Perceived benefits and health risks of cigarette smoking among young adults: insights from a cross-sectional study
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Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal
Department of Public Health, Pokhara University, Nobel College, Kathmandu, Nepal
Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Hatyai, Thailand
Submission date: 2014-12-29
Acceptance date: 2015-07-08
Publication date: 2015-07-31
Corresponding author
Umesh Raj Aryal   

Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
Tobacco Induced Diseases 2015;13(July):22
Perceptions of smoking-related health risks and benefits among young adults (18–24 years) and their smoking behaviour have not been adequately studied in low-income countries like Nepal. This study has examined the perceived risks and the benefits of smoking among young adults who smoke vs. don’t smoke.

A cross-sectional study was carried out from August to September 2013 among 315 young adults (18–24) from four conveniently selected private colleges of different faculties in Kathmandu Metropolis. The anonymous, self-administrated and semi structured questionnaire contained the information on individual information; smoking behaviour; and perceptions on smoking-related risks and benefits. Kaplan-Meier analysis was used to identify the mean age of smoking initiation. Cox proportion hazard regression was used to assess the relationship between current smoking behaviours and the perceived risks and the benefits of smoking.

Overall, the prevalence of current smoking was 16.2 % (Male =28.4 % and female =5.38 %). The mean age of smoking initiation was 16.6 and 17.7 years for male and female respectively. The risk of becoming a current smoking being a management student was higher (HR = 4.72, 95 % CI: 2.19; 10.20) than being a medical student. The risk of current smoking behaviour significantly increased with those who believed that smoking was enjoyable (HR = 4.74, 2.58; 8.72); would help to deal with problems or stress (3.19, 1.76; 5.79); would feel comfortable with friends (4.29, 2.33; 7.92); would be relaxing (6.95, 3.60; 13.43); and something to do when feel bored (3.42, 1.91; 6.13). The young adults who believed that smoking would make yellow teeth (0.53, 0.30; 0.94) and yellow nail (0.53, 0.29; 0.95); and would be bad to their health (0.45, 0.21; 0.98) were significantly at lower risk of becoming a current smoking.

Positive perceptions related to smoking are common among young adults. To discourage smoking, future intervention programs should focus communicating not only health risks but also counteract perception of benefits related to smoking.

Alwan A. Global Status Report on Noncommunicable Diseases 2010. Geneva: World Health Organization; 2011.
World Health Organization. Noncommunicable Diseases Country Profiles 2011. Geneva: World Health Organization; 2011.
Ministry of Health and Population [Nepal]. Noncommunicable Diseases Risk Factors: STEPS Survey Nepal 2013. Kathmandu: Ministry of Health and Population; 2014.
Ministry of Health and Population[Nepal]. Global Health Students Profesional Survey:2011. Kathmandu: Ministry of Health and Population; 2012.
Aryal UR, Lohani S. Perceived risk of cigarette smoking among college students. JNHRC. 2011;9:176–80.
Binu V, Subba S, Menezes R, Kumar G, Ninan J, Rana M, et al. Smoking among Nepali youth– prevalence and predictors. Asian Pac J Cancer Prev. 2010;11:221–26.
Tyas SL, Pederson LL. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control. 1998;7:409–20.
Ministry of Health and Population[Nepal]. Tobacco Control and Regulation Act 2011. Kathmandu: Ministry of Health and Population; 2011.
Yang J, Hammond D, Driezen P, Fong GT, Jiang Y. Health knowledge and perception of risks among Chinese smokers and non-smokers: findings from the Wave 1 ITC China Survey. Tob Control. 2010;19 Suppl 2:i18–23.
Weinstein ND. Unrealistic optimism about future life events. J Pers Soc Psychol. 1980;39:806–20.
Helweg-Larsen M, Nielsen GA. Smoking cross-culturally: risk perceptions among young adults in Denmark and the United States. Psychol Health. 2009;24:81–93.
Aryal UR, Petzold M, Krettek A. Perceived risks and benefits of cigarette smoking among Nepalese adolescents: a population-based cross-sectional study. BMC Public Health. 2013;13:187.
Song AV, Morrell HE, Cornell JL, Ramos ME, Biehl M, Kropp RY, et al. Perceptions of smoking-related risks and benefits as predictors of adolescent smoking initiation. Am J Public Health. 2009;99:487.
Seigers DK, Terry CP. Perceptions of risk among college smokers: relationships to smoking status. Addic Res Theory. 2011;19:504–9.
Lenz BK. Tobacco, depression, and lifestyle choices in the pivotal early college years. J Am Coll Health. 2004;52:213–20.
Dalton MA, Sargent JD, Beach ML, Bernhardt AM, Stevens M. Positive and negative outcome expectations of smoking: implications for prevention. Prev Med. 1999;29:460–65.
Global Youth Tobacco Survey (GYTS) Core Questionnaire. 2011. [] (Accessed on November 15, 2012).
Halpern-Felsher BL, Biehl M, Kropp RY, Rubinstein ML. Perceived risks and benefits of smoking: differences among adolescents with different smoking experiences and intentions. Prev Med. 2004;39:559–67.
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21.
Sreeramareddy CT, Suri S, Menezes RG, Kumar H, Rahman M, Islam MR, et al. Self-reported tobacco smoking practices among medical students and their perceptions towards training about tobacco smoking in medical curricula: a cross-sectional, questionnaire survey in Malaysia, India, Pakistan, Nepal, and Bangladesh. Subst Abuse Treat Prev Policy. 2010;5:29.
Zhu T, Feng B, Wong S, Choi W, Zhu SH. A comparison of smoking behaviors among medical and other college students in China. Health Promot Int. 2004;19:189–96.
Smith D, Leggat P. An international review of tobacco smoking among medical students. J Postgrad Med. 2007;53:55–62.
Chatterjee T, Haldar D, Mallik S, Sarkar G, Das S, Lahiri S. A study on habits of tobacco use among medical and non-medical students of Kolkata. Lung India. 2011;28:5.
Andreeva TI, Krasovsky KS, Semenova DS. Correlates of smoking initiation among young adults in Ukraine: a cross-sectional study. BMC Public Health. 2007;7:106.
Rigotti NA, Moran SE, Wechsler H. US college students’ exposure to tobacco promotions: prevalence and association with tobacco use. Am J Public Health. 2005;95:138–44.
Ling PM, Glantz SA. Why and how the tobacco industry sells cigarettes to young adults: evidence from industry documents. Am J Public Health. 2002;92:908–16.
Sreeramareddy CT, Kishore P, Paudel J, Menezes RG. Prevalence and correlates of tobacco use amongst junior collegiates in twin cities of western Nepal: a cross-sectional, questionnaire-based survey. BMC Public Health. 2008;8:97.
Tsai Y-W, Tsai T-I, Yang C-L, Kuo KN. Gender differences in smoking behaviors in an Asian population. J Women Health. 2008;17:971–78.
Al-Mohamed H, Amin T. Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia. East Mediterr Health J. 2010;16:56–64.
Murphy-Hoefer R, Alder S, Higbee C. Perceptions about cigarette smoking and risks among college students. Nicotine Tob Res. 2004;6 Suppl 3:S371–74.
Verlato G, Melotti R, Corsico AG, Bugiani M, Carrozzi L, Marinoni A, et al. Time trends in smoking habits among Italian young adults. Respir Med. 2006;100:2197–206.
Aryal UR, Petzold M, Bondjers G, Krettek A. Correlates of smoking susceptibility among adolescents in a peri-urban area of Nepal: a population-based cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site. Glob Health Action. 2014;7:24488.
Cosci F, Zagà V, Bertoli G, Campiotti A. Significant others, knowledge, and belief on smoking as factors associated with tobacco use in Italian adolescents. ISRN Addict. 2012;2013:968505.
Ministry of Health and Population[Nepal]. Global Youth Tobacco Survey:2011. Kathmandu: Ministry of Health and Population; 2012.
World Health Organization. Guidelines for Implementation of Article 12 of the WHO Framework Convention on Tobacco Control (Education, Communication, Training and Public Awareness). Geneva: World Health Organization; 2010.
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