Smoking is a problem with worldwide dimension. It is one of the most important causes of pulmonary and cardiac diseases. Government of India has passed a law not just highlighting the dangers of smoking but also banning it in various forms to protect the health of the public [1].

Health professionals, including medical students, should ideally play an important role in the fight against tobacco use but several reports suggest that a good number of medical students are themselves addicted to tobacco. We need to take steps to stop its use by them so as to prevent them from being exposed to its hazardous effects. This will also make their role in the advocacy of the smoking cessation activities more trustworthy [2].

As medical students, who are usually in their adolescence, progress through the medical school, their behavior regarding the use of tobacco equals or even exceeds the rates in the non-medical peer groups, despite their knowledge of smoking-related diseases. As such, many researchers have historically investigated tobacco-smoking rates among this demographic group [3].

As future physicians who will witness the continued burden of smoking-related diseases among their patients, medical students represent a primary target for tobacco-prevention programs. A recent study in Kerala showed that substantial proportion of physicians and medical students continue to smoke [3].

Over the past 60 years many studies have been done, in which recent studies among medical students show- Prevalence of smoking in south India was found to be 22.4% [2]; In Orissa in the year 2005 the prevalence of smoking was 8.7% [3]. The prevalence of smoking among tobacco users (28.8%) was found to be 87.5% in a study conducted in Lucknow in the year 2008 [4]. In a study done in Allahabad prevalence of smoking was 33% out of 560 responders [5]. Prevalence of smoking was observed as 5.5% in Kannur district of Kerala in the year 2011 [6]. There was 32.55% prevalence of smoking in Maharashtra in the year 2008 [7].

This study was done to understand the magnitude of current smoking scenario and to find effective measures to reduce tobacco smoking among medical students in future.

Table-1: Knowledge related to Smoking. (N=342.)

Practice: Among the smokers, 22 (78.57%, mild smokers) were smoking less than 10 cigarettes per day, 3 (17.85%, moderate smokers) were smoking 10 to 20, and 1 (3.5%) was severe smoker, smoking more than 20 cigarettes per day. Among the smokers, 22 (73.3%) were spending less than 100 rupees and 4(26.7%) were spending more than 100 rupees per day.

Eleven (3.2% of the total and 34.37% of smokers) claimed to smoke in the college campus outside the hostel. Fifteen (4.4% of total and 46.89% of smokers) have thought of quitting smoking in the last one month and the same applies for attempt to quit in the last one year.

Four (1.2% of the total and 12.5% of smokers) never share their cigarette, eight (2.3% of the total and 25% of the smokers) sometimes share their cigarette with someone else, and 20 (5.8% of the total and 62.5% of the smokers) usually share their cigarettes with their friends.

Thirteen (3.8% of the total and 40.63% of the smokers) considered themselves to be social smokers as compared to 19 (5.6% of the total and 59.37% of the smokers) considered themselves to be regular smokers. Out of 342 (100%) of the subjects, only 108 (31.6%) like to socialize or engage in activities with smokers.

Prevalence: This study showed a prevalence of 7.6% total; 21.0% for male subgroup and 0.44% for females. Study by Joge et al show a prevalence of 32.5%, which was from Maharashtra state and study by Ganesh Kumar et al in 2011 shows a prevalence of 22.4% from Kerala among male medical students, this can be compared with our study [2][8]. The prevalence in girls is 0.44% and for ever-smoked the prevalence is 5.38% which reflects the change in culture that is showing up these days. We also see that 67.43% of the hostellers had tried smoking between the ages of 16-26 years. Similar findings were observed in the study of Swathy et al among medical students where prevalence of smoking among hostellers was found to be 68.27%.

Knowledge: In our study, more than 95% of the responders are strongly aware of the hazardous effects of smoking. The knowledge of awareness about sterility caused by smoking and reversal of pathological changes in 10-15 years of quitting smoking was lacking in 32 (9.4%) and 41 (12.0%) of students, respectively, was a major finding. In a study conducted by Chatterjee among medical and non-medical students of Kolkata, 98% of smokers among medical students had knowledge on the harmful effects of smoking. In a similar study by Al Haqwi et al in Riyadh, 94% of the study sample indicated that smoking could cause serious ill effects.

Practice: Most smokers were mild or moderate smokers, smoking less than 20 cigarettes a day and were spending less than Rs. 100/- per day on smoking. Unlike us, Gupta et al found that students were spending more than Rs 200/- per month [9]. Eleven (3.2% of the total and 34.37% of smokers) claimed to smoke on the college property excluding the hostel, even though smoking is completely banned on the college property, outside the hostel. Harini Priya et al showed that approximately 47% of current smokers had smoked on college property.[10] Unlike Ganesh Kumar et al, we did not find that students from rich families are more likely to be smokers, but like them we did find those with family history of smoking are more likely to smoke [2].

Thirteen (3.8% of the total and 40.63% of the smokers) considered themselves to be social smokers as compared to 19 (5.6% of the total and 59.37% of the smokers) considered themselves to be regular smokers.