire was prepared in March 2015 for the participating students. In this questionnaire, we directed questions about their smoking history, their attempts for cessation, and the reasons of their success or failure. The obtained data evaluated statistically. Results Two hundred twenty (25,9%) of the 869 students participating in our study have been using tobacco products. The mean age of starting to smoke regularly, was found as 18. Among the reasons for regular tobacco use, curiosity (n=77; 44%), relaxing and pleasure-inducing effect (n=27; 15,4%), stress and personal problems(n=24; 13,7%) were the most common respectively. The reported periods of increased tobacco use were; exam periods (n=118; 58,4%) and emotional stress (n=103; 51%), and the periods of decreased usage were; when at home (n=57; 30,5%) and on vacations and holidays (n=49; 26,2%). It was realized that in stressful situations the tobacco usage increases whereas during relaxed and comfort periods it conversely decreases. The first three reasons to quit smoking were; thinking that it is harmful for their health (n=108; 71,1%), the financial burden (n= 67; 44,1%) and for the health problems smoking may cause in the future(n=63; 41,4%). The reason that they have choosen as a profession was found to be at the bottom places on the list. Ninety nine of the smoking students (53,2%) stated that they have tried to quit smoking at least once in the last year. The most stated reasons for attempt to quit smoking were; thinking that it is harmful for their health (n=77; 66,4%), the financial burden (n= 58; 50%) and for the health problems smoking may cause in the future (n=47; 40,5%). Having chosen medicine as a profession was found to be at the 8th place on the list. The mostly stated factors that have made them successful in their attempt to quit smoking were found to be; their will (self control) (n=41; 71,9%) and friend support (n=12; 21,1%); the most frequent reasons for their failures in their attempts were found as ; yearn for cigarette (n=42; 51,2%) and having difficulties with studying during exam periods (n=28; 34,1%). About the question that if any doctors have ever asked about their smoking history; 149 students (33,9%) stated that they have only been asked whether they use or not; 58 ( (45,3%) have been recommended to quit. 14 (30,4%) students stated that some doctors recommended them professional support. It was found that mostly the pulmonologists have asked smoking history, and advised to quit, also have offered to arrange professional support. Conclusion More than half of the students who have chosen medicine as a profession have used tobacco products. Smoking rate increases during exam periods and in case of emotional stress, while it decreases when at family home or on holidays and vacations. Nearly half of the students have been asked about their smoking history by the physicians that they have consulted for their health problems, however even fewer of them have been advised to quit smoking and offered professional support. Most commonly pulmonologists have advised cessation. It is remarkable that family physicians inquire about tobacco use however a few of them offer support for quitting smoking. Key Words: Medical Students, tobacco use, tobacco addiction, smoking cessation