Knowledge and Attitude towards Smoking among Fayoum University Students

Smoking is a behavioral cause of premature morbidity and mortality, resulting in approximately four million persons dying of smoking-related diseases annually worldwide. This study aims to investigate the extent of smoking habit, knowledge toward smoking among Fayoum University students. A cross sectional analytical study was conducted in Fayoum University during the academic year 2010. A total of 804 students were selected by using randomized multi-stage sampling using self-administered questionnaire for data collection. Data were analyzed using SPSS version 16. The respondents age ranged from 18 to 26 years 20.36 ± (1.21) years. The males were 51% (n=410) and females were 49% (n=394). The prevalence of smoking among students was 13.4%. a large percentage of the smokers 82.4% used cigarettes while 8.3% smoked water pipe. Regarding knowledge about smoking related diseases, 97.3% of the students knew that smoking causes diseases; but only 5.6% of the sample had good/and satisfactory knowledge score about the causal role of tobacco in the development of specific diseases, and 66.7% of smoker students want to quit with a higher intention of for older group. In conclusion, smoking is prevalent among the university students and their knowledge about the harmful effects of smoking is generally superficial. Definite counseling programs are greatly needed to help students quit smoking.


INTRODUCTION
Smoking is the most important preventable cause of death, there are 4 million persons dying of smoking-related diseases annually.
The annual mortality will exceed ten million during the 2020s. The prevalence of smoking in African countries ranged from 17% to 32%. (1)

US Department of Health and
Human Services reported that 48% of men and 7% of women in developing countries smoke. While in industrialized countries, 42% of men and 24% of women smoked. (2) The harmful effects of cigarette smoking are destructive and widespread. Smoking affect, nearly every organ in the body and 574 Bull High Inst Public Health Vol.40 No. 3 [2010] half of all long-term smokers die prematurely from smoking-related disease.
For every person who dies from tobacco use, another 20 suffer; with at least one serious tobacco-related illness. (3) According to CDC report; 80% of adult smokers begun smoking before the age of 18 years and every day, nearly 3000 young people become regular smokers. (3) If there is no action plan to stop initiate smokers, more than 5 million children will die prematurely because of future smoking as adolescents. Tobacco smoking among youth is a serious health issue in Egypt as it is reported that smoking prevalence among overall youth is 19.6%. (4) University students are at high risk of smoking as they become exposed to smoking peers and face social, emotional and educational challenges. (5) Knowledge about the dangers of smoking was a predictor of smoking behavior; and risk awareness alone seems to be insufficient to stop smoking. (6) Smoking cessation is the most important, cost-effective preventive intervention that can offer to smoker person. (7) Helping smokers to stop smoking should be the goal of every health professional through motivational process. (8) This process begins with counseling; a skill that requires the ability to evaluate smokers readiness to quit and to encourage them into effective action.
Doctors should ask all patients about their smoking habits according to guidelines of smoking cessation state regardless of the reason for consultation and should offer them brief advice on smoking quitting. (9) This study aims to investigate the extent of the smoking problem among Fayoum University students and to determine their knowledge about smoking related diseases and their intention towards quitting. • Poor knowledge was considered if < 50% of questions were answered correctly.

SUBJECTS AND METHODS
• Satisfactory knowledge was considered if from 50% to 75% of questions were answered correctly.
• Good knowledge was considered if > 75% of questions were answered correctly.

RESULTS
In the present study, from 804 participating students, male respondents were 51% (n=410) and females were 49% (n=394), the students age ranged from 18 to 26 years with a mean (± SD) of 20 These differences are statistically significant (P < 0.05). as showe in Table 5.
While 72 (66.7%) of smoker students intended to attempt quitting smoking, 36(33.3%) of them were not intended to do so even theugh they know its health hazasds.
The positive attitude of quitting is statistically significant among older age group (21-26) while no significaut difference was found fer the other studied vairiables (residence, focety type and knowledye score.

DISCUSSION
Smoking and the use of other tobacco products has been linked to a wide range of detrimental health outcomes including cancer, cardiovascular disease and respiratory illness.
WHO (2008) (11) estimates that 50% of smokers in Egypt will die of tobacco-related diseases. In addition, a growing number of Egyptian youth smoke Shisha (traditional water pipe), under the mistaken impression that it is less harmful.
The overall smoking prevalence of Egyptians aged 10-29 years is 26%. The majority of those who smoke are males in the age category 18-29. (12) The results of our study showed a smoking prevalence of 26.3% of male university students, which is almost the same as the overall national level, but lower than the prevalence of current smokers in Ain Shams University (31.5%). (13) The majority of the smokers (82.4%) used cigarettes while (8.3%) smoked water pipe (Shisha). In a study of tobacco prevalence among Health Sciences College students in Riyadh, 33% of males and 6% of females smoked cigarettes and 30% of males and 5.6% of females smoked Shisha (14) . want to give up. (19) In another study, Glantz and Jamieson. (20) found that the majority of young smokers report that they want to quit, and the prevalence of ex-smokers increases with age among 16-24 year olds. Abolfotouh reported that among 44 smokers students in Alexandria University Hostels, 90.1% wanted to reduce their smoking as a first step to quit. (15)

CONCLUSION AND RECOMMENDATIONS
This study concluded that smoking is prevalent among Fayoum University students. • An intensive anti-smoking educational program aimed at changing behavior and attitude of tobacco smoking.
• Opening of smoking cessation clinic in the University hospital to help students in quitting with a motivational counseling sessions.
• Activation of policy and regulation to reduce youth access to tobacco products.
• Introducing teaching information about dangerous effect of smoking in the school and university curricula.