Analysis of stress and smoking behavior among medical students in Jember University
DOI:
https://doi.org/10.30742/jikw.v15i1.4698Keywords:
stress, smoking behavior, phenomenology, DASS-SAbstract
Background: Prolonged stress commonly induces specific coping strategies, including the adaptive problem-focused and the less adaptive emotion-focused coping. One example of emotion-focused coping is smoking. Objective: This study aimed to characterize the stress experienced by medical students and how they correlate with smoking behaviors. Methods: This descriptive research employed the Depression, Anxiety, Stress Scale – Stress Domain (DASS-S) and Silvan-Tomkin’s smoking behavior questionnaires as guides for semi-structured interviews. Five all-male medical students aged 19-22 years who were regular smokers were interviewed. Result: One respondent admitted the presence of significant stress. Despite the absence of significant stress, other respondents admitted occasional tension due to academic stressors. Two respondents associated smoking with obtaining positive emotions, while three associated smoking with coping with negative emotions. Conclusion: There is no clear correlation between stress and smoking behavior Future research might benefit from obtaining data from a larger sample number and considering the timing of the occurrence of stress when inquiring about smoking behavior to better establish the characteristics of stress and its correlations with smoking behavior.
References
Ablelo, F. O., Kusuma, F. H. D., & Rosdiana, Y. (2019). Hubungan Antara Frekuensi Merokok Dengan Tingkat Stres Pada Remaja Akhir. Nursing News: Jurnal Ilmiah Keperawatan, 4(1). https://doi.org/10.33366/nn.v4i1.1490
Abu-Elenin, M. M., Atalla, A. A. O., & El-Salamy, R. (2017). Cigarette smoking among medical students and some associated risk factors. Tanta Medical Journal, 45(4), 206. https://link.gale.com/apps/doc/A530883593/HRCA?u=anon~b4d7c8d3&sid=googleScholar&xid=9f77a94c
Algorani, E. B., & Gupta, V. (2025). Coping Mechanism. StatPearls Publishing.
Almalki, S. A., Almojali, A. I., Alothman, A. S., Masuadi, E. M., & Alaqeel, M. K. (2017). Burnout and its association with extracurricular activities among medical students in Saudi Arabia. International Journal of Medical Education, 8, 144–150. https://doi.org/10.5116/ijme.58e3.ca8a
Brown, R. W., & Kolb, B. (2001). Nicotine sensitization increases dendritic length and spine density in the nucleus accumbens and cingulate cortex. Brain research, 899(1-2), 94-100.
Cattaruzza, M. S., & West, R. (2013). Why do doctors and medical students smoke when they must know how harmful it is?. The European Journal of Public Health, 23(2), 188-189.
Chaaya, R., Sfeir, M., Khoury, S. E., Malhab, S. B., & Khoury-Malhame, M. E. (2025). Adaptive versus maladaptive coping strategies: insight from Lebanese young adults navigating multiple crises. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-22608-4
Cortez, P. A., da Silva Veiga, H. M., Stelko-Pereira, A. C., Lessa, J. P. A., Martins, J. Z., Fernandes, S. C. S., Priolo-Filho, S. R., Queluz, F. N. F. R., Trombini-Frick, L., & Peres, R. S. (2023). Brief Assessment of Adaptive and Maladaptive Coping Strategies During Pandemic. Trends in Psychology. https://doi.org/10.1007/s43076-023-00274-y
Cui, Y., Guo, Z., Yang, T., Zhang, M., Mu, H., Li, J., Fang, J., Du, T., & Yang, X. (2025). Stress and Interpersonal Relationships in Medical Students During Public Health Emergencies: A Network Analysis. Advances in Medical Education and Practice, Volume 16, 123–133. https://doi.org/10.2147/amep.s495472
Dinis, T., Santiago, L. M., Caetano, I. R., & Marôco, J. P. (2020). Perfeccionismo, Burnout e as Atividades Extracurriculares nos Estudantes de Medicina da Universidade de Coimbra. Acta Médica Portuguesa, 33(6), 367. https://doi.org/10.20344/amp.12083
Dyrbye, L. N., Harper, W., Durning, S. J., Moutier, C., Thomas, M. R., Massie Jr, F. S., ... & Shanafelt, T. D. (2011). Patterns of distress in US medical students. Medical teacher, 33(10), 834-839.
Han, M. Y., Chen, W. Q., & Chen, X. (2011). Do smoking knowledge, attitudes and behaviors change with years of schooling? A comparison of medical with non-medical students in China. Journal of community health, 36, 966-974.
Harun, S. N. F., Jasman, N., Mustapha, F., Jaafar, N., Nadzir, S. N. B. M., Zaini, Z., Krishnan, M., & Subramaniam, P. (2025). Noteworthy trends in maladaptive coping strategies and hindrances to help-seeking behaviour among adolescents living in Malaysia’s People’s Housing Project (PPR) during the COVID-19 pandemic: A qualitative study. PLoS ONE, 20(3).
Huang, Y. S., Tan, Y., Chen, D. X., Xie, M. S., & Zhang, X. Q. 2013. The status Quo of test anxiety and coping behavior of senior students in Guangzhou high school. China Journal of Health Psychology. 2013 Mar;21(1), 107–109.
Iqbal, S., Gupta, S., & Venkatarao, E. (2015). Stress, anxiety & depression among medical undergraduate students & their socio-demographic correlates. The Indian journal of medical research, 141(3), 354. doi: 10.4103/0971-5916.156571
Jarvis, M. J. (2004). Why people smoke. BMJ, 328(7434), 277 279. https://doi.org/10.1136/bmj.328.7434.277
Khan, M. J., Altaf, S., & Kausar, H. (2013). Effect of Perceived Academic Stress on Students' Performance. FWU Journal of Social Sciences, 7(2). Malathi A, Damodaran A. Stress due to exams in medical students--role of yoga. Indian J Physiol Pharmacol. 1999 Apr;43(2):218–24.
Melaku, L., Mossie, A., & Negash, A. (2015). Stress among medical students and its association with substance use and academic performance. J Biomed Educ, 2015(4), 1-9. https://doi.org/10.1155/2015/149509
Mental Health Foundation. Stress: Are we coping? London: Mental Health Foundation. 2018.
Nada, Q., Herdiana, I., & Andriani, F. (2022). Testing the validity and reliability of the Depression Anxiety Stress Scale (DASS)-21 instrument for individuals with psychodermatology. Psikohumaniora: Jurnal Penelitian Psikologi, 7(2), 153–168. https://doi.org/10.21580/pjpp.v7i2.11802
Pipe, A., Sorensen, M., & Reid, R. (2009). Physician smoking status, attitudes toward smoking, and cessation advice to patients: an international survey. Patient education and counseling, 74(1), 118-123.
Rafidah K, Azizah A, Norzaidi MD, Chong SC, Salwani MI, Noraini I. The Impact of Perceived Stress and Stress Factors on Academic Performance of Pre-Diploma Science Students: A Malaysian Study. Int J Sci Res Educ. 2009;2(June):13–26. RISKESDAS 2018. Riset Kesehatan Dasar 2018. [Internet]. 2018. Available from http://www.kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf Accessed 21 December 2019.
Rotenstein, L. S., Ramos, M. A., Torre, M., Segal, J. B., Peluso, M. J., Guille, C. & Mata, D. A. (2016). Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. Jama, 316(21), 2214-2236. https:// doi:10.1001/jama.2016.17324
Samele, C., Lees-Manning, H., Zamperoni, V., Goldie, I., Thorpe, L., Wooster, E., ... & Grange, R. (2018). Stress: Are we coping? London: Mental Health Foundation. Mental Health Foundation.
Suyanti, I. (2018). InfoDATIN: Situasi Umum Konsumsi Tembakau di Indonesia. Jakarta: Kementrian Kesehatan RI, 06-7.
Tamaki, Tetsuo, Yoshitaka Kaneita, Takashi Ohida, Eise Yokoyama, Yoneatsu Osaki, Hideyuki Kanda, Shinji Takemura, and Kenji Hayashi. "Prevalence of and factors associated with smoking among Japanese medical students." Journal of epidemiology 20, no. 4 (2010): 339-345.
Tomkins, S. S. (1966). Psychological model for smoking behavior. American Journal of Public Health and the Nations Health, 56(12_Suppl), 17–20. https://doi.org/10.2105/ajph.56.12_suppl.17
Vidović, S., Rakić, N., KraÅ¡tek, S., PeÅ¡ikan, A., DegmeÄić, D., Zibar, L., Labak, I., Heffer, M., & Pogorelić, Z. (2025). Sleep Quality and Mental Health Among Medical Students: A Cross-Sectional Study. Journal of Clinical Medicine, 14(7), 2274. https://doi.org/10.3390/jcm14072274
Wali, S. O. (2011). Smoking habits among medical students in Western Saudi Arabia. Saudi Med J, 32(8), 843-848.
World Health Organization. (2012). Global adult tobacco survey: Indonesia report 2011.
Zhang, J., Cao, Y., Mo, H., & Feng, R. (2023). The association between different types of physical activity and smoking behavior. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-05416-1
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