Prevalence and correlates of nicotine, alcohol, and digital addiction among dental students in Aegean region in Turkey: a multicenter cross-sectional study

Background Dental students may be vulnerable to substance-related and behavioral addictions because of academic and social pressures. This multicenter study assessed nicotine, alcohol, and digital addiction indicators and differences by sex and academic year.Methods A cross-sectional survey included 1,034 students aged 18–25 years from five dental faculties in Turkey. Participants completed the Fagerström Test for Nicotine Dependence, CAGE questionnaire, and Digital Addiction Scale. Group comparisons used chi-square, Mann-Whitney U, and Kruskal-Wallis tests (p < 0.05).Results Smoking, alcohol use, and digital gaming were reported by 33.2%, 49.4%, and 67.2% of participants. Men reported more smoking and gaming, whereas women reported more alcohol use. Tobacco and alcohol use were moderately associated (κ = 0.398; p < 0.001). Moderate and high nicotine dependence affected 11.4% and 2.6%, respectively; Fagerström and CAGE scores did not differ by sex. Men scored higher for gaming, while women scored higher for social media use and daily-life impact. Nicotine and alcohol outcomes did not vary across academic years, but gaming and daily-life impact did.Conclusions Substance use and digital engagement were common, with sex-related digital patterns. Dental schools should implement proportionate screening, co-use prevention, digital well-being education, and healthy-coping support.