Associations of smoking behavior with lifestyle and mental health among Japanese dental students

BACKGROUND: Smoking is a major risk factor for cancer and cardiovascular disease. However, mental stress leads to smoking in dental students. We believe that dentists, as health professionals, should set an example for the public. Therefore, this study determined the prevalence of and factors associated with regular smoking among Japanese dental students. We also surveyed their attitudes regarding smoking cessation and how to counsel smokers about quitting. METHODS: We collected demographic and behavioral data from 453 students at Kyushu Dental University, and evaluated their mental health with the 12-item General Health Questionnaire (GHQ 12). We also asked them nine questions related to their intentions to counsel smokers about quitting. A multivariate binary logistic regression analysis was used to identify factors associated with smoking. RESULTS: Fifty-two (11.5%) of the dental students smoked. Univariate analyses indicated that male gender, higher academic year, greater number of times eating out per day, alcohol consumption, prevalence of skipping breakfast, poor health, and poor sleep habits were significantly associated with regular smoking. Regular smokers were less likely to have GHQ 12 scores ≥4. On multivariate analysis, male gender (OR = 5.449, 95% CI = 1.851–16.040), sixth year students (OR = 21.971, 95% CI = 1.686–286.290), eating out two or more times a day (OR = 2.492, 95% CI = 1.165–5.331), drinking alcohol three or more times per week (OR = 9.484, 95% CI = 3.335–26.970), and GHQ 12 score ≥ 4 (OR = 0.339, 95% CI = 0.136–0.845) were significantly associated with regular smoking. Overall, 50.1% of the non-smokers and 71.2% of the regular smokers responded that patients’ chances of quitting smoking are not increased when a dentist advises them to quit. CONCLUSIONS: Regular smoking was strongly associated with male gender, higher academic year, alcohol consumption, and higher frequency of eating out per day. Mental health status among regular smokers was better than that among non-current smokers. Furthermore, we found that more than half of dental students have inadequate attitudes to advise their patients to quit smoking. It is necessary to develop educational programs regarding smoking for dental students.