Study of Smoking Habit among Soldiers in Cairo Security Forces Hospital

Background: Smoking in Egypt is prevalent as 19 billion cigarettes are smoked annually in the country making it the largest market in the Arab world. In the past few years smoking in Egypt has reached an all-time high with an estimated twenty percent as fifteen million people regularly using tobacco products. Nearly forty percent of all men in Egypt smoke. The percentage of the population using any tobacco product elevated to around 23% among the productive age group 25-44 and the prevalence of using any tobacco product among all university graduates is about 16%. Aim of the work: This work aimed to study the smoking habit and its effects among soldiers in Cairo Security Forces Hospital and their trend to quit. Patients and methods: The study was conducted on patients attending the outpatient clinic in Cairo Security Forces Hospital in a period from June 2014 to December 2014. All patients were subjected to Full history taking, Clinical examination, Smoking questionnaire, and Chest X-ray for patients complaining of respiratory symptoms. Results: The sample number was 1100 subjects' males' soldiers cigarette smokers aged 19-23 years old. The majority of them (96.91%) smoke daily, there was highly statistical difference in number of cigarettes smoked per day with the majority (54.45%) smoke a pack to pack and half of cigarettes, also there was high statistical difference of current smokers (96.73%) and ex-smokers(3.27%) with the majority (80.55%) start smoking between the age 15 to less than 20 years old. The main cause of initiation of smoking was due to friends and social reasons and there was high significance that they smoke for the first in the day at morning with highly statistical difference that they smoke all over the day than during morning with the majority (91.45%) accept smoking as it is not a harmful habit. Most soldiers have moderate levels of craving to smoke, (51.91%) of soldiers don't stop smoking inspite of their illness, (55%) of the group sample like smoking mainly to relieve tension, and (51.91%) to avoid problems like getting irritable or gaining weight. Expectoration is the main complain followed by frequent coughing then shortness of breath. As regard systemic symptoms; gastrointestinal symptoms in the form of heart burn and oral cavity problems are the most common encountered symptoms. The majority of soldiers (99.82%) would quit smoke because of serious illness, also (99.55%) didn't give up or greatly reduced any important activity such as sports gathering with relatives or friends,(90.73%) of sample group didn't advice other to quit smoking. Although (59.64%) of soldiers thought about quitting smoking, yet (95.09%) of them never tried to quit while, only (4.91%) tried to quit, (74.07%) of whom, tried less than three times, (68.52%) quitted smoking for less than one month. Also the majority of soldiers who tried to quit (88.89%) found it is difficult to quit with (61.11%) of them answered that the last try to quit smoking was more than one year ago. The majority of soldiers (85.18%) tried to quit smoking to improve health followed by suffering of the high cost of smoking. Health concern was the most useful way of quitting smoking in (57.4%) of soldiers who tried to quit followed by seeking good lifestyle, while (42.59%) hadn't received any positive support during the quitting process. Soldiers who tried to quit found that there is problems that occurred in the first two days of quitting were craving (92.59%), headache (88.89%), getting irritable or angry (81.48%), palpitation (74.07%), trouble concentration (57.41%). Most of soldiers who tried to quit (66.67%) found that they could quit while (33.33%) couldn't quit with the majority of them (77.78%) found that the first cigarette in the morning is the most hated one to give up, (61.11%) resume smoking due to cigarette craving,(38.89%) due to stress/tension. The majority of all soldiers (95.73%) prefer the plain packs than the discouragable pictured packs. Most of soldiers (71.73%) spent about 5-10 L.E per day on cigarettes. Most symptomatized soldier smokers had no chest X-ray abnormality (81.03%) while in minority of smokers (18.97%) showed increase in broncho-vascular markings. Conclusions: Cigarette smoking is a common habit among soldiers and it starts in a relatively young age mainly due to social influence. Respiratory and gastrointestinal symptoms are the most frequent encountered complaints among soldiers. Main causes that led them to try quitting were health concerns and financial issues; as most of them spend a considerable percentage of their monthly income to obtain cigarettes. Unfortunately there was no organized positive support to help the quitters. (C) 2016 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.