socio-cultural determinants of tobacco smoking initiation among university students in bucaramanga, colombia, 2012

background: tobacco smoking is the leading cause of preventable mortality. the prevalence of smoking in adolescents in high schools ranges from 23.5% to 41%, respectively. in colombia, these figures are similar and students entering the university are exposed to initiate smoking. the purpose of this study was to establish the determinants associated with the initiation of tobacco smoking among university students. methods: a case–control paired by sex and age study design was used. the study population was the students of a private university of bucaramanga, santander, colombia. the final sample consisted of 167 cases and 314 controls randomly select undergraduate university students. data analysis was performed using a logistic regression model adjusted by gender and age; using the initiation of tobacco smoking as the dependent variable, and as independent variables relationship with parents, history of parental smoking, university social environment, being away from hometown, steady girlfriend/boyfriend who smokes, alcohol consumption, physical activity, and francis score. results: the social environment (odds ratio [or]: 32.70, 7.40-144.55), being away from hometown (or: 3.06, 1.55-6.07), history of steady girlfriend/boyfriend who smoke (or: 2.87, 1.43-5.76), a bad relationship with the father (or: 8.01, 2.01-31.83), history of tobacco consumption of the mother (or: 2.66, 1.37-5.17) and alcohol consumption (or: 4.79, 1.91-12.00) appeared as determinants of initiation of tobacco smoking. as protector factors we found media advertisement (or: 0.19, 0.05-0.71), light physical activity 2-3 times a week (or: 0.33, 0.12-0.88), and a high result in francis score (or: 0.95, 0.919-0.99). conclusions: university efforts for tobacco‑free policies should focus on preventive advertisement, promoting physical activity and awareness among young students of social environmental factors that could influence their decision to start smoking tobacco.