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SMAD. Revista eletrônica saúde mental álcool e drogas

versão On-line ISSN 1806-6976

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.) vol.8 no.2 Ribeirão Preto ago. 2012




Tobacco use among nursing students of a private college


Uso del tabaco entre estudiantes de enfermería de una facultad privada



Bruno Pereira da SilvaI; Carolina Maia Martins SalesII; Marilene Gonçalves FrançaIII; Marluce Miguel de SiqueiraIV

IMaster's student, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, SP, Brazil. Assistent Professor, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil
IIMSc, Assistent Professor, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
IIIMSc, RN, Prefeitura Municipal de Vitória, Vitória, ES, Brazil
IVPhD, Associate Professor, Universidade Federal do Espírito Santo, Vitória, ES, Brazil





The aim of this study was to draw a prevalence profile of smoking among nursing students of Faculdades Unificadas Doctum, Guarapari-ES. This is an exploratory, descriptive and quantitative research, developed with 68 nursing students. The data was collected on February and March 2009, with a self-administered questionnaire. Our findings show that the majority of students are female, from 20 to 25 years-old, living with their parents, without their own income. Among them, 50% have tried smoking sometime in life, these experiences have happened among relatives in 53%; 32.4% among friends and 58.5% among other smokers. The study has allowed thoughts on the use/abuse of tobacco, making aware of the damage caused by this substance among young adults.

Descriptors: Smoking; University; Prevention.


El objetivo de este estudio fue conocer la superioridad del tabaquismo entre universitarios del curso de graduación en Enfermería de las Facultades Unificadas Doctum, Guarapari-ES. Se trata de un estudio exploratorio, descriptivo y cuantitativo, desarrollado con 68 universitarios de Enfermería. La recogida de datos ocurrió en los meses de febrero y marzo de 2009, utilizándose un cuestionario auto-aplicable. Nuestros hallazgos muestran que la mayoría de los estudiantes es del sexo femenino, en la banda etaria de 20 a 25 años, viven con los padres; sin renta propia. Entre ellos, 50% experimentaron fumar nunca en la vida; siendo la experiencia con el tabaco referida en familiares 53%, amigos 32,4% y a través de la convivencia con fumadores 58,5%. El estudio posibilitó ponderaciones sobre el uso/abuso de tabaco, alertando sobre los perjuicios causados por esta substancia entre los adultos jóvenes.

Descriptores: Tabaquismo; Universidad; Prevención.




Tobacco was previously used in religious rituals or as medicine. Nowadays, as part of social integration the substances in its casing are harmful to health, especially nicotine which causes the tobacco dependence. The use of tobacco products is worldwide recognized as harmful to health as well as their harmful effects that smoking causes to its users and to other people - the passive smokers(1).

Although it has been happening in recent years several attempts to reduce the number of smokers, smoking remains a serious public health problem, affecting the physical and mental health of the population, the economy, the quality of the environment, through the destruction of trees and decreased of soil fertility(2-3).

It is estimated that 1 billion and 200 million people, that is, one third of the adult population are smokers, and that among the male population, 47% are smokers, while among females this ratio is 12%(4). About 100,000 young people start smoking every day, 80% of these are from developing countries. The average age for tobacco use is 15 years, which led the World Health Organization (WHO) to consider it a pediatric disease(5-6).

The world mortality rate because of diseases related to tobacco is around 4.9 million per year which represents 10,000 deaths per day. If the current epidemiological progression remains, it is believed that in 2030 there will be 10 million deaths per year, half of them in working age individuals(4). Smoking is a risk factor for the four leading causes of death in the world - heart disease, chronic obstructive pulmonary disease, cancer and cerebrovascular accident. Still, it is an independent risk factor for coronary artery disease. In Brazil, after hypertension, smoking is the second most important risk factor for death(3).

When compared to individuals from 15 to 24 years, adult population (25 years or more) had a higher consumption of cigarettes(7). However, this difference tends to decrease in more urbanized cities, indicating higher participation of the youth group in global prevalence, because this group presents behavior changes regarding problems due to the use of psychoactive substances (SPAs)(8).

In a study conducted at the Federal University of Espírito Santo (UFES)(9), it was observed that the use of SPAs had a high prevalence for alcohol (82.1%), tobacco (22.3%), followed by anxiolytics, amphetamines, solvents, marijuana, and finally, barbiturates  anticholinergics, hallucinogens and cocaine. Tobacco was considered the second most used substance among undergraduate Nursing students of UFES.

Tobacco use affects all strata of society, and has been occurring increasingly earlier, being the second most used drug among college students. What leads college students to a concern about the use of it(9).

Given the above, this study aims to investigate the prevalence of smoking among undergraduate Nursing students of Faculdades Unificadas Doctum, Campus Guarapari-ES, as an auxiliary measure for the development of educational strategies to be targeted to this population.


Material and methods

This is an exploratory, descriptive and quantitative research developed among Nursing students of the Faculdades Unificadas Doctum, Campus Guarapari-ES We used a self-administered questionnaire developed by researchers of the Rio de Janeiro State University (UERJ) adapted to this Institution.

The pilot study took place in November 2008, involving 10% of the total students in the College in the second half of this year. The individuals were chosen by lot according to the corresponding number of order in the call list. After evaluating the results, the data collection has undergone the necessary adaptations, for example, periods offered, period of the course, year of entry, state/city of the college and the students' residence.

The data collection occurred during February and March 2009, composed of 82 students, and 69 of them were present at the time of the questionnaire, covering all Nursing classes (from 1st to 8th period). However, a student refused to participate in the study, therefore, 68 subjects have signed an informed consent.

For data analysis, we have created a Microsoft Excel database, and the descriptive analyzes was performed with the use of absolute frequency and percentage for information analysis, with the statistical software SPSS version 11(10).

The study was approved by the Ethics Committee on Human Research of the Center for Health Sciences, Federal University of Espírito Santo (CEP-CCS-UFES), No.088/08, with the provisions of the Resolution No. 196/96 of the National Health Council(11).



The sociodemographic profile (Table 1) shows that the majority of the students are female (85.3%), aged from 20 to 25 years (53%); of these 77.9% are single, 82.2% live in Guarapari-ES, and 42.7% live with their parents, and 22% with their spouses. There is a predominance of students who do not have income (48.5%).



Regarding the college students experience, relatives, friends and how they deal with the situation, Table 2 shows that among the students 53% have not experienced smoking and 32.4% had experienced and have not continued using tobacco, 53% said they have smoking relatives and 32.4% have close friends who smoke.



With regard to the current use of tobacco, among the students who have already smoked before, 32.3% are not using it; 14.7% continue to smoke and for them the main reasons for smoking are: curiosity and urge to smoke; it helps relieve tension and studies; and the extra-familial group influence, as it can be seen in Table 3.



By analyzing the continuation of students smoking, according to their starting age, it is observed, in Table 4, that 60% have started between 16 to 20 years, 30% between 10 and 15 years and 10% between 21 and 26 years.



The analysis of the students attempts who could stop smoking are shown in Figure 1, showing that 90% have tried at least one time, from these, 60% stopped smoking and 50% used the "willpower" as a method.




Regarding gender, we found a higher prevalence of female individuals (85.3%), corroborating the results of the study made with students from Biological Sciences of  a public university in São Paulo(12), in which most of the students were female (60.7%), reflecting the nursing culture as a profession with its female predominance since the beginning. Most of them were single (95.2%) and lived with their parents or relatives (79.8%).

In contrast to this study, the students had monthly income higher than 20 minimum wages, which showed significant influence on the use of illicit drugs (12). Although this study investigates tobacco use among college students, a licit drug, the student's economic and cultural influence can contribute to unhealthy lifestyle habits, such as alcohol and tobacco, drugs easy to find - because of their value and legalization - often the first drugs to be used.

Regarding the student's experience with tobacco at least once in their lives, 53% reported that they have not experienced smoking, so, the results of this study are similar to the study with the Nursing students of UERJ(13), where 58% of the students have not used tobacco at least once in their lives.

Regarding the experience of graduating students with tobacco, 32.3% of them have already used some time in their lives. In the national literature(9) it was found in 22.3% of Nursing students; 28.4% in Pharmacy students(14); 27%(15) in Dentistry students; 22%(16) in Medicine students and 24.9%(17) in Health Sciences students of UFES, who used tobacco at least once. Thus, the tobacco use at least one time among nursing college students of Faculdades Unificadas Doctum was higher compared to the researchers developed at UFES. We also emphasize that the use of tobacco by students in this research is lower than the general population consumption, in which the lifetime use is 44.0%; in a year is 19.2% and the use in the month is 18.4%(18).

When asked about the main reasons for smoking, 33.3% of them answered curiosity and desire to smoke and 19% said influence from outside the family. The result mentioned above is similar to the result of the study developed with college students at the University of Brasília (UNB)(19), where the majority (57.6%) reported as main reason the curiosity and desire to smoke, followed by 23.2% who said it was because influence from outside the family.

Among the students who have already used at least one time (50%), 14.7% continue to smoke and 32.3% do not smoke, confirming the national findings(2), where only a small portion continued using tobacco (8.2%).

It is considered young people those from 15 to 24 years old(20), which has been an audience targeted by the consumer and leisure industries, which see them as potential consumers of psychoactive substances.

Regarding age of smoking initiation, in the research it was observed the prevalence of 16-20 age group (60%). A similar result to that found in the study developed at UERJ(14), where most students started smoking between the ages 16 to 20. And in studies with medical students at the Federal University of Pelotas (UFPel)(21), and with college students at the UnB, it was detected the prevalence of 15 to 19 as starting age(19).

The analysis of the attempts of the students who achieved quitting smoking shows that 9 (90%) have ever tried, 6 (60%) stopped smoking and 5 (50%) used the "willpower" method. In the study developed at UERJ(13), the analysis of the students' attempts who achieved quitting smoking, most of them tried and could stop smoking.


Final consideration

The results show that the college students of private Higher Education Institution (HEI) are as exposed as well the public HEI students (Federal and State).

The results are worrying, in respect of health of this population, since the substances in tobacco are harmful for both smokers and for passive smokers. Tobacco use is absolutely worrying, since the majority of students began using tobacco around 16 to 20 years old (60%), therefore, during adolescence, and this habit was acquired even before entering the college, demanding attention of the whole society.

The research students are nursing students, some of them will become health professionals soon, making necessary to improve knowledge on the licit psychoactive substances subject, through the inclusion in the students' curriculum, as well as conducting seminars with the participation of several areas of knowledge to address the issue. In particular, in health care courses, the issue could be addressed in an interdisciplinary way, in mental health, psychiatry and pediatrics areas as well as for adolescents and youth, with an emphasis on the preventive aspects.

The study should be continued along with other courses of the Faculdades Unificadas Doctum, Campus Guarapari-ES, to allow intervention proposals for this specific population, as well as the adoption of measures for the promotion of health and prevention of smoking related diseases in the Institution.

Finally, this study has provided several reflections on the subject use/abuse of tobacco and its impacts for both personal and professional life, making clear the damage caused by this substance among young adults who will serve as a model for the population in decision making on facilitator habits of healthy quality of life.



We would like to thank the Center for Alcohol and other Drugs Studies (NEAD) for the opportunity to carry out this research. We would also like to thank the Foundation of Support of Science and Technology of Espírito Santo (FAPES) for financial support.



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Bruno Pereira Silveira
Universidade Federal do Acre
Gleba Formoso
Bairro: Canela Fina
CEP: 69980-000, Cruzeiro do Sul, AC, Brasil

Received: Mar. 1st 2010
Accepted: Jan. 15th 2013