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Licensed Unlicensed Requires Authentication Published by De Gruyter June 9, 2020

Tobacco use and associated health risk behaviours among university students in 27 countries

  • Supa Pengpid ORCID logo and Karl Peltzer ORCID logo EMAIL logo



Evidence of the relationship between tobacco use and multiple health risk behaviours is limited.


The study aimed to investigate the relationship between tobacco use and health risk behaviours in university students across different cultures.


In a cross-sectional study the sample included 23,396 university students from 27 countries in Africa, Asia and the Americas.


Indicate that 5.8 and 5.5% were daily and not daily tobacco users, respectively. In adjusted logistic regression analysis, less than daily and/or daily tobacco use was associated with nutrition and dietary risk behaviour (overweight or obesity, high sodium consumption, rarely or never having breakfast and not avoiding fat and cholesterol), addictive behaviour (binge drinking, drug use, and gambling), sleep risk behaviours (long sleep, poor sleep quality and restless sleep) and other health risk behaviour (having been in a physical fight, inadequate tooth brushing, and multiple sexual partners in the past year).


Compared to non-tobacco users, less than daily and/or daily tobacco users had significantly higher overweight or obesity, dietary risk behaviour, addictive behaviour, sleep risk behaviours and other health risk behaviour. These associations may be taken into account in health promotion strategies targeting multiple health compromising behaviours.

Corresponding author: Prof. Karl Peltzer, Department of Research Administration and Development, University of Limpopo, Turfloop Campus, Private Bag X1106, Sovenga 0727, Turfloop, South Africa, E-mail:


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Received: 2019-12-25
Accepted: 2020-01-30
Published Online: 2020-06-09

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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