Exposure to tobacco smoke, concurrent short-term symptoms of respiratory, allergic, cardiovascular morbidities and health-services use among young adults in Kuwait

Exposure to tobacco smoke remain major public health concerns due to its’ association with multiple morbidities and increased health-services use. This cross-sectional study aimed to, (i) assess the prevalence of exposure to tobacco smoke (first-hand and second-hand) among students at a public university; (ii) assess the prevalence of tobacco smoke-related concurrent morbidities; (iii) assess the prevalence of health-services use (≥ 1 vs. none) during the past one-year; and (iv) evaluate the association between demographics, tobacco smoking, concurrent morbidities, and health-services use during the past year. A cross-sectional study was conducted in October 2022 among undergraduate students at Kuwait University using a structured electronic questionnaire. Participants were recruited as a sample of convenience. The prevalences (%) of exposure to tobacco smoke (1st hand and 2nd hand at home) were estimated. Self-reported respiratory symptoms, physician-diagnosed morbidities, and health-services use (≥ 1 visit vs. none) during the past year were assessed. Multivariable logistic regression analysis was conducted to examine the association between sociodemographics, lifestyle factors, concurrent morbidities, and health-services use during the past year. The adjusted odds ratios (OR) and 95% confidence intervals (CI) were used to interpret the final model. Of 1,323 participants, the majority were Kuwaiti (87.5%) and female (75.8%). The prevalence of exposure to first-hand tobacco smoke was 13.4% (177/1,323), while 50.8% (672/1,323) reported exposure to second-hand tobacco smoke at home. Overall, the prevalence of exposure to tobacco smoke was 55.9% (740/1323). The reported respiratory symptoms were shortness of breath (59.1%), cough (46.3%), chest pain (26.9%), and difficulty during exercise (21.6%). Physician-diagnosed conditions included asthma (16.8%), eczema (11.2%), and chronic obstructive pulmonary disease (1.4%). Of the participants, 44.6% (590/1323) used the health-services at least once during the past year. In the multivariable model, after adjusting for effects of age and sex, participants were significantly more likely to report at least one instance of health-services use during the past year if they reported cough (adjusted OR = 2.10; 95% CI: 1.66–2.64; p < 0.001), shortness of breath (adjusted OR = 1.30; 95% CI: 1.01–1.67; p = 0.044), nausea/vomiting (adjusted OR = 2.52; 95% CI: 1.79–3.54; p < 0.001), or asthma (adjusted OR = 1.95; 95% CI: 1.43–2.65; p < 0.001). However, tobacco smoking (active and/ or secondhand) was not significantly associated with health services use at least once during the past year in this evaluation. This study reports high prevalence of second-hand tobacco smoke exposure at home among young adults, along with high levels of respiratory and allergic morbidities. Although tobacco exposure (first and/ or secondhand) itself was not directly associated with health-services use at least once in the past year, smoking-related symptoms and ill-health conditions were significantly associated with health-care use at least once during the past year. Public health interventions aimed at reducing exposure to tobacco smoke may help decrease related morbidities and subsequent health-services use among young adults.