Determinants of Tobacco Use and Nicotine Dependence Among Health-care Students and Their Undergraduate Peers

Background: Global estimates suggest that tobacco will account for 8 million deaths per year by 2030. The Global Adult Tobacco Survey (2016-17) reported that more than half of men and one in ten women aged 15 years and above smoke in India. Introduction: Health science courses students (HCS), being the future of our health care system, are expected to be more knowledgeable regarding the hazards of tobacco and are considered less likely to use it compared to their peers (non-HCS) from other fields. The aim of the study is to determine the prevalence and determinants of tobacco use and levels of nicotine dependence amongst HCS and non-HCS students. Methods: Web-based survey (response rate of 72%) employing Global Youth Tobacco Survey (GYTS) and Fagerstrom standardized questionnaires (n = 4770 [21.5 (SD: +/- 1.61) years: 62% male] was filled by HCS (43.5%) and non-HCS (56.3%) students from three universities. A descriptive, comparative and multivariate analysis was performed. Results: Half of non-HCS and a third of HCS used tobacco, with a higher proportion of male users in both groups. 70% of overall participants showed 'low nicotine dependence' with a higher proportion of 'high dependence' within the non-HCS group (13.89% vs. 9.2%). There were crucial differences in specific determinants and ages of initiation of tobacco use between the two groups. Conclusion: Tobacco use in HCS, apart from personal health risks, may potentially affect their future commitment to support patients in tobacco cessation programs. There is a need for further research into tobacco prevention and cessation programs tailored to the needs of student groups based on the determinants affecting them.