Impact of Parents and Peers Smoking on Tobacco Consumption Behavior of University Students

Introduction: In the United Arab Emirates, smoking prevalence has increased in both sexes, especially among young adults. Various factors have led to this catastrophe; examples include coverage on TV and social media, as well as market availability. One major influence is smoking by parents and peers. A lot of students may start smoking because of the behavior of their family and friends, and therefore it is necessary to quantify adverse contributions. The aim of this project was to study to what degree parents and peers smoking habits may impact on smoking behavior of students at the University of Sharjah.
Methods: This cross-sectional observational study with a non-probability convenient type of sampling, was conducted with university students aged 18 to 23. Information was collected using a self-administered questionnaire, comprising 23 questions, developed by ourselves.
Results: A total of 400 University of Sharjah students (50% males and 50% females) were included.Some 15.8% of the smoking students had smoking parents, and 17.1% of them had smoking peers. The respective figures were 22.2% and 21.7% for males and 10% and 7.8% for females. Conclusions: Peers had a stronger impact than parents and both parents and peers had greater influence on males than on females. Interestingly, almost 80% of the smoking students did not have smoking parents or peers, which leaves the question unanswered of why they started smoking in the first place. Actions at a societal level should be taken into consideration to prevent smoking and thus help create a non-smoking generation. Creative Commons Attribution License

Introduction

Smoking is considered as a life-threatening habit based on its associated health disorders. To avert this, there have been widespread campaigns geared towards encouraging people to stop smoking. Smoking cessation represents an important health issue for both public health policy regulators and primary healthcare providers. According to the World Health Organization (WHO), tobacco smoking kills half of its users, with one tobacco associated death occurring in every 6 seconds; this surpasses death rate does not result from any other disease. Additionally, it was proved that the highest numbers of health complications are associated with smoking such as cardiovascular diseases, respiratory diseases and cancer.

To date, few studies were conducted to study the effect of peers and parents on university students smoking, while no study addressed the issue in the gulf region.

Among both genders, especially young adults, smoking prevalence was actually increased. Multiple and diverse reasons can lie behind such an increase, but some of them include TV and social media along with the easy access and availability of smoking products in the market.

An interesting factor that I thought was worth studying, is the impact of smoking parents and peers. What came into my notice is that many of the students who started smoking were actually influenced by the fact that their parents and peers are smokers. If the results came to be true, this study can open a new path for future studies and this impact can be further analyzed which will then make it possible for precautions to be taken towards smoking prevention.

The aim of this project is to study whether parents and peers smoking habits have any impact on the students of University of Sharjah’s attitude toward smoking.

Materials and Methods

Participants

The Cross-sectional observational study presents baseline data collected from student’s questionnaire (medical and non-medical) in University of Sharjah. The sample was made up of 400 students. (50% males and 50% females) within an age range from 18 to 23 years old.

The analyzed variables were measured with questionnaires that were conducted with subjects that fit within the sample to collect data. The questionnaire was developed by the group members based on the research objectives, and other questions were built based on the research articles read by the group members. The questionnaire contained 23 questions.

Procedure

Once the Ethical Committee approved the procedure and gave me the approval. I proceeded to identify the students that would participate in the study, in each campus.

All participating students fulfilled a questionnaire during 10 minutes. The data collection task was divided among the 5 members of the group equally and each questionnaire included a consent form that the participants will have to read and sign before answering any of the questions.

Data analysis and statistical method

In order to see the impact of parents and peers smoking on the university students’ attitude towards smoking in Sharjah, I have tried to establish a link between parents and peers smoking and the students’ attitude towards smoking. A peer was defined as any person who shares the same interests, age, background or social status as the student. Moreover, three different factors in the student’s lifestyle were studied to check whether they were affected by the impact of parents and peers smoking; which were student’s health, social life and personality. I defined social affect as any change in the student’s emotions, intentions, or beliefs, health as any discomfort or complaint that the student felt due to their parents or peers smoking, and personality as any change in the way the student thinks, acts or speaks.

The data collected was analyzed and any patterns were recognized. The data acquired from the questionnaire were inserted in the “SPSS 22” software, to get the data analysis and to use the appropriate statistical tests for the different types of data.

The results were analyzed using chi-square test, a result is considered significant if its p value which was obtained using chi-square test is 0.05 or less.

Results

Data was analyzed with the aim of answering the research questions of the article. The results for each research question are written separately.

Comparing the impact of smoking parents and peers on the students’ smoking

The number of students who had smoking parents and smoked was 15 out of 95 (15.8%), while the number of students who didn’t have smoking parents but smoked was 26 out of 300 (8.7%).

The number of students who had smoking parents and smoked was significantly higher than the number of students who didn’t have smoking parents and smoked (p=0.0486).

The number of students who had smoking peers and smoked was 40 out of 234 (17.1%), while the number of students who didn’t have smoking peers but smoked was 1 out of 135 (0.74%).

The number of students who had smoking peers and smoked was significantly higher than the number of students who didn’t have smoking peers and smoked (p=0.0001).

Comparing the impact of smoking parents with the impact of peers smoking

Results weren’t significantly different as there were 95 students with smoking parents, 15 of them were smokers (15.8%). On the other hand, there were 234 students with smoking peers, 40 of them were smokers (17.1%).

The percentage of the smoking students who smoked with smoking peers is not significantly higher than the number of students who smoked with smoking parents. (p=0.775).

Comparing the impact of smoking parents and peers and whether it varies with gender

Results were significant as I found out that out of 45 males with smoking parents, 15 of them were smokers (22.2%) (Table 1), while 5 out of 50 females with smoking parents were smokers with percentage of (10.0%) (Table 1).

Table 1

The Impact of Smoking parents and Peers on Various Groups

Group	Frequency	Percentage	P Value
Smoking parents and smoking males	15	22.20%	0.005
Smoking parents smoking females	5	10%
Smoking peers and smoking males	34	21.70%	0.008
Smoking peers and smoking males	6	7.80%
Smoking peers and smoking males	8	18.60%	0.462
Smoking peers and smoking males	7	13.40%
Smoking peers and smoking males	11	10.50%	0.0156
Smoking peers and smoking males	29	22.50%

The percentage of smoking male students with smoking parents is significantly higher than smoking female students with smoking parents. (p=0.005)

On the other hand, results showed that in males with smoking peers; 34 students out of 157 were smokers (21.7%), while out of 77 female students with smoking peers, 6 were smokers (7.8%).

The percentage of smoking male students with smoking peers is significantly higher than smoking female students with smoking peers (p=0.008).

The impact of smoking parents and peers on medical and non-medical students

Measuring the impact of smoking parents and peers on medical and non-medical students, 8 out of 43 medical students with smoking parents were smokers (18.6%), and 7 out of 52 non-medical students who had smoking parents were smokers (13.4%).

The percentage of smoking medical students with smoking parents is not significantly higher than smoking non-medical students with smoking parents. (p=0.462).

On the other side, when identifying the impact of peers on smoking medical students and non-medical students, there were 105 medical students with smoking peers, 11 of them were smokers (10.5%) (Table 1), while out of 129 non-medical students with smoking peers, 29 of them were smokers (22.5%) (Table 1).

The percentage of smoking non-medical students with smoking peers is significantly higher than smoking medical students with smoking peers (p=0.0156).

The impact of smoking parents and peers on the students’ lifestyle

In my research study; I aimed to assess the effect of parents and peers smoking on the students’ social life, health, or personality, and all obtained results regarding the impact on social life were significant.

Regarding the social impact; 95 students with smoking parents; 9 of them claimed being affected socially by their smoking father (9.5%). On the other hand, 234 students had smoking peers, 25 students claimed they were affected in their social life (10.7%).

The percentage of smoking students with smoking peers who claimed being affected socially is not significantly higher than smoking students with smoking parents who claimed being affected socially (p=0.774).

Moving to the health aspect, I found out that out of 95 students with a smoking parents, 58 claimed being affected in their health (61%), while there were 234 students with smoking peers, 146 claimed being affected in their health (62.4%).

The percentage of smoking students with smoking peers who claimed being affected in their health is not significantly higher than smoking students with smoking parents who claimed being affected health-wise. (p=0.820).

Regarding the personality impact, there were 95 students with a smoking parents, 7 claimed that their personally was affected (7.4%). Finally, with the effect of smoking peers on personality, 20 students out of 234 reported being affected (8.5%) (Table 2).

Table 2

The Impact of Smoking parents and Peers on the Students Lifestyle

Group	Frequency	Percentage	P Value
Smoking parents impact on health	58	61%	0.82
Smoking peers impact on health	146	62.40%
Smoking parents impact on social life	9	9.50%	0.774
Smoking peers impact on social life	25	10.70%
Smoking parents impact on personality	7	7.40%	0.724
Smoking parents impact on personality	20	8.50%

The percentage of smoking students with smoking peers who claimed being affected in their personality is not significantly higher than smoking students with smoking parents who claimed being affected in their personality (p=0.724).

Discussion

The results answer the main objective of the article, which is to find out whether there is a relation between the parents and peers smoking and the students’ smoking behavior. I found a significant relationship between the effect of both parents and peers as they had a noticeable impact on the students’ smoking behavior, which can be issued a risk factor behind university students smoking.

By comparing the impact of parents and the impact of peers, there was no significant difference between the two. Thus, parents don’t get the dominant hand on peers in affecting the students vice versa. This can be explained by the fact that although university students spend time with their friends and they are affected by them, they still depend on their parents sometimes and get influenced by their actions, as they are still considered in the stage of building their character.

Additionally, the fact that the impact of smoking parents on medical students is not significantly higher than the impact of smoking parents on non-medical students this can be explained by the same principle as both groups are students and they are still dependent on their families no matter what major they are enrolled in. The impact of smoking peers on non-medical students is higher than the impact of smoking peers on medical students can be due to the nature of studying in the medical colleges which doesn’t have much student-student interactions compared to the non-medical colleges. Moreover, medical students devote most of their time to studying and they barely engage in social interactions and thus less likely to be affected by peers behavior.

In terms of gender, male students were 2 times more likely to be affected by their smoking parents and 3 times more likely to be affected by their smoking peers. A proper explanation for this can be the fact that the smoking behavior in the society is more prevalent and common among males, as it is regarded by many of the male students as a cool and manly behavior that should be followed by all males. Furthermore, many of the famous and successful movies reflect and portray smokers as successful and attractive (Page, 2012). While among the females, majority of them consider the smoking as “unfeminine” behavior, resulting in the low prevalence that I have in the results, which is also consistent with findings from Sirichotiratana et al., (2008). Female smoking is relatively uncommon in Asia, and there are generally strong negative perceptions toward female smokers (Lai et al., 2004).

Lastly, regarding the impact on the three students’ lifestyle factors that were studied (health, social life and personality), it appeared to be that there was no significant difference between them as parents and peers had almost the same impact on the students. The impact itself can be explained by second-hand smoking theories. In Taiwan, the Bureau of Health Promotion (2012) reported that 42.2% of students indicated they were exposed to secondhand smoke at home in 2011. This is followed by the social factor, as some students feel embarrassed because of their smoking parents or peers. Lastly having a smoking parent or friend can lead to changes in the students’ personality and their point of view towards the smoking behavior.

The study focuses on the behavior that youngest people exhibit due to them being influenced by their parents and peers. I also wish by my results to spread the awareness among both parent and the students since the initiating and quitting behavior considered as a point of change in the students, their family and peers. Once parents realize that there is association between their smoking and their children’s attitude toward smoking, this will encourage parents to quit smoking, which might carry a positive reflection on the student’s smoking behaviors later on. Also, actions should be taken on a societal level to reduce smoking among adults for the aim of creating a non-smoking generation. Other factors that are also in need of being taken into consideration are media and educational level of a person since the education will make person open minded and more aware about different aspects in his life including his physical and mental health. The self-satisfaction should be also considered to see the level of regression or acceptance and this might influence their thinking in future regarding smoking cessation.

Prior research has shown that both general parenting behaviors and smoking-specific parenting practices contribute to adolescent smoking behaviors (Wang et al., 2014). Therefore, understanding and identifying the correlation between parents smoking and university students’ attitudes toward smoking can really improve the parents’ cognition and parenting practices to drive their sons and daughters away from smoking. This can be achieved through campaigns and raising awareness. It shouldn’t be considered as words that are said on spot; it must be a collaboration between different groups for building a shining generation that knows where to step.

Limitations

Possible limitations are that even though no names were required form the participants, there could be a possibility that some students didn’t declare the truth about their smoking behavior, or the smoking behavior of their peers and parents due to embarrassment. Also the correlation between the smoking of the parents or peers and the smoking of students can be made, but you can’t establish a decisive cause-and-effect relationship between these two, because there are other factors that need to be taken into consideration, and there is a possibility that the correlation was made due to chance.

In conclusion, peers had a stronger impact than parents. The impact of smoking parents was more prominent on medical students rather than non-medical students, while peers had more impact on non-medical students. Parents and peers had more impact on males rather than females. Smoking mothers had even more impact on students in comparison to fathers or both parents smoking. Lastly, health was the most prominent lifestyle factor in which the students were actually affected.

Media campaigns, smoke-free operations, prohibition on smoking advertising and sales are important measures in the prevention of students’ smoking (Jacobson, 2000). There should be decisions made on the governmental level to try to eradicate this phenomenon.

Directions for future research

Further studies in the area are needed to support the claims of the article, as the university students are considered to be the building blocks of the society and are passing through a very critical and sensitive stage of life, and thus their social life needs to be studied as a measure to prevent various diseases caused by smoking.

One of the interesting results that I had is that almost 80% of the smoking students in the population smoked without the effect of parents or peers, which makes you wonder what reason could those university students have had caused them to start smoking.

Author contributions

All authors were involved in study conception/design, data collection and analysis, drafting of manuscript, statistical expertise, administrative work, and critical revisions for important intellectual content.

Declaration of interests

None.