Two-Year Change in Tobacco Use Prevalence and Associated Factors Among Medical Students

Background and Purpose:Tobacco use remains a major public health concern worldwide, including among medical students who will serve as future health professionals. This study aimed to examine the two-year change in tobacco use prevalence among medical students and to identify factors associated with smoking in the third year. Methods: A cross-sectional study was conducted among first-year medical students in 2022 and the same cohort in their third year in 2024 at a single medical faculty. Data were collected using a structured questionnaire. Descriptive statistics, chi-square tests, t-tests, and logistic regression analyses were performed. Results: The prevalence of tobacco use increased from 29.8% in the first year to 33.9% in the third year. Cigarette smoking prevalence rose from 24.8% to 29.5%. Male sex, working to cover expenses, exposure to peer pressure, and having close friends who smoked were significantly associated with smoking. Students whose closest friends mostly smoked were more than six times more likely to smoke. A considerable proportion of tobacco users reported an intention to quit. Conclusion: Tobacco use increased during medical education and was strongly influenced by peer factors. Targeted tobacco control interventions and tobacco-free campus policies may help reduce tobacco use among medical students.