Patterns and associated factors of cigarette smoking among medical students in 2020: a cross-sectional study from a North African country

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OBJECTIVE: The aim of this study was to describe patterns of cigarette smoking and to determine its associated factors among medical students in the university of Monastir, Tunisia. METHODS: We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire. We collected data on the students' smoking status, age of first cigarette use, intention to quit smoking and the level of nicotine dependence among smokers. Chicha, e-cigarette, alcohol, cannabis use and other addictive behavior were also investigated through the questionnaire. A multivariate logistic regression model was employed to identify associated factors with cigarette smoking. The threshold of statistical significance was set at p < 0.05. RESULTS: A total of 748 students participated in this study. Of all respondents, 12.6% (95% CI [10.22-14.98]) consumed at least one form of tobacco. The prevalence of cigarette smoking was 10.7% (95%CI [8.5-12.9]). Male sex (aOR = 5.12; 95%CI [2.39-10.99]), living alone or with colleagues (aOR = 3.90; 95%CI [1.49-10.23]), alcohol consumption (aOR = 20.03; 95%CI [8.66-46.32]) and a high stress level (aOR = 3.22; 95%CI [1.08-9.61]) were found to be independently associated with cigarette smoking. Conversely, smartphone addiction (aOR = 0.34; 95% CI [0.14-0.82]) was identified as being inversely associated with cigarette smoking. CONCLUSION: This study highlights a considerable prevalence of tobacco use among students. While several well-known factors were associated with cigarette smoking, an inverse association with smartphone addiction emerged as a novel finding. These results may help inform targeted interventions to address this public health concern among medical students.

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