{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:07:26Z","timestamp":1793066846655,"version":"4.5.0"},"reference-count":43,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Cigarette smoking among the youth population has increased significantly in developing countries, including Bosnia and Herzegovina. However, no extant literature assesses the prevalence of tobacco use, nor identifies factors associated with smoking. This study determined the prevalence of cigarette smoking among a specific cohort of students and assessed factors related to tobacco use in this population. Materials and Methods: This cross-sectional study included 1200 students at all faculties of Banja Luka University. Data were collected from questionnaires adapted from the Global Youth Tobacco Survey (GYTS) and the Global Health Professional Student Survey (GHPSS) standardized questionnaires and were analyzed using descriptive statistics, Pearson\u2019s \u03c72 test, and logistic regression. Results: When the prevalence of cigarette smoking within the last thirty days was recorded, we found that 34.1% of students smoked within this period. Nearly three-quarters (74.9%) of the student population had smoked or experimented with cigarette smoking. However, medical students were 27.2% less likely to smoke than their counterparts from other faculties. Overall, 87% of all students were aware of the harmful effects of cigarette smoking, 79% were aware of the harmful effects of secondhand smoke, and 65% reported that it was difficult to quit. Increased spending of personal money was associated with a higher probability of smoking, while exposure to secondhand smoke increased the odds of smoking by 62%. Conclusion: Policies, strategies, and action plans should be introduced in order to reduce the prevalence of smoking among university students and to create a smoke-free environment at the various universities involved.<\/jats:p>","DOI":"10.3390\/medicina58040502","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T21:34:29Z","timestamp":1648762469000},"page":"502","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Prevalence of Cigarette Smoking and Influence of Associated Factors among Students of the University of Banja Luka: A Cross-Sectional Study"],"prefix":"10.3390","volume":"58","author":[{"given":"Ivana","family":"Todorovi\u0107","sequence":"first","affiliation":[{"name":"Vanke School of Public Health, Tsinghua University, Beijing 100084, China"},{"name":"Association of Medical Students, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Vanke School of Public Health, Tsinghua University, Beijing 100084, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stela","family":"Stojisavljevi\u0107","sequence":"additional","affiliation":[{"name":"Public Health Institute of The Republic of Srpska, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Marinkovi\u0107","sequence":"additional","affiliation":[{"name":"Association of Medical Students, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"},{"name":"Center for Biomedical Research, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-8208","authenticated-orcid":false,"given":"Stefan","family":"Kremenovi\u0107","sequence":"additional","affiliation":[{"name":"Association of Medical Students, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pane","family":"Savi\u0107","sequence":"additional","affiliation":[{"name":"Association of Medical Students, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6883-4739","authenticated-orcid":false,"given":"Ana","family":"Goli\u0107-Jeli\u0107","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nata\u0161a","family":"Stojakovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8278-2071","authenticated-orcid":false,"given":"Svjetlana","family":"Stoisavljevi\u0107-\u0160atara","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajko","family":"Igi\u0107","sequence":"additional","affiliation":[{"name":"The Academy of Sciences and Arts of The Republic of Srpska, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranko","family":"\u0160krbi\u0107","sequence":"additional","affiliation":[{"name":"Center for Biomedical Research, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"},{"name":"Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"ref_1","unstructured":"(1964). Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service, U.S. Department of Health, Education, and Welfare. Available online: https:\/\/www.unav.edu\/documents\/16089811\/16155256\/Smoking+and+Health+the+Surgeon+General+Report+1964.pdf."},{"key":"ref_2","unstructured":"World Health Organization (2022, February 01). Tobacco Fact Sheet, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tobacco."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1080\/17476348.2019.1645010","article-title":"The impact of smoking and the influence of other factors on lung cancer","volume":"13","author":"Schuller","year":"2019","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_4","unstructured":"U.S. Department of Health and Human Services (2022, February 01). The Health Consequences of Smoking\u201450 Years of Progress: A Report of the Surgeon General, Available online: https:\/\/www.hhs.gov\/sites\/default\/files\/consequences-smoking-exec-summary.pdf."},{"key":"ref_5","unstructured":"Centers for Disease Control and Prevention (US), National Center for Chronic Disease Prevention and Health Promotion (US), and Office on Smoking and Health (US) (2022, February 01). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53017\/."},{"key":"ref_6","unstructured":"U.S. Department of Health and Human Services (2022, February 01). Women and Smoking: A Report of the Surgeon General, Available online: https:\/\/www.cdc.gov\/tobacco\/data_statistics\/sgr\/2001\/complete_report\/index.htm."},{"key":"ref_7","unstructured":"Public Health Institute of the Republic of Srpska (IPH-RS) (2015). Health Risk Factors for Non-Communicable Disease (NDC)-Implications for Policy and Practice, IPH-RS."},{"key":"ref_8","unstructured":"Public Health Institute of the Republic of Srpska (IPH-RS) (2019). Global Youth Tobacco Survey among School Children in the Republic of Srpska, IPH-RS."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12971-016-0092-9","article-title":"Susceptibility to cigarette smoking among secondary and high school students from a socially disadvantaged rural area in Poland","volume":"14","author":"Wojtysiak","year":"2016","journal-title":"Tob. Induc. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Pengpid, S., and Peltzer, K. (2020). Tobacco use and associated health risk behaviors among university students in 27 countries. Int. J. Adolesc. Med. Health.","DOI":"10.1515\/ijamh-2019-0268"},{"key":"ref_11","unstructured":"(2022, January 24). Global Youth Tobacco Survey (GYTS) Questionnaire. Available online: https:\/\/www.who.int\/teams\/noncommunicable-diseases\/surveillance\/systems-tools\/global-youth-tobacco-survey\/questionnaire."},{"key":"ref_12","unstructured":"Centers for Disease Control and Prevention (2022, January 24). Global Tobacco Surveillance System Data. Global Health Professions Students Survey Protocol, Available online: https:\/\/nccd.cdc.gov\/GTSSDataSurveyResources\/Ancillary\/Documentation.aspx?SUID=3&DOCT=1."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kirchherr, J., and Charles, K. (2018). Enhancing the sample diversity of snowball samples: Recommendations from a research project on anti-dam movements in Southeast Asia. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201710"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bro\u017cek, G.M., Jankowski, M., Lawson, J.A., Shpakou, A., Pozna\u0144ski, M., Zielonka, T.M., Klimatckaia, L., Loginovich, Y., Rachel, M., and Gereov\u00e1, J. (2019). The prevalence of cigarette and e-cigarette smoking among students in central and eastern europe\u2014Results of the YUPESS study. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16132297"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kaleta, D., Polanska, K., Wojtysiak, P., and Szatko, F. (2017). Involuntary smoking in adolescents, their awareness of its harmfulness, and attitudes towards smoking in the presence of non-smokers. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14101095"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.18332\/tid\/92547","article-title":"Smoking prevalence, attitudes and associated factors among students in health-related Departments of Community College in rural Yemen","volume":"16","author":"Nasser","year":"2018","journal-title":"Tob. Induced Dis."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Karado\u011fan, D., \u00d6nal, \u00d6., and Kanbay, Y. (2018). Prevalence and determinants of smoking status among university students: Artvin \u00c7oruh University sample. PLoS ONE, 13.","DOI":"10.1101\/361345"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Sanchez, Z.M., Opaleye, E.S., Martins, S.S., Ahluwalia, J.S., and Noto, A.R. (2010). Adolescent gender differences in the determinants of tobacco smoking: A cross sectional survey among high school students in S\u00e3o Paulo. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-748"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1477-7517-9-39","article-title":"Determinants of cigarette smoking among school adolescents in eastern Ethiopia: A cross-sectional study","volume":"9","author":"Reda","year":"2012","journal-title":"Harm. Reduct. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Rachiotis, G., Muula, A.S., Rudatsikira, E., Siziya, S., Kyrlesi, A., Gourgoulianis, K., and Hadjichristodoulou, C. (2008). Factors associated with adolescent cigarette smoking in Greece: Results from a cross sectional study (GYTS Study). BMC Public Health, 8.","DOI":"10.1186\/1471-2458-8-313"},{"key":"ref_22","unstructured":"Bori\u010di\u0107, K., Vasi\u0107, M., Grozdanov, J., Raki\u0107, J.G., \u0160ulovi\u0107, M.\u017d., and Kne\u017eevi\u0107, N.J. (2014). Results of the National Health Survey of the Republic of Serbia 2013, The Institute of Public Health of Serbia \u201cDr Milan Jovanovi\u0107 Batut\u201d."},{"key":"ref_23","first-page":"11","article-title":"Socio-demographic factors associated with smoking habits among university students in Belgrade, Serbia","volume":"58","year":"2019","journal-title":"Zdr. Varst."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Rodakowska, E., Mazur, M., Baginska, J., Sierpinska, T., la Torre, G., Ottolenghi, L., D\u2019Egidio, V., and Guerra, F. (2020). Smoking Prevalence, Attitudes and Behavior among Dental Students in Poland and Italy. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207451"},{"key":"ref_25","first-page":"e701","article-title":"Prevalence and Associated Factors of Smoking among Final Year Medical Students: A Multicentric Survey from Pakistan","volume":"8","author":"Khubaib","year":"2016","journal-title":"Cureus"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.puhe.2004.02.009","article-title":"Psychosocial correlates of substance use among adolescents in Mersin, Turkey","volume":"118","author":"Yazici","year":"2004","journal-title":"Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Balogh, E., Faubl, N., Riemenschneider, H., Bal\u00e1zs, P., Bergmann, A., Cseh, K., Horv\u00e1th, F., Schelling, J., Terebessy, A., and Wagner, Z. (2018). Cigarette, waterpipe and e-cigarette use among an international sample of medical students. Cross-sectional multicenter study in Germany and Hungary. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5494-6"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e036512","DOI":"10.1136\/bmjopen-2019-036512","article-title":"Prevalence of tobacco use, exposure to secondhand smoke and knowledge on smoking cessation among students of health professions in Central Greece: A cross-sectional study","volume":"10","author":"Samara","year":"2020","journal-title":"BMJ Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"55","DOI":"10.4103\/0022-3859.30333","article-title":"An international review of tobacco smoking among medical students","volume":"53","author":"Smith","year":"2007","journal-title":"J. Postgrad. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3961\/jpmph.15.061","article-title":"Assessment of tobacco habits, attitudes, and education among medical students in the United States and Italy: A cross-sectional survey","volume":"50","author":"Armstrong","year":"2017","journal-title":"J. Prev. Med. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1071\/HE05233","article-title":"Tobacco smoking habits among Chinese medical students and their need for health promotion initiatives","volume":"16","author":"Smith","year":"2005","journal-title":"Health Promot. J. Austr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"270","DOI":"10.5588\/ijtld.12.0377","article-title":"Correlates of cigarette smoking among university students in Cameroon","volume":"17","author":"Luma","year":"2013","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.sdentj.2014.03.003","article-title":"Smoking among dental students at King Saud University: Consumption patterns and risk factors","volume":"26","author":"AlSwuailem","year":"2014","journal-title":"Saudi Dent. J."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Rudatsikira, E., Abdo, A., and Muula, A.S. (2007). Prevalence and determinants of adolescent tobacco smoking in Addis Ababa, Ethiopia. BMC Public Health, 7.","DOI":"10.1186\/1471-2458-7-176"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"17959","DOI":"10.1038\/srep17959","article-title":"Gender differences in the association between cigarette smoking, alcohol consumption and depressive symptoms: A cross-sectional study among Chinese adolescents","volume":"5","author":"Yue","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1590\/S1806-37132013000500008","article-title":"Prevalence of and factors influencing smoking among medical and non-medical students in Tbilisi, Georgia","volume":"39","author":"Chkhaidze","year":"2013","journal-title":"J. Bras. Pneumol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1747-597X-9-10","article-title":"Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: Secondary analysis of Global Youth Tobacco Survey","volume":"9","author":"Aslam","year":"2014","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_38","unstructured":"World Health Organization (2022, January 24). World No Tobacco Day 2010\u2014Gender and Tobacco: Emphasis on Marketing to Women, Available online: https:\/\/www.who.int\/news-room\/events\/detail\/2010\/05\/31\/default-calendar\/world-no-tobacco-day-2010."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1093\/ntr\/nty128","article-title":"Prevalence and Determinants of Susceptibility to Tobacco Smoking among Students in The Gambia","volume":"21","author":"Jallow","year":"2019","journal-title":"Nicotine Tob. Res."},{"key":"ref_40","first-page":"244","article-title":"Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh","volume":"6","author":"Hossain","year":"2017","journal-title":"Cent. Asian J. Glob. Health"},{"key":"ref_41","first-page":"181","article-title":"Twenty five years of antismoking movement started by medical students: Some further goals","volume":"12","author":"Jerinic","year":"2007","journal-title":"J. Balk. Union Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1136\/thx.54.1.70","article-title":"Teaching medical students about tobacco","volume":"54","author":"Richmond","year":"1999","journal-title":"Thorax"},{"key":"ref_43","first-page":"1709","article-title":"Cigarette smoking and medical students","volume":"26","year":"2021","journal-title":"J. Balk. Union Oncol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/4\/502\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:47:15Z","timestamp":1760136435000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/4\/502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,31]]},"references-count":43,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["medicina58040502"],"URL":"https:\/\/doi.org\/10.3390\/medicina58040502","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,31]]}}}