Alcohol and Tobacco Use Among Undergraduate and Postgraduate Medical Students in India: A Multicentric Cross-sectional Study
Main Article Content
Abstract
Background: Substance use among medical fraternity is a well-known phenomenon among both undergraduate (UG) and postgraduate (PG) medical students. Yet, there have been very few multi-centric studies to estimate the actual burden of this problem in this important population group in India. This study was conducted to estimate the prevalence of alcohol and tobacco use, assess the knowledge and attitudes towards this issue, and identify factors associated with substance use among UG and PG medical students in India.
Methods: A pre-tested, self-report, anonymous questionnaire was administered to medical undergraduates and post graduate medical residents of eight medical colleges across India. This study used a convenience sample of medical colleges with random selection of study participants within each college for each group, UG and PG.
Results: Prevalence of alcohol and tobacco use among UG students was 16.6%, 95% CI [14.5, 18.9] and 8.0%, 95% CI [6.4, 9.6], respectively, whereas prevalence was 31.5%, 95% CI [26.3, 37.0] and 14.5%, 95% CI [10.7, 18.9], respectively for PGs. For both substances, males had a higher prevalence of use compared to females in both groups (p < 0.001). Positive family history of substance use (p < 0.001 for both groups) and early age of initiation (p = 0.011 for tobacco; p > 0.05 for alcohol) were associated with a greater difficulty to quit the habit. Over 90% of study participants felt that substance use adversely affected their skills and reported not using substances prior to managing their patients.
Conclusions: Since substance use is a relatively common phenomenon among UG and PG medical students in India, future prospective studies and interventions are required to better understand the pattern of substance use and reduce its prevalence.
Article Details
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.
References
Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: From medical students to doctors. Drug Alcohol Depend. 2001;64(3):265-270.
Domenighetti G, Tomamichel M, Gutzwiller F, Berthoud S, Casabianca A. Psychoactive drug use among medical doctors is higher than in the general population. Soc Sci Med. 1991;33(3):269-274.
Kumar P, Basu D. Substance abuse by medical students and doctors. J Indian Med Assoc. 2000;98(8):447-452.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington D. C.: American Psychiatric Association; 1994.
Holtman MC. Disciplinary careers of drug-impaired physicians. Soc Sci Med. 2007;64(3):543-553.
Baptista T, Uzcàtegui E. Substance use among resident doctors in Venezuela. Drug Alcohol Depend. 1993;32(2):127-132.
Ghosh S, Samanta A, Mukherjee S. Patterns of alcohol consumption among male adults at a slum in Kolkata, India. J Health Popul Nutr. 2012;30(1):73-81.
Neufeld KJ, Peters DH, Rani M, Bonu S, Brooner RK. Regular use of alcohol and tobacco in India and its association with age, gender, and poverty. Drug Alcohol Depend. 2005;77(3):283-291.
Murthy P, Manjunatha N, Subodh BN, Chand PK, Benegal V. Substance use and addiction research in India. Indian J Psychiatry. 2010;52(5):189-199.
Ramakrishna GS, Sankara Sarma P, Thankappan KR. Tobacco use among medical students in Orissa. Natl Med J India. 2005;18(6):285-289.
Seshadri S. Substance abuse among medical students and doctors: A call for action. Natl Med J India. 2008;21(2):57-59.
World Health Organization (WHO). Global Health Observatory: Prevalence of alcohol use disorders. 2012; www.who.int/gho/substance_abuse/burden/alcohol_prevalence/en/index.html. Accessed July 8, 2012.
Agrawal A, Lynskey MT. Tobacco and cannabis co-occurance: Does route of administration matter. Drug Alcohol Depend. 2009;99(1-3):240-247.
Deepa M, Pradeepa R, Anjana RM, Mohan V. Noncommunicable diseases risk factor surveillance: Experience and challenge from India. Indian J Community Med. 2011;36(Suppl 1):S50-S56.
World Health Organization (WHO). Global Health Observatory: Prevalence of tobacco use. 2012; www.who.int/gho/tobacco/use/en/. Accessed July 10, 2012.
British Medical Association. The Misuse of Alcohol and Other Drugs by Doctors. London: British Medical Association; 1998.
Ray R. The Extent, Pattern and Trends of Drug Abuse in India: National Survey. Ministry of Social Justice and Empowerment, Government of India & United Nations Office on Drugs and Crime, Regional Office for South Asia; 2004.
Boland M, Fitzpatrick P, Scallan E, et al. Trends in medical student use of tobacco, alcohol and drugs in an Irish university, 1973-2002. Drug Alcohol Depend. 2006;85(2):123-128.
Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366(9498):1744-1749.
Smith DR, Leggat PA. An international review of tobacco smoking among medical students. J Postgrad Med. 2007;53(1):55-62.