Evaluation of the relationship between stress and smoking patterns among the citizens of Hail City, Kingdom of Saudi Arabia

 

 

Abstract              Background: Tobacco is considered the most important preventable cause of deaths worldwide; the current situation is severe, particularly in developing countries. Tobacco smoking is global public health anxiety leading to pulmonary disease, various cancers, including those of the respiratory, digestive, and genitourinary systems, and definite types of leukaemia and premature death. In recent years, smoking cigarettes or other tobacco-related products is a significant public health issue in Saudi Arabia, particularly among adolescents. Therefore, our present study aimed to evaluate the relationship between stress and smoking patterns among Hail city citizens. Materials and Methods: This cross-sectional descriptive-analytical study was conducted at the Department of Physiology, Hail University, Kingdom of Saudi Arabia. A questionnaire was designed to obtain important information regarding stress, demographic, and behavioural factors, including the Perceived Stress Scale (PSS). Results: A total number of 2000 adult male from different regions of Saudi participated in this study. The cross-sectional descriptive analysis showed a strong relationship between perceived stress and smoking behaviour. A higher frequency of smoking was observed among smokers in student, employed and married group of participants. The maximum academic pressure, high job strain and financial problems were directly associated with heavy smokers participants. Conclusion: Our present study has established a strong link between stress and smoking this highlight the necessity to formulate outreach programs on these lines, which will help our youth, abstain from such harmful addiction to smoking.

Keywords: Perceived Stress, Smoking, Tobacco, Lifestyle 

 

INTRODUCTION

Worldwide, tobacco is the only legally sold product scientifically known to cause morbidity and mortality in one-half of its regular users. Thus, of the estimated 1.3 billion people in the world who smoke, nearly 650 million will die prematurely as a consequence.^1,2 Throughout the world; tobacco smoking is becoming a rapidly increasing problem of a public health concern. It has also been estimated that approximately a third of the world’s population, aged 15 years above, are smokers². Globally, the tobacco smoking epidemic is on the rise, particularly in developing countries. College life is a critical transition period during which young adults tend to explore tobacco use. Some surveys have reported that cigarette smoking prevalence continues to rise among college students.^3-5As expected, an increasing trend is anticipated among college-going students, as this will be related to the alleviation of peer pressure, academic-related problems, examination stress, social acceptance, the desire to attain a high personality profile, lower educational level of family members and their history of smoking,^6-8 Stress and its consequences on health have been an important research topic over the last decades. Perceived stress is an important factor in the onset, course and progression of various diseases, e.g., anxiety, cardiovascular and respiratory diseases, depression, and it has been related to higher overall mortality.⁹ On the other hand, perceived stress is also linked to a decline in life satisfaction. The popular Perceived Stress Scale (PSS) by Cohen is a well-established self-report measure based on stress's psychological conceptualization.¹⁰ The scale assesses the degree to which life has been experienced as overloaded, uncontrollable and unpredictable in the past month. The literature lacks studies investigating age differences of perceived stress associated with smoking behaviour and nicotine related symptomatology. Therefore, the overall study aimed to evaluate the relationship between perceived stress and smoking behaviours and nicotine-related symptomatology and determine if these relationships varied by any other parameters. The relationship between perceived stress and sociodemographic variables will also be explored. There is no research study regarding the prevalence of smoking and its predictors among Hail city citizens, though some studies conducted among school adolescents. Thus, the present study's purpose was to evaluate the prevalence of smoking behaviours and their related factors among Hail city citizens. We hypothesized that perceived stress would positively associate smoking behaviours, such as the number of cigarettes smoked per day, with a stronger association in younger males than adult. We also hypothesized that perceived stress would positively associate with smoking-related symptomatology, such as nicotine withdrawal, nicotine dependence, and smoking urges, with a stronger association in younger males than adult. Lastly, we hypothesized a positive correlation between perceived stress and certain sociodemographic variables, namely lower-income and minority status. Those individuals would consume an increased number of cigarettes per day.

 

MATERIAL AND METHODS 

Study Design: This cross-sectional descriptive-analytical study was conducted at the Department of Physiology, Hail University, Kingdom of Saudi Arabia. This was a cross-sectional study carried during the period of June 2020 to December 2020. Selection of Subjects: This study has enrolled 2000 participants in the age group of 11 to 70 years. The age-matched control and smoker groups were selected based on inclusion and exclusion criteria. An informed consent form was obtained from all the participants. Data Collection: Residents of Hail City invited to participate in the study by filling an anonymous self-administered questionnaire; this also included the Perceived Stress Scale (PSS).¹⁰ The entire questionnaires were in English and Arabic language.

Statistical Analysis: The collected data was converted into a computer-based spreadsheet; SPSS version 16 was used. Statistical analysis was carried out with the help of the chi-square test for statistically significance (P-value P<0.5).

In this study, we observed that cigarette smoking behaviour directly associated with increased body weight and BMI. The participants with a cigarette smoking frequency of five cigarettes per day shown less BMI than those with over ten cigarettes per day (p<0.001). This study had few limitations; one of them was participants of this study were not representing the whole community. We have purposely excluded the female participants for overcoming some administrative and social difficulties related to female participation. 

 

DISCUSSION

Globally, tobacco is a leading cause of preventable deaths, mainly in high-income countries, now a day becoming increasingly prevalent in low-income countries.¹ By 2030, approximately 70% of deaths are attributable to smoking worldwide.² The adverse health consequences of smoking are significant and have been well researched and documented. Our findings from the present study highlight the positive relationship between the perceived stress and frequency of cigarette smoking. Academic and Occupational stress casts imminent effects on the physical, mental and behavioural health of every individual of any institutions and organizations. Smoking being a candid abettor further maligns the situation, ensuing a vicious cycle. Modifiable factors like smoking and non-modifiable aggravators such as age must be promptly addressed to break this detrimental play of cause and effects. It is opined to hold counselling sessions and smoking cessation programs at all age groups.^3-6

However, our present study could not establish a statistically significant relationship between perceived stress levels and participants from two different groups. Most of the studies from Saudi Arabia evaluated the socio-demographic and epidemiologic factors rather than stress and behavioural parameters that lead to the initiation of tobacco smoking.^5-8 Therefore, the present study focused on the assessment of stress, behavioural, social, and occupational factors that might contribute to the commencing of tobacco smoking in individuals. In general, stress is a global phenomenon, and every individual will experience it. Stress can occur from both positive and negative experiences, and it can have physical, emotional, intellectual, social, and spiritual consequences. Stress is the human body’s reaction to initiate the change, which requires a response from the body. These changes can be emotional, psychological and physical and can originate from the surrounding environment or mere thoughts.^8-11Perceived stress is different. It is more about personal feelings about the lack of control and unpredictability than the actual stressors. Perceived work stress is a severe health issue. It can result in headaches, pain, fatigue and tension.^12-14 The findings of this study would definitely highlight the need for future biochemical and haematological studies investigating in-depth the association between stress and tobacco smoking.

 

CONCLUSION 

The present observations and information from our study would aid in the development and improvement of social support interventions, particularly in making the tailored made guidelines to every adult individuals and socially disadvantaged populations, also advising tips for healthier lifestyles that promote the stress coping skills and its management.

 

 

 

 

REFERENCES

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