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21% of medical students chew tobacco

KARACHI: In a study, 21 percent of medical students were found to chew tobacco in some form or another in their lifetime, raising concern that future doctors would not be able to influence their patients to give up smoking. The study appeared in BMC Public Health on Sept 3.

Chewing tobacco is common in South Asia. Tobacco is a major cause of morbidity and mortality. Doctors make one of the best avenues to influence patients’ tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of chewing tobacco among Pakistani medical students.

A cross sectional study was carried out in three medical colleges of Pakistan - one from the north and two from the southern region – 1,025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life), current use (at least once in the last 30 days), and established use (more than 100 times in their life) of chewing tobacco.

Two-hundred and twenty (21.5%) students had used tobacco in some form (smoked or chewed) in their lifetime. Sixty-six (6.4%) students were lifetime chewers of tobacco. Thirteen (1.3%) were daily users while 18 (1.8%) fulfilled the criteria for established users. Naswar was the most commonly used form of chewing tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. Lifetime use of chewing tobacco showed significant associations with the use of cigarettes, student gender, student residence and location of the college. Other analysis showed independent association of lifetime use of chewing tobacco with concomitant cigarette smoking, student gender and location of the medical college.

The use of chewing tobacco among medical students cannot be ignored. The governments should add the goal of eliminating chewing tobacco to existing drives against cigarette smoking. Drives in Karachi should focus more on eliminating paan usage while those in NWFP should focus more on the use of naswar. Medical colleges should provide greater education about the myths and hazards of chewing tobacco. daily times monitor

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