BACKGROUND

In August of 2004, Trinidad & Tobago ratified the Framework Convention on Tobacco
Control. The framework Convention calls for smoke-free environment in indoor public
places, indoor workplaces, public transport and other public places as deemed
appropriate.

In support of this move, The Pan American Health Organization (PAHO) embarked upon
a smoke- free pilot Project in conjunction with The North West Regional Health
Authority, the University of the West Indies, the National Parent -Teachers Association
and the Power Generation Company of Trinidad Tobago . The project aims, firstly, to
raise the awareness of the harm caused by second-hand smoke and secondly, to
emphasise the need to promote written and enforced policy requiring key sectors to
become smoke-free.

In this regard, The Coalition for a Tobacco-Free Trinidad & Tobago as the leader of the
campaign sought the cooperation of the University of the West Indies (UWI) to fulfill one
of the activities of the project, which is to conduct and publicize the results of public
opinion polls on a smoke free environment at the University of the West Indies.

The Health Service Unit of the St. Augustine Campus led the initiative to collaborate
with The Coalition for a Tobacco-Free Trinidad & Tobago to conduct a survey on the
UWI campus. The objectives of the survey were outlined as follows;

To obtain evidence on the prevalence of smoking of a sample of the student

population on the St. Augustine Campus

To obtain an understanding of the attitudes, knowledge and behaviors related to

smoking and its health impact

To assess the opinion of students towards a smoke free campus environment

To provide information to guide in policy / programming planning in addressing

tobacco use on the campus

INTRODUCTION
CURRENT SITUATION

NATIONAL
An estimate of tobacco use among the youth in Trinidad & Tobago is difficult to
determine in light of the limited number of studies previously conducted. The Global
Youth Tobacco Survey conducted in 2000 found among their conclusions that about 40%
of all students between the ages 13-15 have experimented with cigarette smoking at one
or another; that an equal percentage of male and females are experimenting with smoking
before the age of 10; that media advertising is a major contributor; and that a major
influential factor is that they live in households where parents and other adults smoke.
Additionally, the majority felt that in order to curb exposure to environmental tobacco
smoke, smoking should be banned in public places.

INTERNATIONAL
In a 1999 national survey (N. Rigotti, JE Lee and H Wechsler Jama 2000;699-705) of
119 national four- year colleges in the United States , the primary objectives were to
assess the prevalence of all forms of tobacco use among US college students and to
identify student and college level factors associated with use. It was intended that the
study would provide the opportunity to explore the impact of Massachusetts Tobacco
Control Program on smoking by young adults.

It was found that students in those

colleges use tobacco products at substantial rates and the cigarette smoking was said to be
just under 30%.

The study concluded that tobacco use was common among college students and that
colleges appeared to be the time when many students were experimenting with tobacco

products and were susceptible to developing nicotine dependence and that Colleges
provided the opportunity for intervention to discourage tobacco use.

THE SURVEY

METHODOLOGY

Sampling
The sample size was initially based on 10% of the current (2004/2005) student population
at the St. Augustine Campus, UWI. Faculty samples were calculated based on its
proportionate ratio to total existing enrolment. On that basis, the sample population to be
targeted for each faculty was the n divided equally into years 1, 2 and 3 at the
undergraduate level. The calculation resulted in a sample size 1200 students of which 200
were postgraduates.

Data on class sizes for all faculties were obtained from The Campus IT department and
this information was used for the distribution of the questionnaires. Both undergraduate
and postgraduate classes to be surveyed were then randomly selected based on the faculty
ratios.

Questionnaire
The Global Tobacco Youth Survey was chosen as the most appropriate questionnaire.
This questionnaire is available to all countries and was developed by The World Health
Organisation (WHO) in conjunction with the Tobacco Free Initiative (TFI), the United
Nations Childrens Fund (UNICEF), and the Office on Smoking and Health Centers for
Disease Control and Prevention (OSH-CDC). The questionnaire is a standard instrument
used to assess smoking prevalence and other variables related to smoking in the youth
aged 13-15.

The questionnaire originally had fifty-six questions, but modifications were made to
make them more culturally relevant and more appropriate to the age of the students
population at the St. Augustine Campus. The revised questionnaire for the Smoking
Survey at the St. Augustine Campus comprised forty- four questions, the first eight of
which related to personal information on gender, age, ethnicity and status at UWI. The
remaining questions dealt with experience, knowledge and opinions towards smoking,
exposure to smoking, and attitudes toward stopping smoking and a smoke free
environment on the campus.

The questionnaires were distributed to classes by field officers and self administered by
respondents. Questions had response categories, which had to be ticked off. Multiple
responses to any question were not allowed and participation was voluntary and
anonymous.

Data Collection
The distribution of the questionnaires was handled by students who were hired
specifically to administer the questionnaires, give a brief introduction to the survey,
collect and collate them and return them to the project coordinator.

Analysis
The Database manager and an assistant entered data into the Access database for the
creation of queries and reports. The Project Coordinator analysed the data, which formed
the basis of the observations and trends that were highlighted. The limitations of the
analysis were also discussed and proposed action for follow up was identified.

RESULTS
A total of 1165 students of the 1200 students targeted on the St. Augustine Campus, UWI
undertook to participate in the survey. This yielded a 97% response rate. The sample
included students across the five faculties, and from all three levels of study. All 1165
respondents did not however, answer all the questions. For the purpose of this paper the
sample population decided upon was based on 1144 respondents. These respondents
however, all answered the question, which was used to determine current smokers from
non-smokers.

Characteristics of the sample

Of the 1144 respondents, 90% were undergraduates and 10% were postgraduates. The
distribution of the respondents by faculty was as follows; Education 4.47%, Engineering
16%, Humanities 17.0%, Law 2.2%, Medical Sciences 7.6%, and the majority from
Science and Agriculture 30% and Social Sciences 25%.

In terms of gender distribution, approximately 40 % were male and 60% female, 52% of
the sample was between the ages 18-21, 27% between 22-25 and 20% over 25. In terms
of ethnic background, 39 % was of Indian origin, 35% African, 22% of mixed races and
4% of Chinese, Spanish, Syrian and other ethnicities.

Eighty-nine percent of the sample population was single and 10% percent married. The
majority of the students (85%) were registered as full-time and 38% were in level 1 (or
first year), 32% in level 2, 25% in level 3. Less than 3% were in levels 4 and 5 and this
comprised mainly students in the faculty of Medical Sciences.

Experimentation with smoking

Students were asked whether they had ever tried or experimented with cigarette smoking,
even one or two puffs, the results indicated that 567 or 49% of the respondents answered
positively, of which 53% were female and 43% male. From the base of the sample
population, the majority of students who admitted to having experimented with smoking
came from Science and Agriculture (26%) and Social Sciences (26%), Engineering
(16%) and Humanities (16%) and 45% were in the age group 18-21.

Chart 1 Experimentation with Smoking

60

50

Percentage

40
Female

30

Male

20

10

Yes

No

Female

26.4

33.3

Male

23.1

16.8

Chart 2 -Experimentation with Smoking

9

Percentage

Female
Male

0
Education

Engineering

Humanities

Law

Medical
Sciences

Sciences

Social
Sciences

Prevalence of smoking
In order to assess the prevalence of smoking on the campus, the methodology defined
current smokers, as students who had smoked cigarettes on one or more occasion within
the last thirty days. 122 students or 11% of the respondents were identified as current
smokers. More males (64%) were current smokers than females (36%). Thirty-seven
percent of respondents indicated that they were 16 years or older when they first tried a
cigarette, inferring that most students first tried smoking under 16 ( 26% of whom were
between 14-15).

Current smokers
The highest percentage of current smokers were in the faculty of Science and Agriculture
with 27%, Engineering with 24% followed by Social Sciences 21%, Humanities 13%,
Medical Sciences 8%, Education 2.5% and Law 1.6%. More students from the younger
age group18-21 were current smokers (56%), about 28% were between the ages 22-25
and 11 % over 25.

Smokers were also assessed in terms of their ethnic background. According to the data
response persons of Indian background smoked most (51%), others were of mixed races
( 26%), and Africans at 19%. Smokers of Chinese, Spanish, Syrian and other ethnicities
comprised 2.4%.

Many of the current smokers (27%) said that they most smoked at social events, less at
home (22%) and the least at school (17%). The majority of students who were smokers
(83%) mainly chose cigarettes as their only form of tobacco use.

Table 1 : Experimentation and Prevalence

Category

Gender
Faculty

Age

Experimentation

Prevalence
Current smokers

First
Smoked
Cigarette before
age of 16

Total

49.5

10.7

13.0

Male
Female

46.5

63.9

14.6

53.2

36.0

13.1

Engineering

16.2

23.8

6.3

Education

5.3

2.5

0.7

Humanities

15.9

13.1

4.2

Law

1.4

1.6

0.3

Medical
Sciences
Science
&
Agriculture
Social
Sciences
<18

8.1

8.2

2.5

25.6

27.0

7.0

25.6

20.5

7.2

0.2

1.6

18-21

45.3

55.7

13.1

22-25

30.2

27.9

8.6

>25

23.8

11.5

5.6

Chart 3 -Current smokers by Gender & Faculty

50

Percentage

40
30

Male
Female

20
10
0

Education

Engineering

Humanities

Law

Medical Sciences

Sciences

Male

0.0

23.0

7.4

0.0

4.9

16.4

Social Sciences
9.8

Female

2.5

0.8

5.7

1.6

3.3

10.7

10.7

Chart 4-Current Smokers by Gender& Ethnicity

Percentage

60
50
40
Male

30

Female

20
10
0

Chinese

Indian

Mixed

African

Spanish

Syrian

Male

0.8

31.1

17.2

13.1

0.8

0.0

Female

0.0

19.7

9.0

5.7

0.0

0.8

10

Chart 5 - Current Smokers by Gender & Age

70

Percentage

60
50
40
Male

30

Female

20
10
0
Male
Female

>18

18-21

22-25

>25

0.8

36.9

20.5

4.9

21.3

7.4

7.4

Chart 6 - Current Smokers by Gender & Level of Study

50
45
40

Percentage

35
30
Male

25

Female

20
15
10
5
0
Year 1

Year 2

Year 3

Year 4

Year 5

Male

15.6

23.8

18.9

2.5

0.8

Female

13.1

13.9

8.2

0.0

0.8

11

Frequent Smokers
Students who smoked cigarettes on 20-30 days of the month were considered frequent
smokers. Approximately, 40% of the current smokers were frequent smokers with the
highest percentage of frequent smokers being in Engineering and Science and Agriculture
at 28% each. There were more male frequent smokers (73%) as compared to female ones
(27%). Some 28% claimed to be casual smokers or those smoking only on one or 2 days
of the month. At least 51% of the smokers indicated that they smoked anywhere from 2
to 10 cigarettes a day.

Age of first attempt with smoking

When asked how old they were when they first tried a cigarette, 54% stated that they
were between 10-15, 37% indicated that they were 16 or older and only 8% of the current
smokers said they were younger than 10.

Knowledge and Attitudes Towards Smoking

The question was posed to current smokers as to whether anyone in the family had
discussed the harmful effects of smoking with them. It was concluded that more smokers
(63% of which 69% were male) than non-smokers (47% of which 66% were female)
indicated that they did have discussions.

In response to question as to whether they thought smoking cigarettes helped people feel
more or less comfortable at celebrations, parties, or in other social gatherings, both
current smokers and non- smokers equally believed that it made people feel more
comfortable.

In general, the majority of respondents believed that smoking was harmful to ones
health. Among the current smokers, 73% (of which 60% male) indicated that it was
definitely harmful, and as predicted, many more of the non-smokers (93% of which 64%
were female) shared the same opinion.

12

When asked about their impressions of a man smoking, the majority of the results
indicated that the respondents had negative impressions. Seventy- five percent of the nonsmokers indicated that they thought the man was stupid, lacking confidence and felt they
were losers. However less of the smokers (22%) shared the same view.

In reference to a woman smoking, more non-smokers (83%) than smokers (34%) felt
women lacked confidence, were losers or were stupid.

Percentage

Chart 7 Attitudes towards Smoking

100
90
80
70
60
50
40
30
20
10
0

Current smokers
Non-smokers

Think smoking is harmful to

one's health

Think smoking makes people

feel comfortable

Think smoke from other people's

cigarettes is harmful

13

Table 2 : Knowledge and Attitude

Category

Think smoking
makes people
feel
more
comfortable

Think smoking
is
definitely
harmful
to
ones health

Has
negative
impressions of
man
who
smokes

Has
negative
impressions of a
woman
who
smokes

Current
smokers
40.9

Nonsmokers
42.0

Current
smokers
73%

Nonsmokers
92.5

Current
smokers
35.2

Nonsmokers
74.6

Current
smokers
22.1

Nonsmokers
82.6

Male

30.3

14.5

45.9

32.7

15.5

26.0

25.4

29.3

Female

10.6

27.2

27.0

59.5

6.5

48.4

9.8

53.0

Engineering

11.5

7.0

15.6

13.6

4.1

10.8

9.8

12.2

Education

0.8

0.0

2.5

4.2

0.8

3.3

0.8

3.5

Humanities

4.1

7.0

9.8

15.8

2.5

13.5

4.9

14.9

Law
Medical
Sciences
Science &
Agriculture
Social
Sciences
<18

0.8

1.1

0.8

2.3

0.0

2.0

0.0

2.1

4.9

4.0

4.9

7.2

1.6

6.0

3.3

6.3

9.0

10.6

18.9

25.3

4.9

20.0

8.2

22.9

7.4

9.8

18.0

23.0

6.6

18.5

6.6

19.9

0.8

0.1

0.1

0.8

0.09

0.8

0.1

18-21

25.4

22.5

14.8

48.3

13.1

40.3

23.0

44.2

22-25

11.5

11.7

2.5

22.2

6.6

18.8

9.0

21.3

>25

3.3

7.5

6.6

18.8

1.6

15.3

1.6

16.6

Total
Gender
Faculty

Age

Social Influence
It was found that 23% of the students who were surveyed had parents who smoke. More
current smokers (38%) indicated that either one or both of their parents smoke, but of the
non-smokers less of them (22%) said that their parents smoke.

In reference to the question about having close friends who smoke, it was found that the
majority (97%) of the current smoker respondents replied positively, 64% of which were
males. Contrastingly, less of the close friends (53%) of the non-smokers were smokers.

14

Percentage

Chart 7 -Social Influence

100
90
80
70
60
50
40
30
20
10
0

Current smokers
Non-smokers

Have parents who smoke

Have close friends who

smoke

Harmful effects of smoking

has been discussed in the
family

Exposure to Smoking
The belief that smoke from other peoples cigarettes was harmful was felt by 84% of the
sample population on the whole but more non-smokers (87%) compared to current
smokers (62%) agreed with this view.

Students were also asked to respond to whether or not they were in favour of banning
smoking in public places (restaurants, buses, schools, playgrounds, gyms, sports arenas
discos etc.) The general response from the sample population suggested that 85% (63%
female, 31% male) were agreeable to banning smoking in public places. Only 41% of the
current smokers said yes to banning smoking in public areas. Among the non-smokers
ninety percent of the respondents were more inclined to banning smoking in public places
and more females (64%) than males (35%) supported the choice.

Student opinion on banning smoking in designated student areas on the campus was also
assessed. The data indicate that overall, a majority of 88% of the sample population (62%
female and 38% male) preferred smoking to be banned on the campus. At a closer
analysis, a greater proportion (93%) of the non-smokers favored a smoke free campus
while only 52% of the current smokers supported that option.

15

Percentage

Chart 9- Exposure to Smoking

100
90
80
70
60
50
40
30
20
10
0

Current smokers
Non-smokers

Exposed to smoke at Exposed to smoke

home
from other places
than home

In favour of banning In favour of banning

smoking in public
smoking on the
places
campus

Table 3 : Exposure to Smoking

Category

Total
Gender
Faculty

Age

Exposed
to
smoke
from
others at home

Definitely think
smoke
from
others
is
harmful to them

Percentage who
think smoking
should
be
banned
in
public places

Percentage who
think smoking
should
be
banned
in
student
areas
on Campus

Current
smokers
59.8

Nonsmokers
30.0

Current
smokers
63.0

Nonsmokers
87.0

Current
smokers
40.9

Nonsmokers
90.1

Current
smokers
52.4

Nonsmokers
93.0

Male

43.4

11.9

39.3

30.4

16.4

32.2

30.3

33.5

Female

16.4

18.0

23.0

56.4

24.5

57.7

22.1

59.2

Engineering

14.8

4.8

14.8

12.9

9.8

15.1

9.8

15.2

Education

2.5

1.2

1.6

4.0

1.6

4.5

1.6

4.6

Humanities

7.4

5.3

9.0

15.3

4.9

17.1

6.6

17.1

Law

0.8

0.4

0.8

2.0

0.8

2.2

0.8

2.3

Medical
Sciences
Science &
Agriculture
Social
Sciences
<18

6.6

2.8

2.5

6.5

1.6

7.5

1.6

7.5

19.7

8.9

17.2

24.0

8.2

27.1

17.2

27.1

6.6

6.3

13.9

21.3

12.3

25.0

12.3

25.0

0.0

0.0

0.8

0.1

0.8

0.1

0.8

0.1

18-21

38.5

17.5

40.2

45.9

23.0

51.8

29.5

51.8

22-25

13.9

7.8

18.0

22.5

13.9

27.0

17.2

34.5

>25

7.4

5.1

4.1

18.3

2.5

19.7

4.1

19.9

16

Intention to smoke / Desire to stop.

The non-smokers indicated that only 3% of them would definitely smoke if one of their
best friends offered them a cigarette, the majority of whom were females (71%).
However, less than 2% of them thought that they would be smoking cigarettes 5 years
from now.

Just about 34% of the current smokers indicated that they wanted to stop smoking but
more males (74%) than females showed this desire. Thirty-six percent of those who
indicated a desire to stop smoking was from the faculty of Science and Agriculture but
of the 39% who said that they did not want to stop smoking, at least 31% was students
from Engineering.

Of the smokers who responded, 46% indicated that they had stopped smoking (61%
males 39% females) and 41% stated that they had stopped

anywhere between 1 to 11

months.
Only 16% of the current smokers ever received help to stop smoking, and 36% of those
who said they had stopped indicated that improving their health was the main reason for
doing so.

17

DISCUSSION

Observations
At least 50% of all the respondents had experimented with smoking at one time, but more
females (53.2%) than males (46.5%) had tried smoking. It is also evident that more
persons in the younger age group 18-22 had tried their first cigarette before the age of 16.
The habit of smoking was more prevalent among the male gender as 64% of the current
smokers were male and 36% female. Students in the age group 18-21 comprised most
(58%) of the current smokers.

Frequent smokers were defined as those who smoked on all of the 30 days. The
percentage of frequent smokers among the current smokers was found to be significantly
high at 33% (75% percent of whom are male).

Students were divided on the issue of whether smoking made people feel comfortable,
42% believed it made people feel more comfortable, 42% said there was no difference
and 11% indicated that it made people feel less comfortable. Persons who had close
friends who smoked also tended to be smokers as distinct from no n-smokers who had less
close friends who smoked. At least 65% of the respondents were not exposed to other
peoples smoke in their homes but 73% claimed that they were exposed to other peoples
smoke in places other than their home anywhere from 1 to 7 days. In the male dominated
faculty of Engineering smoking tended to be more acceptable and there was more
reluctance from them to stop smoking.

An overwhelming 90% of the sample population agrees that smoking is definitely

harmful to ones health, while 84% think that smoke from other peoples cigarettes is
harmful to them. The consensus (85% of the sample population) on the campus is that
smoking should be banned in public places and more believe (88%) that this should be
extended to student areas on the campus. It must also be recognised that a significant

18

proportion of the student sample have articulated a desire to stop smoking but
interestingly less females have indicated this will.

Limitations
The analysis of the survey was restricted to the extent where students failed to complete
responses to some questions. Although the questionnaire included a wide range of
questions regarding the use, attitude, beliefs, influence and exposure to smoking, the
analysis was limited to a selected number of questions, focusing on the prevalence and
experience in smoking behavior and attitudes of the student population towards a smoke
free campus. Responses were few in number at the postgraduate level and not evenly
distributed and they were therefore considered to be too few to lend significance to the
study.

Some answers were ambiguous and this created a difficulty in the analysis particularly as
it was related to the response, I have never smoked cigarettes which was identified as a
response in more than one question. In all instances the numbers responding were
different.

This survey is the first of its kind to be conducted on the campus and therefore
comparisons could not be drawn to measure any change in the pattern of smoking nor the
profile of smokers. The existing national survey entitled, Global Youth Tobacco
Survey conducted in 2000 by the Ministry of Health dealt mainly with the target age
group 13-15 in 61 schools across the country. While the report concentrated on a
younger survey population, it was able to conclude that cigarette smoking was a cause for
growing concern and that among those surveyed at least 40% has smoked cigarettes once
in their lives.

Comparative Data
In the final report of the task force on a smoking survey (June 2004) conducted at the
three campuses of the University of New Brunswick, Canada, it was noted that

19

approximately 16% of the 1144 student respondents smoked. The trends have been
similar to the study at UWI in that, about 40% have thoughts of quitting while 98% were
aware of the health issues related to smoking and 92% were concerned about the effects
on their health.

Across the three campuses there were general encouragement for added measures to
reduce smoking on the campus ranging from 75% to 85% and 60% to 70% backing for
the total ban on smoking on the campuses.

At the California State University Sacramento, California, US, results of a 2003 survey of
1155 respondents demonstrated that there was a decline in the percentage of students who
were smokers from 32% in 2001 to 15% in 2003. The issue of secondhand smoke was a
main concern to 60% of the survey respondents while 52% indicated that it was important
to have campus designated smoking areas.

Conclusions
It has been observed that while only 11% of the students have admitted to being current
smokers the practice of smoking is more common among the younger age group 18-21,
which represented 56% of the smokers, and at least 43% of this age cohort indicated that
they first smoked a cigarette under the age of 16.

There was

a higher ratio of smoking among the male population and those in the

faculties of Science and Agriculture and Engineering and also among students registered
in level two and from Indian ethnicity. There was less occurrence of smoking among
persons of African and Mixed descent. There was also a higher incidence of smokers
among those who had parents and or close friends who smoked.

Exposure to environmental smoke is a growing concern among the student population.

Opinion on the harmful effects of smoking to ones health and from other peoples smoke
and tend to be stronger among the non-smokers and there is also overwhelming support

20

for banning smoking in public places and select student areas and the campus. Notably,

there is also considerable support from the smoking population for the creation of

smoke free campus.

The information from the smoking students indicates that there is a receptiveness towards
quitting smoking and similarly and a greater inclination from them to having tried stop
smoking cigarettes in the past year. A significant proportion (38%) have claimed that
they have never received help nor advice to help them stop smoking, it seems therefore
that this is an opportunity for the campus to foster programmes to assist those who are
partial to giving up the habit.

It is safe also to assume from the available data that less than 20% of the persons
identified as nonsmokers, would ever begin to smoke.

Follow-Up
As part of the objective of this survey, it is important to acknowledge the indicators of
the sample population as representative of the campus body. Smoking is evidently
unpopular and the general feeling is that environmental smoke is unwanted. There is also
strong advocacy for mechanisms to be put in place for establishing smoke free student
areas on the campus in support of the general consensus.

The survey has been able to identify where and with whom, the prevalence of smoking is
greatest. There must therefore be more surveillance in terms of programmes and policies
to be developed for smoking cessation and for the intervention required to discourage
smoking and other forms of substance abuse especially where the use patterns are related
One item for follow up is the commitment to repeat similar surveys in the future for the
continuous monitoring of the habitual trends of the student population in tobacco and
other forms of substance use.

21

References
1. The Ministry of Health, Directorate of Health Policy , Research and Epidemiology, B.
Carr, L. Alleyen and D. Renaud Global Youth Tobacco Survey. June 2000.
2. N A Rigotti, S Regan, N E Majchrzak, J R Knight and H Wechsler, Tobacco Use by
Massachusetts Public College Students: long term effect of the Massachusetts Tobacco
Control program. Tobacco Control 2002;11(Suppl 11) ii 20- ii24
3. P. Bovet, B Vishwanathan, W. Warren, Ministry of Health , Victoria , Seychelles, The
Global Youth Tobacco Survey in the Seychelles 2002.
4. International Union against Cancer (UICC) & Tobacco Control Resource Centre, J.P
Pierce,

Conducting

smoking

prevalence

survey.

(http://

factsheets.globallink.org/en/prevalence.
5. Statistics Canada: 2002 Youth Smoking Survey.
6. D. Wybou , A Final Report of a Task Force on Smoking Survey, The University of
New Brunswick, June 2004. Submitted to the UNB Joint Health and Safety Committee.
7. Survey of the California State University 2003. www.sacstand.org/survey

22