Evaluation of Risk Factors Associated With Initiation and Changes in Habits Related to Smoking Among Migrant Indian Medical Students in Armenia

Abstract

BACKGROUND: Tobacco is a risk factor for six of the eight leading causes of deaths worldwide. Health professionals are at the forefront of the war against tobacco. Because of this role tobacco use among health professionals, especially doctors, is a barrier to smoking cessation practices in the community. It is therefore important to target smoking cessation policies among health professionals while they are still in medical school. Migrants are known to change their habits and lifestyles and adapt to the environment of a new country. But changes in smoking practices and risk factors leading to such changes have not been studied among migrant medical students. OBJECTIVE: This study aims to find the differences in risk factors leading to smoking among medical students in India and Indian medical students in Yerevan, Armenia. METHODS: A multi-centre cross-sectional study design with self –administered questionnaires given to randomly selected clusters consisting of 213 undergraduate students in Armenia and 133 undergraduate students in India. RESULTS: Smokers in Armenia were at higher odds of having at least 2 smoker friends (OR=4.65, p=0.016), having female friends (OR=4.63, p=0.045) and never missing family (OR=9.21, p=0.018) compared to non-smokers in Armenia. Smokers in India were at higher odds of having at least 2 smoker friends (OR=6.22, p=0.033), having smoker father (OR=6.78, p=0.010), consuming alcohol (OR=14.28, p<0.005) and never missing family (OR=4.35, p=0.009) compared to non-smokers in India. Smokers in Armenia were more likely to have higher monthly income (OR=9.56, p=0.010), perceiving that cigarettes make girls look more attractive (OR=12.37, p=0.040) and less likely to want to stop smoking now (OR=0.12, p=0.012) compared to smokers in India. CONCLUSION: Students in Armenia smoke more because of a complex combination of various individual and cultural factors that play a role in modifying lifestyle behaviours associated with the destination country profile.