Knowledge, Attitudes, and Oral Health Literacy Regarding Tobacco and Substance Use among Students of Medical Sciences

Abstract Background Tobacco and substance use are associated with various oral health consequences, while knowledge, attitudes, and oral health literacy are important factors related to exposure to these consequences. The present study aimed to assess knowledge and attitudes regarding the oral health consequences of tobacco and substance use and their association with oral health literacy among student of medical sciences in Iran. Methods This cross-sectional analytical study was conducted during the 2025–2026 academic year on 225 medical sciences students from across Iran who were enrolled at Arak University of Medical Sciences at the time of the study; these individuals were selected using stratified random sampling. Data were collected using a questionnaire assessing knowledge and attitudes regarding tobacco products and substances, as well as the Adult Oral Health Literacy–Adult Questionnaire (OHL-AQ), and were analyzed using SPSS version 27. Results The mean scores for knowledge, attitudes, and oral health literacy were 7.37 ± 1.07, 25.24 ± 4.51, and 10.86 ± 3.00, respectively. A significant positive correlation was observed between knowledge and oral health literacy (ρ = 0.329, P < 0.001), as well as between knowledge and attitudes (ρ = 0.326, P < 0.001). In contrast, no significant association was found between attitudes and oral health literacy (ρ = 0.016, P = 0.807). Furthermore, knowledge and oral health literacy scores differed significantly according to sex, field of study, and parental educational level (P < 0.05). Conclusion Iranian medical sciences students demonstrated a relatively favorable level of knowledge and attitude regarding the oral health consequences of using tobacco products and other substances. Given that the students in this study came from diverse cultural backgrounds across Iran, it is recommended that health education programs for medical sciences students emphasize both the cognitive and skill-based dimensions of oral health—while accounting for variables such as sex, field of study, and parental education level.