Water pipe and smokeless tobacco use among medical students in South Africa.
BACKGROUND
This study sought to determine the sociodemographic and behavioral factors associated with water pipe and smokeless tobacco (SLT) use among a population of medical students in the Pretoria area, South Africa.


METHODS
Undergraduate medical students (N = 722) in their 2nd and 6th year of study in 2 medical schools in South Africa completed a self-administered questionnaire during 2008. Information on ever and current use of water pipe and SLT was obtained along with information on sociodemographic variables, alcohol use, and cigarette smoking status. Multiple logistic regression analysis were used to determine factors associated with current use of water pipe and SLT.


RESULTS
The mean age of study participants was 23 years. Of the participants, 53% were female and 55% were self-identified as Black Africans. Of the study participants, 18.6% were current water pipe users, 3.1% were current SLT users, while 17.3% were current cigarette smokers. Factors independently associated with current water pipe use were having an alcohol drinking-problem (odds ratio [OR] = 2.43; 95% CI = 1.48-3.40), currently smoking cigarettes (3.40; 2.04-5.67), and reporting exposure to smoking in places other than home (2.51; 1.29-4.90). Compared with Black students, White medical students were more likely to have smoked a water pipe in the past month (3.14; 1.74-5.70) but less likely to have ever used SLT (0.37; 0.19-0.73).


CONCLUSIONS
These findings suggest that the use of alternative tobacco products is common among South African medical students and may form part of a pattern of risk-taking behavior. Furthermore, there appear to be cultural differences in the use of certain tobacco products.
Department of Public Health Medicine, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. fsenkubuge@gmail.com
Flavia
F
Senkubuge
Olalekan A
OA
Ayo-Yusuf
Goedele M C
GM
Louwagie
Kolawole S
KS
Okuyemi
D000328:Adult; D000437:Alcoholism / Q000523:psychology; D044383:Black People / Q000523:psychology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003710:Demography / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology / Q000523:psychology / Q000639:trends*; D013019:South Africa / Q000453:epidemiology; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data; D014030:Tobacco, Smokeless; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult