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

A cross-sectional survey of 1,323 undergraduate students at Kuwait University found that nausea or vomiting, cough, asthma and shortness of breath were associated with at least one healthcare-service visit during the previous year, while tobacco-smoke exposure itself was not independently associated with that outcome. The study, conducted in October 2022, reported exposure to first- or second-hand smoke among 55.9% of participants, alongside common respiratory symptoms and physician-diagnosed conditions. Among the factors significantly associated with healthcare use, nausea or vomiting had the highest adjusted odds ratio, followed by cough, asthma and shortness of breath.

Researchers recruited a convenience sample of students and administered a structured electronic questionnaire. The participants were predominantly Kuwaiti, at 87.5%, and female, at 75.8%. The analysis separated first-hand tobacco-smoke exposure from second-hand exposure at home and assessed self-reported respiratory symptoms, physician-diagnosed conditions and the use of health services during the preceding year, classified as at least one visit or no visits.

Multivariable logistic regression examined associations with sociodemographic characteristics, lifestyle factors, concurrent conditions and healthcare use. The reported effect estimates were adjusted odds ratios with 95% confidence intervals. First-hand tobacco-smoke exposure was reported by 177 of 1,323 participants, or 13.4%.

Second-hand exposure at home was substantially more common: 672 participants, or 50.8%, reported it. In total, 740 participants, corresponding to 55.9%, reported exposure through active smoking, second-hand smoke at home or both. Respiratory symptoms were frequent in the survey population.

Shortness of breath was reported by 59.1% of participants, cough by 46.3%, chest pain by 26.9% and difficulty during exercise by 21.6%. Physician-diagnosed conditions included asthma in 16.8% of participants, eczema in 11.2% and chronic obstructive pulmonary disease in 1.4%. At least one healthcare-service visit during the past year was reported by 590 participants, or 44.6%.

In the multivariable model, students reporting nausea or vomiting had 2.52 times the adjusted odds of reporting healthcare use compared with those not reporting it (95% confidence interval, 1.79–3.54; p<0.001). Cough was associated with 2.10 times the adjusted odds of healthcare use (95% confidence interval, 1.66–2.64; p<0.001), while physician-diagnosed asthma was associated with 1.95 times the adjusted odds (95% confidence interval, 1.43–2.65; p<0.001). Shortness of breath was also associated with healthcare use, although its estimate was closer to the null: an adjusted odds ratio of 1.30 with a 95% confidence interval of 1.01–1.67 (p=0.044).

The researchers found no statistically significant independent association between tobacco smoking, active or second-hand exposure, and reporting at least one healthcare visit in the final model. That finding does not establish that smoke exposure was harmless or unrelated to the reported conditions; it means that exposure was not independently associated with the broad healthcare-use outcome in this particular analysis after the measured factors included in the model were considered. Because the study was cross-sectional, used a convenience sample from one university and relied on questionnaire reports, the results cannot establish that smoke exposure caused the symptoms or diagnoses, or that any symptom caused a healthcare visit.

The outcome also did not capture the number of visits or the reasons for seeking care. Within these limits, the study identifies a high level of smoke exposure and concurrent health burdens among the surveyed students, while distinguishing the conditions associated with healthcare use from tobacco exposure itself.

Subject of Research: Tobacco-smoke exposure, concurrent health conditions and healthcare use among Kuwait University undergraduates

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

Article References: Akhtar, S., Almutairi, S., Alhajri, W., Alrashidi, S., Almutairi, N., Almutairi, G., Aladwani, M., & Al-Sanafi, L. (2026). Exposure to tobacco smoke, concurrent short-term symptoms of respiratory, allergic, cardiovascular morbidities and health-services use among young adults in Kuwait. BMC Health Services Research, 26(1), Article 1253. https://doi.org/10.1186/s12913-026-15530-x

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15530-x

Keywords: Kuwait University, young adults, tobacco smoke, second-hand smoke, respiratory symptoms, asthma, healthcare use, cross-sectional study, public health, Exposure, tobacco, smoke