Impact of COVID-19 pandemic on overall and exams-related energy drinks consumption among students of the University of Sarajevo, Bosnia and Herzegovina.

Background: A pilot study conducted in academic 2017/18 among undergraduates of the University of Sarajevo showed energy drinks to be most frequently consumed during academic activity, less frequently mixed with alcohol in leisure, and rarely in the sports activity. The aim of this study was to assess the impact of the COVID-19 pandemic on energy drinks consumption among undergraduates of the same University, with a focus on their consumption during exams. Study design: A cross-sectional study was conducted by an online questionnaire. Methods: The questionnaire, mainly based on the Consortium Nomisma-Areté questionnaire, was customized to compare energy drinks consumption before and during the COVID-19 pandemic, and distributed among students between July 26th, 2020 and April 3rd, 2021. Results: Out of 1,045 students who chose to participate in the study (participation rate of 14.7%), 653 students, mostly women, attending the lower study years, reported energy drinks consumption. Both be-fore and during pandemic, overall energy drinks consumption was most frequently reported as rare [281 (43.9%) before, 326 (51.2%) during the pandemic], and exams-related energy drinks consumption as once or twice a week [156 (43.8%) before, 130 (42.1%) during pandemic]. The pandemic increased the number of frequent consumers (consumption of 4-5 energy drinks per week) in both overall [35 (5.5%) before, 46 (7.2%) during pandemic] and exams-related energy drinks consumption [42 (11.8%) before, 48 (15.5%) during pandemic]. Study year (OR=0.842; 95% CI 0.77-0.921; p<0.001), being single and living alone [OR=0.512; 95% CI 0.296-0.883; p=0.016), or living with a partner and children [OR=0.377; 95% CI 0.168-0.847; p=0.018) were identified as negative independent predictors for exams-related energy drinks consumption, while being a regular smoker (OR=0.429; 95% CI 0.223-0.875; p=0.011) appeared its new negative independent predictor during pandemic. Conclusions: The pandemic seemed to decrease both the overall and exam-related energy drinks consumption among undergraduates of the University of Sarajevo with the exception of a portion of already frequent energy drinks consumers.

Impact of COVID-19 pandemic on patterns of cigarette, hookah and marijuana consumption among undergraduate students of University of Sarajevo Bosnia and Herzegovina: a repeated cross-sectional study.

Aim: The aim of the study was to assess the impact of COVID-19 pandemic on patterns of cigarette, hookah and marijuana consumption among undergraduate students of Bosnia and Herzegovina. Methods: The first part of the double cross-sectional study was conducted among undergraduate students of the University of Sarajevo from 22nd to 26th January 2020, prior to the first COVID-19 case in the country (study period 1), and the second part from March 25th to August 26th 2021, during the third wave of COVID-19 outbreak (study period 2). Results: The majority of the 1,230 respondents were women (N1 70.9%, N2 70.1%), pursuing medical sciences (N1 60.0%, N2 55.0%), in their 3rd year of study (N1 26.3%, N2 26.7%), and living in urban environment (N1 84.9%, N2 86.4%). Similar proportion of cigarette smokers (N1 38.5%, N2 39.2%), and smaller, similar portions of hookah smokers (N1 19.3%, N2 21.1%) were classified in both study periods, while the smallest portion of marijuana smokers (N2 8.0%) was classified during COVID-19. Similar number of cigarettes per day, types of cigarettes consumed and consumption frequency in the last 30 days, with the similar independent predictors of cigarette consumption (being woman and living in rural environment associated with decreased risk, and age older than 22 associated with increased risk) were identified both before and during COVID-19 pandemic. Compared to before COVID-19 pandemic, increased trends in intentions (73.6% vs. 81.2%) and attempts (51.9% vs. 75.1%) to smoking cessation among cigarette smokers, but decreased determination not to smoke in the coming year among cigarette non-smokers (N1 72.2%, N2 51.6%) and decreased awareness of smoking harmfulness among both cigarette smokers (N1 68.0%, N2 46.5%) and especially cigarette non-smokers (N1 60.9%, N2 22.9%) were seen during COVID-19 pandemic. Also, risky behavior among hookah smokers was evident during COVID-19 pandemic. Conclusions: COVID-19 pandemic seemed to positively affect intentions and attempts to smoking cessation among cigarette smokers while negatively affecting attitudes towards cigarette smoking among cigarette non-smokers.

Patterns of cigarette, hookah and other tobacco product consumption habits among undergraduate students of the University of Sarajevo before the COVID-19 outbreak in Bosnia and Hercegovina, a cross-sectional study.

Background: Tobacco products represent a major health risk factor and a potent way to help transmission of COVID-19. Current data regarding consumption of these products in the region are scarce. The aim of this study was to evaluate patterns of cigarette, hookah and other tobacco products consumption among undergraduate students from the University of Sarajevo before the COVID-19 outbreak in the country. Methods: This cross-sectional study based on a National Youth Tobacco Survey (NYTS) was conducted among undergraduate students from the University of Sarajevo in Bosnia and Hercegovina via an online questionnaire from 22nd to 26th of January 2020. Results: Out of 605 students involved in the study, most of them were female (N=429, 70.9%); 363 (60.0%) were enrolled in medical sciences; 159 (26.3%) were attending the 3rd year of their curriculum; 224 (37%) were original from Canton Sarajevo and 514 (84.9%) were living in urban environment. Two hundred thirty five students out of 605 (38.8%) were current smokers and 117 (19.3%) hookah smokers. Being female (OR=0.539, 95% CI 0.368-0.790, p=0.002), in the 1st or 2nd year of study (OR=0.805, 95% CI 0.667-0.972, p=0.024) and living in a rural environment (OR=0.335, 95% CI 0.191-0.585, p<0.001) were associated with reduced risk of cigarette consumption, while older age (22+ years) (OR=1.287, 95% CI 1.122-1.476, p<0.001) increased the same risk. On the other side, being female (OR=0.595, 95% CI 0.380-0.930, p=0.023), of younger age (18-21 years) (OR=0.832, 95% CI 0.743-0.932, p=0.001) and medical science student (OR=0.567, 95% CI 0.328-0.978, p=0.041) were associated with decreased risk of consuming hookah. Conclusions: This study provides an insight in prevalence of smoking among students at the University of Sarajevo. More antismoking efforts are needed, especially in urban environments; and a follow-up study, to be planned in the near future, should determine whether COVID-19 pandemic (and all the modifications of lifestyles connected with it) have eventually changed tobacco consumption patterns among undergraduate students.

COVID-19 vaccination knowledge, attitudes and practices among residents of Bosnia and Herzegovina during the third wave of COVID-19 outbreak.

Background: Bosnia and Herzegovina hasn't still developed and started any vaccination programs to contain the current COVID-19 outbreak and prevent further spreading and death from this disease. The aim of this study was to assess current knowledge, attitudes and practices towards COVID-19 vaccination during the third wave of the outbreak when the healthcare system is facing a collapse and to create a paradigm for developing vaccination programs in the country. Methods: his cross-sectional study was conducted by an anonymous online questionnaire based on a Congo study and Center for Disease Control and Prevention facts regarding COVID-19 vaccination during the third wave of the COVID-19 outbreak in the country. Results: In total, 570 subjects, mostly female 474 (83.1%), with a high school degree or lower 230 (40.3%), married 305 (53.5%), engaged in intellectual labor 302 (53.0%), from urban environment 531 (93.1%) and with a mean age of 35.28±11.35, were included in the study. The mean COVID-19 vaccination knowledge test score was 11.29±1.91. Being single (OR= 1.88, 95% 1.20-2.94) or in a relationship (OR=1.87, 95% 1.12-3.11), being engaged in intellectual labor (OR=1.59, 95% CI 1.06-2.37) and having a Master's degree or higher (OR=1.65, 95% CI 1.10-2.46) were associated with higher knowledge test scores. Only 264 (46.3%) subjects agreed that COVID-19 vaccination programs will prevail in a battle versus COVID-19 and only 36 (6.3%) were currently vaccinated against COVID-19. Higher knowledge regarding COVID-19 and its vaccination was determined as an independent predictor for vaccinating itself against COVID-19 (OR=23.09, 95% CI 11.94-44.68), as well as respecting socio-epidemiological measures such as avoidance of crowded places (OR=2.07, 95% CI 1.28-3.35) and wearing face mask (OR=6.95, 95% CI 2.07-23.29). Conclusions: Our study shows that Bosnia and Herzegovina population has poor knowledge, relatively pessimistic attitudes and a very low vaccinal rate against COVID-19 during the third wave of the outbreak which promotes COVID-19 vaccination hesitancy and further COVID-19 spreading and death toll. By activating proper socioepidemiological measures and educating population about COVID-19 and COVID-19 vaccination, as well as vaccination against COVID-19, the current situation could be changed.

Knowledge, attitudes, and practices towards COVID-19 among residents of Bosnia and Herzegovina during the first stage of COVID-19 outbreak.

Study design: A cross-sectional study conducted by an online questionnaire-based survey. Methods: This study was conducted by an anonymous online questionnaire based on a Chinese study during the fifth week from the beginning of outbreak of COVID-19 in Bosnia and Herzegovina. Background: In order to control the spread of COVID-19, prevent the crash of health care system and ensure well-being of its residents, Bosnia and Herzegovina has taken rigorous preventive epidemiological measures in the beginning of the pandemic. Currently the situation has dramatically changed. The aim of this study is to present knowledge, attitudes and practices at the beginning of the outbreak in Bosnia and Herzegovina when the spreading of COVID-19 was well controlled and provide useful information to policymakers at this challenging time. Results: In total 1,201 respondents, predominantly female (943 or 78.5%), with a mean age 30.57±11.26, scored very high on the knowledge test with a mean score 9.13±1.90. Being male (ß: -0.141, p<0.001) and aged >30 (ß: -0.099, p=0.030) were associated with lower knowledge scores, while education level of bachelor's degree and above (ß: 0.092, p=0.003), living in urban environment (ß: 0.062, p=0.044) and being a student (ß: 0.240, p<0.001) were associated with higher knowledge scores. Only 638 (53.1%) of the participants agreed that COVID-19 will be successfully controlled. The vast majority of the participants (1,092 or 90.9%) have not visited any crowded place and 1,043 (86.9%) wore masks when they were going out... Decreased exposure to crowded places [(OR=0.427, p<0.001);(OR=0.805, p<0.001)] and an increase of wearing a mask while leaving home [(OR=1.564, p=0.022);(OR=1.219, p<0.001)] were associated with female sex and higher knowledge scores, respectively. Age group 18-29 (OR=0.616, p=0.007) and living in rural environment (OR=0.600, p<0.025) were associated with not wearing a mask outside the home. Conclusions: Our study suggests that residents of Bosnia and Herzegovina have had good knowledge, a relatively optimistic attitudes and appropriate practices towards COVID-19 during the first period of outbreak.

Patterns of energy drinks consumption in leisure, sports and academic activities among a group of students attending University of Sarajevo, Bosnia and Herzegovina.

BACKGROUND: Energy drinks (EDs) are non-alcoholic beverages that contain caffeine and other ingredients, marketed for their actual or perceived effects as stimulants, energizers and performance enhancers. The aim of this pilot study was to evaluate patterns of EDs consumption in leisure, sports, and academic activities over the last year among a group of pregraduate students of the University of Sarajevo, Bosnia and Herzegovina. STUDY DESIGN: A cross-sectional study conducted by an online questionnaire-based survey. METHODS: An anonymous questionnaire was mainly based on a Consortium Nomisma-Areté questionnaire [background information and consumer profile, general EDs consumption practices and reasons; alcohol mixed with EDs (AmEDs) consumption, EDs consumption in sports, consumption of other caffeinated beverages], and an additional part to evaluate EDs consumption during academic activities. RESULTS: Out of 812 respondents from 22 faculties (participation rate of 23%), mean age 21.37 ± 1.98 years, 498 (61.7%) reported EDs consumption over the last year. Three main reasons for EDs consumption were to stay awake (58.2%), to enjoy the taste (46.8%), and to boost energy (38.0%). Energy drinks were mainly consumed less than once a month (70.5%), most frequently during academic activity (50.4%), less frequently mixed with alcohol for relaxation (21.5%), and only rarely in association with sports or other physical activity (10%). Drinking coffee (OR = 2.022; 95% CI 1.416-2.830; p < 0.001) and being a higher year student (OR = 0.723; 95% CI 0.639-0.819; p < 0.001) were independent predictors for EDs consumption; being single and living with parents (OR = 17.138; 95% CI 1.328-221.528; p = 0.030) for consumption of AmEDs; and being a man (OR = 2.251; 95% CI 1.493-3.392; p < 0.001) and living in urban environment (OR = 1.193; 95% CI 1.125-3.251; p = 0.017) for consuming EDs in association with sports or other physical activity. CONCLUSION: Based on these preliminary data and taking low participation rate into account, EDs consumption seems not to be alarming among university students in our region. EDs are most frequently consumed during academic activity, less frequently mixed with alcohol for relaxation, and only rarely in association with sports or other physical activity. However, as EDs are increasingly aggressively promoted and easily accessible, the larger study is warranted to provide more reliable and up to date conclusions, and if necessary, to inform measures preventing health risks associated with EDs consumption.