The Relationship Between University Students’ Smoking Attitudes and Depression

Background: There is limited research on the impacts of smoke-free policies on students’ attitudes and smoking behaviors at Historically Black Colleges and Universities (HBCUs) in the United States. This study examined African American students’ attitudes toward differential smoke-free campus policies and their smoking behavior at two HBCUs in the Mid-Atlantic region. Methods: In this original study, 202 African American undergraduate and graduate students enrolled at two urban HBCUs participated and completed the online and in-person surveys conducted between October and December 2019. Descriptive statistics (Chi-square χ2 and t-statistics) and multivariable logistic regression were used to examine differences in smoking attitudes and behaviors by smoking-free policies. Results: One of the two surveyed HBCUs supported a comprehensive smoke-free policy (CSFP), which prohibits any tobacco use, including smoking, anywhere on campus at any time. The other HBCU followed a regular smoke-free policy (RSFP), which limits smoking to certain designated areas. The majority of students at the two schools reported that the smoke-free policy had not affected their smoking behavior. The multivariable analysis did not indicate a statistically significant association between students’ attitudes toward smoke-free policies and their smoking behavior. Furthermore, the difference in smoking prevalence between the two schools was not statistically significant by policy type. Conclusions and Implications for Translation: Smoke-free polices have the potential to educate about smoking and impact attitudes toward smoking. Implementing and enforcing a comprehensive or regular smoke-free policy is an essential initiative to ensure a healthy learning environment for students. Understanding the context-specific factors that contribute to smoking behaviors among African American students provides additional important insights into developing programs for students at HBCUs. Key words: • Comprehensive or Regular Smoke-Free Policy • Health Equity • Health Disparities • Historically Black Colleges and Universities (HBCU) • Tobacco Control • Student Copyright © 2020 Martin, Jr. et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

BackgroundE-cigarettes use “vaping” is a growing public health concern. The Arabic-validated Vaping Attitude and Perceptions Scale (VAPeS) instrument assesses vaping determinants across five constructs: Social Influence, Perceived Harms, Vaping Pleasure, Behavioral Influences, and Economic and Self-Efficacy. We aimed to examine the prevalence of cigarette, e-cigarette, and narghile use among Arab university students and to identify the associations between demographic/VAPeS-related variables and the smoking attitudes among vapers.MethodsA cross-sectional survey was distributed online among university students across Arab countries during January–April 2025. Prevalence estimates were calculated using one-sample proportions with Wilson Score confidence intervals. The modified VAPeS scale comprising four constructs after confirmatory factor analysis (Social Influence, Perceived Benefits, Behavioral Influence - Risk, and Behavioral Influence - Situational Triggers) was used to assess tobacco use attitudes. The primary outcome was the Endorsement of Tobacco Use Attitude Score (ETUAS). Multivariate analyses using multinomial logistic and linear regressions were conducted to examine factors associated with tobacco use attitudes.ResultsAmong 1,338 university students surveyed, the majority were from Kuwait (21.0%), Egypt (18.5%), Kingdom of Saudi Arabia (KSA, 17.8%), Jordan (16.7%), and the United Arab Emirates (UAE, 10.0%). Vaping was the most prevalent form of tobacco use (21.2%), surpassing narghile (12.9%) and cigarette smoking (10.8%). Multivariate analyses revealed that male students were more likely to engage in all three tobacco use forms. Male sex was associated with higher prevalence of vaping (adjusted odds ratio (AOR) = 6.97; p < 0.001), with higher odds among UAE students (AOR = 2.31; p = 0.013), and lower odds among those studying in Egypt, Jordan, and KSA. Among current smokers, the mean ETUAS indicated a moderate level of agreement with attitudinal statements endorsing tobacco use (3.25 ± 0.92). In linear regression among vapers, male sex (B = −0.325; p = 0.003), Social Influence (B = 0.300; p < 0.001), and Behavioral Influence - Situational Trigger (B = 0.205; p = 0.002) were significantly associated with favorable attitudes toward tobacco use.ConclusionThis multinational study found vaping to be the leading form of tobacco use among Arab university students. Favorable attitudes toward tobacco use were associated with male sex, social influence, and the situational triggers. Interventions should target social normalization, strengthen regulations, and apply tools like VAPeS to understand youth vaping risks.

University students are at high risk of practicing the smoking habit being exposed to smoking peers and easier cigarette availability. This study aims to explore prevalence, attitude and pattern of tobacco smoking and quitting among Beni-Suef University students. A cross-sectional study was conducted from March to May 2019. A total of 4,599 students were selected by using randomized multi-stage sampling using self-administered questionnaire for data collection. The mean age of students found to be smokers was 20.8 ± 1.42 years. Males: Females' ratio was 2:1 (66 vs.34%). Prevalence of smoking was 17.4%. Students of non-medical and non-health colleges showed a significant high smoking rate (18.8 and 18.3% respectively) than students in health faculties (15.2%); p=0.017. Participants believed that they might smoke because of: peers' pressure (73.3%), stress (71.4%), imitating popular figures (61.7%) and availability of money (60.4%). Regarding smoking provinces; 86.1% did smoke in coffee-shops, 73.1% in university yards and only 16.87% used to smoke at home Regarding the attitudes of smokers and nonsmokers towards smoking; the acceptance of indoor smoking was significantly higher (85.6%) among smokers than non-smokers (6.42%); p=0.0001. Of note; 51.2% of smokers versus 86.3% of non-smokers agreed to ban smoking in public places (P=0.001). Majority of smokers (72.1%) had the desire to stop smoking while (57.8%) tried to stop smoking but failed. Smoking is becoming a habit among university students and initiative of a smoke free environment should be encouraged and subject and method.

Background: Tobacco smoking is a global concern, and tobacco use is increasing among youth in Arab countries, such as Yemen, particularly among university students. The aim of this study was initially to explore smoking behaviours, attitudes and smoking-related knowledge among students in Yemen in various colleges/ departments. Methods: A cross-sectional descriptive study was conducted in urban and rural areas from March-May 2019. The data were collected from the faculties of Hodeidah University, as well as from the departments of Community College. The questionnaire was adapted from the Global Health Professionals Survey and Global Youth Tobacco Survey. A total of 760 students were randomly selected. Results:In the present study, 53 (27.3%) smokers who scored very high were considered vulnerable to high smoking dependency based on the FTND. Linear regression analysis revealed that students’ smoking-related knowledge was strongly statistically associated with age, residence, smoking status, and geographic area (P<0.001). Sex, marital status, and school-year level were also significant predictors of smoking-related knowledge (P<0.05). The analysis revealed that age, family income, marital status, and school-year level were strongly associated with students’ attitudes and beliefs concerning smoking (P<0.001). However, the analysis revealed that age >24 years and second and fourth school years were strongly associated with smoking behaviour (P<0.001). Students who obtained high attitude scores had low scores for smoking dependence (P<0.05). The attitudes and beliefs of smokers toward smoking were more significantly favourable than those of nonsmokers, and nonsmokers had significantly greater smoking-related knowledge than smokers did (P<0.001). The difference in knowledge levels about the negative effects of smoking and toxic tobacco substances from cigarettes among students from different departments and colleges was highly significant (P<0.001). Conclusions:This study found a high level of smoking dependency among smokers, as indicated by FTND scores. Fourth-year students exhibited stronger smoking attitudes, greater knowledge, and lower dependency. Smokers had more positive attitudes toward smoking, while nonsmokers showed better awareness of its harmful effects. Significant differences in smoking-related knowledge were noted across different departments and colleges, emphasizing the need for targeted anti-smoking programs and enhanced education on the consequences of smoking.

ObjectivesDuring the last two decades, cigarette smoking witnessed a global increase in use, especially among youth. Loneliness is one of the possible psychosocial determinants of smoking. This study examined the...

Background:Students, clergymen and teachers as role models can be very important in encouragement or prevention of cigarette smoking in young people. The aim of this study was to compare prevalence of smoking in 3 male groups of teachers, clergymen and university students. Also, study their knowledge and attitude towards it and the prediction of their future consumption.Methods:In a cross sectional study in 2009 in Tehran, Iran, 1,271 male students, 549 clergymen and 551 teachers were randomly enrolled. Each participant completed the global adult tobacco survey questionnaire. Knowledge, attitude and prediction of smoking for the next 5 years were questioned in these 3 groups. Chi-squared test and logistic regression were used for analysis. P < 0.05 was considered significant.Results:Prevalence of cigarette smoking was 31.1%, 21.9% and 27.2% among students, clergymen and teachers, respectively. Smoking in students was not associated with poor knowledge but were in teachers and clergymen. The odds ratio of smoking in students, clergymen and teachers was higher among those with having inappropriate attitude towards it (OR = 1.6, 6.1 and 4.5). Those with poor knowledge had an inappropriate attitude and predicted higher chance of cigarette consumption in the next 5 years (P < 0.0001). Inappropriate attitude in all 3 groups resulted in higher prediction of future smoking (P = 0.008).Conclusions:This study revealed that the prevalence of smoking among male students and teachers was higher than general population and clergymen who equally smoked. Also, level of knowledge and attitude of students were lower than teachers and clergymen.

Background: Smoking remains a major public health challenge worldwide. This study explores a key aspect and a significant contributor to the smoking habits of young adults who are university students, which is the influence of family and friends. This study helps to organize more targeted health campaigns for smoking cessation and provides a more in-depth look at the psychology of smokers.Methods: This study employs a cross-sectional design. The questionnaire encompassed four sections: demographics, smoking history, reasons for smoking and quitting, and social and family influence.Results: Of all the participants, 24.8% were identified as current smokers. The results showed that the strongest predictor linked to smoking was having smoking friends, with an odds ratio of 5.05 (p<0.001), followed by the family's behavior toward smoking, with an odds ratio of 3.53 (p<0.001). Additionally, around 40.0% of smokers reported being dependent. Only 15.2% of smokers reported a frequent exposure to public health campaigns.Conclusion: The study demonstrates essential factors that contribute to smoking behaviors; one of them is friends who are smokers. Additionally, the lack of public health campaigns is a concern. Therefore, public health interventions targeting smoking cessation are recommended. Further studies can target the effect of public health interventions on the attitudes of smokers.

Healthcare professionals have an important role to play both as advisers - influencing smoking cessation - and as role models. The aims of this study were to examine smoking prevalence, knowledge and attitudes among Italian university students attending medical schools using the Global Health Professions Student Survey (GHPSS) approach. A multicenter cross-sectional study was conducted among University students of 9 Italian medical schools (age ranging between 19 and 29 years). The GHPSS questionnaire was self-administered. A logistic regression model was used to identify possible factors associated with tobacco smoking status. Data were analyzed with the software SPSS 19.0 for Windows. Seven hundred thirty medical students (response rate 100%) were enrolled. The prevalence of current smokers was 20.4% (males 22.4%, females 19.1%). Of the total sample, 87.7% believed that health professionals should receive specific training in techniques to quit smoking, and 65% believed that health professionals had a role in giving advice or information about smoking cessation. However, 89.4% answered that they had not received specific training on smoking cessation techniques. Multivariate analysis showed that students belonging to universities in southern Italy were more likely to be smokers (OR = 2.00; 95% CI: 1.03-3.97). This Italian multicenter survey found that one fifth of future medical doctors are smokers. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.

Healthcare professionals have an important role to play both as advisers - influencing smoking cessation - and as role models. The aims of this study were to examine smoking prevalence, knowledge and attitudes among Italian university students attending medical schools using the Global Health Professions Student Survey (GHPSS) approach. A multicenter cross-sectional study was conducted among University students of 9 Italian medical schools (age ranging between 19 and 29 years). The GHPSS questionnaire was self-administered. A logistic regression model was used to identify possible factors associated with tobacco smoking status. Data were analyzed with the software SPSS 19.0 for Windows. Seven hundred thirty medical students (response rate 100%) were enrolled. The prevalence of current smokers was 20.4% (males 22.4%, females 19.1%). Of the total sample, 87.7% believed that health professionals should receive specific training in techniques to quit smoking, and 65% believed that health professionals had a role in giving advice or information about smoking cessation. However, 89.4% answered that they had not received specific training on smoking cessation techniques. Multivariate analysis showed that students belonging to universities in southern Italy were more likely to be smokers (OR = 2.00; 95% CI: 1.03-3.97). This Italian multicenter survey found that one fifth of future medical doctors are smokers. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.

Tobacco smoking is considered to be the key preventable risk factor for morbidity and mortality at the global level. The aim of this study was to determine the prevalence of tobacco smoking and factors associated with the initiation of smoking among university students in Dhaka, Bangladesh. A cross-sectional survey study was conducted with 264 students of Jahangirnagar University, Dhaka, Bangladesh in 2015. A standard, self-administered questionnaire consisting of questions on socio-demographic variables, tobacco smoking status, family and peer tobacco smoking history, attitudes and beliefs about tobacco smoking, as well as knowledge about the negative health consequences of tobacco smoking was administered to participants. Data were analyzed using logistic regression models, chi square, and Fisher exact tests. The overall prevalence of tobacco smoking was 60.2%, where males smoked at higher rates than females (68.81% and 19.56%, respectively). The influence of friends was the most significant reason for initiating tobacco smoking (OR: 0.862; CI: 0.810-0.917). Perception regarding tobacco smoking was significantly related to continuing tobacco use. Logistic regression models identified that smoking-related attitudes, potential health problems, and family members dying from cardiovascular disease and cancer were significantly associated with tobacco smoking. The current tobacco smoking prevalence among university students in Bangladesh is over 60%. We suggest adopting WHO Framework Convention on Tobacco Control (FCTC) policies, especially for university students.

Smoking habits, knowledge, and attitudes of final year university students in the health professions

Tobacco smoking is a major public health problem globally. The vast majority of smokers start smoking early. The hazards of smoking depend on a plethora of factors such as the age one starts to smoke, number of cigarettes smoked per day, nicotine, and filter type of the cigarette among other factors. According to the World Health Organization, most tobacco-related deaths occur in low- and middle-income countries. Undergraduate students are an important part of the general population, and their life conditions, smoking rates, and the knowledge, attitudes, and exposure to smoking (including secondhand smoke) are an interesting topic for investigation. The aim of the present study is to investigate undergraduate university students' smoking attitudes as well as the prevalence of smoking and their exposure to secondary smoke. A cross-sectional study was conducted in 600 undergraduate students in Central Greece. Anonymous self-report-adjusted questionnaires were distributed in students of the Technological Educational Institute of Thessaly. The total prevalence of tobacco smoking was 35%, while the majority of the smokers were females (65%). Fifty-three of the participants reported daily exposure to secondary smoke inside their houses, and 45% of them reported daily exposure to secondary smoke in their work.

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Smoking is the leading cause of morbidity and mortality worldwide. Smoking killed more than 6 million people, about 80% in the developing countries such as Pakistan in 2011. Now it has become major public health issue in the world.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A descriptive cross-sectional study was conducted among 542 students at University of Azad Jammu and Kashmir in Muzaffarabad, Pakistan from July to December 2015. The data were collected using a pre-tested, self-administered, validated questionnaire requiring information about socio-demographic characteristics, practice and patterns of cigarette smoking, knowledge about its harmful effects and attitude towards smoking control and prevention measures. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The prevalence of cigarette smoking among students was 49.5%. The mean age for starting cigarette smoking was 19.2±2.73 years. Cigarette smoking constituted 61.3% and shisha constituted 18.4%. The main reason for cigarette smoking was peer pressure (35.0%) followed by family influencing (24.5%). About 79.5% of the smokers had intension to quit smoking. There was no significant difference (p value=0.484) between prevalence of cigarette smoking in different faculties of University of Azad Jammu and Kashmir. The majority of the students (84.3%) knew that smoking is harmful for their health. However, rates of non-smoking students who knew the adverse effects of smoking were significantly higher than that of students who smoke. A high rate of students showed positive attitude towards smoking prevention and control measures.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; High prevalence of cigarette smoking was reported among students. There is a need to implement an anti-smoking program among students at University of Azad Jammu and Kashmir.

The purpose of this cross sectional study was to explore university students' knowledge, attitude and practice towards smoking and to compare these factors between smokers and non-smokers. A sample of 2793 students was randomly selected to complete a self-administered questionnaire about knowledge, attitude and practice of smoking at three universities in Irbid, Jordan. The Majority of the smoking students (75.2%) knew the adverse effects of smoking. Rates of non-smoking students who knew the adverse effects of smoking were significantly higher than that of students who smoke. A high rate of students showed an opposing attitude towards the assumption that smoking females would have more friends (89.6%), have stronger personality (93.4%), and be more attractive (90.6%) than non-smoking females. Similar higher rates of negative attitude were also observed towards the smoking male. About 50% of smokers have a misguided belief that smoking helps them concentrate while studying and 37.7% believe that smoking helps in avoiding obesity. Students that started smoking before enrollment in a university had a significantly higher rate of heavy smoking as compared to those who started smoking after being enrolled. Students smoke not because they lack the knowledge about the risk of smoking but due to misguided beliefs and attitudes. Key words: Attitude, knowledge, practice, smoking, students, university.

Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year university completed an online survey in 2008. Current (past 30-day) smoking was reported by 43.5% of 2-year and 31.9% of 4-year college students, and daily smoking was reported by 19.9% of 2-year and 8.3% of 4-year college students. Attending a 2-year college was associated with higher rates of current smoking [odds ratio (OR) = 1.72] and daily smoking (OR = 2.84), and with less negative attitudes regarding smoking, controlling for age, gender, ethnicity and parental education. Also, compared with 4-year college student smokers, 2-year college smokers had lower motivation to smoke for social reasons, but more motivation to smoke for affect regulation, after controlling for age, gender, ethnicity and parental education. Two- and 4-year college students report different smoking patterns, attitudes and motives. These distinctions might inform tobacco control messages and interventions targeting these groups of young adults.