Tobacco Smoking, Secondhand Smoke Exposure and Cessation Perceptions by Dental Students in Al Madinah, a Conservative Saudi Society

Yosra  Ayed; Shadia A.  Elsayed; Osama  Abu-Hammad; Abdulaziz  Turki; Mawadh  Saleh; Moataz  Karbouji; Ranad  Alsaedi; Ismail  Laher; Nebras  Althagafi; Najla  Dar-Odeh

Authors

Yosra Ayed
Shadia A. Elsayed
Osama Abu-Hammad
Abdulaziz Turki
Mawadh Saleh
Moataz Karbouji
Ranad Alsaedi
Ismail Laher
Nebras Althagafi
Najla Dar-Odeh

Keywords:

Students, Dental, Water Pipe Smoking, Tobacco Use Cessation

Abstract

Objective: To explore the prevalence of tobacco use and secondhand smoke (SHS) exposure in dental students and to investigate their perceptions on the role of dentists in tobacco cessation activities. Material and Methods: A questionnaire-based study was conducted in a public university in Al Madinah, Saudi Arabia. The questionnaire investigated demographic factors, tobacco use practices, SHS exposure, and student perceptions of tobacco cessation activities. Descriptive statistics and statistical significance of differences between demographic groups were calculated. Results: A total of 228 students participated with 43.0% (n=98) males and 57.0% (n=130) females. A proportion of 30.7% (n=70) of the participants smoked tobacco, and these constituted 51 males (73%) and 19 females (27%). Only 39 students (15 females and 24 males) indicated their method of tobacco use, which was mainly cigarettes and waterpipes. One in two students was exposed to SHS. Non-smokers had better awareness of the health hazards of SHS (p<0.001), and were more likely to adopt tobacco cessation activities recommended by dentists (p<0.05). Conclusion: A substantial proportion of dental students in a very conservative religious area smoke tobacco and are exposed to SHS. Their perceptions of the harms of SHS and attitudes on cessation need improvement. The influence of culture and religion in shaping health risk behaviors in conservative communities needs to be verified.

References

Thakur JS, Garg R, Narain JP, Menabde N. Tobacco use: a major risk factor for non communicable diseases in South-East Asia region. Indian J Public Health 2011; 55(3):155-60. https://doi.org/10.4103/0019-557X.89943

Dar-Odeh N, Abu-Hammad O. Tobacco Use by Arab Women. In: Laher I. Handbook of Healthcare in the Arab World. London: Springer; 2020.

Teijeiro A, Cuello MN, Raiden MG, Vieyra RE, Solé D, Ellwood P, et al. The relationship between second-hand smoke and wheezing in infants from Córdoba, Argentina. Allergol Immunopathol 2020; 48(1):42-7. https://doi.org/10.1016/j.aller.2019.06.010

Kim SI, Yoon JI, Tommasi S, Besaratinia A. New experimental data linking secondhand smoke exposure to lung cancer in nonsmokers. FASEB J 2012; 26(5):1845-54. https://doi.org/10.1096/fj.11-199984

Al-Zalabani AH, Amer SM, Kasim KA, Alqabshawi RI, Abdallah AR. Second-hand smoking among intermediate and secondary school students in Madinah, Saudi Arabia. Biomed Res Int 2015; 2015(672393):1-8. https://doi.org/10.1155/2015/672393

U.S. National Cancer Institute and World Health Organization. The Economics of Tobacco and Tobacco Control. National Cancer Institute Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; and Geneva, CH: World Health Organization; 2016.

Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA 2014; 311(2):183-92. https://doi.org/10.1001/jama.2013.284692

Ghouri N, Atcha M, Sheikh A. Influence of Islam on smoking among Muslims. BMJ 2006; 332(7536):291-4. https://doi.org/10.1136/bmj.332.7536.291

Alajmi B, Abu-Hammad O, Al-Sharrad A, Dar-Odeh N. Tobacco cessation support among dentists: a cross-sectional survey in Saudi Arabia and Kuwait. Tob Prev Cessat 2017; 3:121. https://doi.org/10.18332/tpc/75795

Dar-Odeh N, Alnazzawi A, Shoqair N, Al-Shayyab MH, Abu-Hammad O. Waterpipe tobacco smoking among dental practitioners: prevalence and health perceptions. Tob Use Insights 2016; 9:29-33. https://doi.org/10.4137/tui.s40568

Beaglehole RH, Benzian HM. Tobacco or Oral Health: An Advocacy Guide for Oral Health Professionals. Lowestoft: FDI World Dental Press Ltd.; 2005.

World Health Organization. WHO report on the global tobacco epidemic 2019: offer help to quit tobacco use. 2019. Available from: https://www.who.int/publications/i/item/9789241516204. [Accessed on January 15, 2020].

Warren CW, Sinha DN, Lee J, Lea V, Jones NR. Tobacco use, exposure to secondhand smoke, and cessation counseling among medical students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2008. BMC Public Health 2011; 11:72. https://doi.org/10.1186/1471-2458-11-72

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. https://doi.org/10.1016/j.sdentj.2014.03.003

Maatouk F, Barkallah M, May W. Prevalence of cigarette smoking among Tunisian dental students. Prev Med 2011; 53(6):435-6. https://doi.org/10.1016/j.ypmed.2011.09.010

da Silva Leonel ACL, Bonan PRF, de Castro JFL, Dos Anjos Pontual A, de Moraes Ramos-Perez FM, Feitosa DS, et al. Tobacco use, attitudes, knowledge, and perception about smoking cessation counseling among Brazilian dental students: a cross-sectional study. J Cancer Educ 2021; 36(1):143-51. https://doi.org/10.1007/s13187-019-01610-6

Puryer J, Wignall R. Tobacco, alcohol and drug use among dental undergraduates at one UK University in 2015. Dent J 2016; 4(1):2. https://doi.org/10.3390/dj4010002

Fujita Y, Maki K. Associations of smoking behavior with lifestyle and mental health among Japanese dental students. BMC Med Educ 2018; 18(1):264. https://doi.org/10.1186/s12909-018-1365-1

Thomas J, Kumar RV, Akhil S, Saji AM, Iype AK, Antony D. Prevalence of smoking among dental students and gauging their knowledge about tobacco cessation methods: an original study. J Family Med Prim Care 2019; 8(5):1562-6. https://doi.org/10.4103/jfmpc.jfmpc_167_19

Khami MR, Murtomaa H, Razeghi S, Virtanen JI. Smoking and its determinants among Iranian dental students. Med Princ Pract 2010; 19(5):390-4. https://doi.org/10.1159/000316379

Al-Turki YA. Smoking habits among medical students in Central Saudi Arabia. Saudi Med J 2006; 27(5):700-3.

Wali, SO. Smoking habits among medical students in western Saudi Arabia. Saudi Med J 2011; 32(8):843-8.

Dar-Odeh NS, Aleithan FA, Alnazzawi AA, Al-Shayyab MH, Abu-Hammad SO, Abu-Hammad OA. Factors affecting oral health determinants in female university students: a cross-sectional survey in Saudi Arabia. Int J Adolesc Med Health 2017; 32(1):1-8. https://doi.org/10.1515/ijamh-2017-0084

Koura MR, Al-Dossary AF, Bahnassy AA. Smoking pattern among female college students in Dammam, Saudi Arabia. J Family Community Med 2011; 18(2):63-8. https://doi.org/10.4103/2230-8229.83370

Mahfouz MS, Alsanosy RM, Gaffar AM, Makeen A. Tobacco use among university students of Jazan Region: gender differences and associated factors. Biomed Res Int 2014; 2014:279231. https://doi.org/10.1155/2014/279231

Dar-Odeh NS, Abu-Hammad OA. The changing trends in tobacco smoking for young Arab women; narghile, an old habit with a liberal attitude. Harm Reduct J 2011; 8:24. https://doi.org/10.1186/1477-7517-8-24

Vupputuri S, Hajat C, Al-Houqani M, Osman O, Sreedharan J, Ali R, et al. Midwakh/dokha tobacco use in the Middle East: much to learn. Tob Control 2016; 25(2):236-41. https://doi.org/10.1136/tobaccocontrol-2013-051530

Shaikh RB, Abdul Haque NM, Abdul Hadi Khalil Al Mohsen H, Abdul Hadi Khalil Al Mohsen A, Haitham Khalaf Humadi M, Zaki Al Mubarak Z, et al. Acute effects of dokha smoking on the cardiovascular and respiratory systems among UAE male university students. Asian Pac J Cancer Prev 2012; 13(5):1819-22. https://doi.org/10.7314/APJCP.2012.13.5.1819

Elsayed Y, Dalibalta S, El Kouche M. Chemical characterization and safety assessment of dokha: An emerging alternative tobacco product. Sci Total Environ 2018; 615:9-14. https://doi.org/10.1016/j.scitotenv.2017.09.255

Elobaid YE, Jabari AL, Al Hamiz A, Al Kaddour AR, Bakir S, Barazi H, et al. Stages of change, smoking behavior and acceptability of a textmessaging intervention for tobacco cessation among cigarette, dokha and shishasmokers: a qualitative research study. BMJ Open 2019; 9(9):e029144. https://doi.org/10.1136/bmjopen-2019-029144

Afifi R, Ghandour L, El Salibi N, Nakkash R, Rady A, Sherman S. Prevalence of Midwakh tobacco smoking in trend-setting Lebanon: an indicator of potential spread across the Arab world? Tob Induc Dis 2018; 16(Suppl 1):A493. https://doi.org/10.18332/tid/84722

Jayakumary M, Jayadevan S, Ranade AV, Mathew E. Prevalence and pattern of dokha use among medical and allied health students in Ajman, United Arab Emirates. Asian Pac J Cancer Prev 2010; 11(6):1547-9.

Mansour AY. Predictors of smoking among Saudi dental students in Jeddah. Am J Health Behav 2017; 41(3):329-37. https://doi.org/10.5993/AJHB.41.3.12

Mansour AY. Determinants of willingness to accept secondhand smoke exposure. Am J Health Behav 2017; 41(5):571-8. https://doi.org/10.5993/AJHB.41.5.6

Merdad LA, Al-Zahrani MS, Farsi JM. Smoking habits among Saudi female university students: prevalence, influencing factors and risk awareness. Ann Saudi Med 2007; 27(5):366-9. https://doi.org/10.5144/0256-4947.2007.366

Mansour AY, Bakhsh Z. Measuring willingness to accept second-hand smoke exposure. Am J Health Behav 2015; 39(6):849-55. https://doi.org/10.5993/AJHB.39.6.12

Abdullah AS, Husten CG. Promotion of smoking cessation in developing countries: a framework for urgent public health interventions. Thorax 2004; 59(7):623-30. https://doi.org/10.1136/thx.2003.018820

Park YD, Patton LL, Kim JH, Kim HY. Smoking prevalence and attitude toward anti-smoking activities among Korean dentists. Int Dent J 2010; 60(6):383-8. https://doi.org/10.1922/IDJ-2576HaeYoungKim06