A Study of the Use, Knowledge, and Beliefs About Cigarettes and Alternative Tobacco Products Among Students at One U.S. Medical School

Abstract

Purpose In the United States, the prevalence of the use of alternative tobacco products (ATPs) (e.g., hookahs, e-cigarettes, cigars/cigarillos) has increased sharply. As future health care providers, medical students will play a critical role in health promotion and disease prevention. This study investigated medical students’ use, knowledge, and beliefs about cigarettes and ATPs. Method In 2014, the authors surveyed all students enrolled at one medical school in New York City. The survey included questions about personal use of tobacco products, perceptions about the harms of ATPs and their role in disease causation, education about ATPs, and cessation training and practices related to ATPs and cigarettes. The authors compared results across medical school classes. Results Of 720 students, 431 (59.9%) completed the survey. Of those, 64 (14.7%) were current users of tobacco or smoking products, including cigarettes (17, 3.9%), ATPs (21, 4.8%), or marijuana (39, 8.9%). Many believed that ATPs contributed less than cigarettes to various diseases. Respondents received less cessation intervention training regarding ATPs than cigarettes (P < .0001). They felt less confident providing ATP cessation counseling than cigarette cessation counseling (P < .0001) and were less likely to report counseling patients on ATP cessation than cigarette cessation (46, 10.7% vs. 280, 64.8%, P < .0001). Conclusions A concerning percentage of surveyed medical students use tobacco products, including ATPs, and lack the knowledge, education, and cessation counseling skills to provide accurate information about them to patients. ATP education should be added to medical school curricula to address this gap.

Knowledge, Beliefs, Behaviors, and Social Norms Related to Use of Alternative Tobacco Products Among Undergraduate and Graduate Nursing Students in an Urban U.S. University Setting

“…Almost 40% of participants reported lifetime hookah smoking, about 10% in the past year, and about 3% in the past 30 days. These rates are similar to those reported in the study of medical students in an urban U.S. medical school, where 43% reported ever using a hookah, 16% in the past year, and 1% in the past 30 days (Zhou et al., ). Overall, 75.8% of student nurses reported lifetime use of an ATP and 5.9% current use.…”

“…A recent study conducted with medical students in an urban U.S. medical center found that about 4% reported current cigarette use, 4.8% currently used ATPs, and 51.7% reported lifetime use of ATPs. Students in the study consistently estimated cigarettes to be more harmful that ATPs despite the absence of research evidence comparing the two (Zhou et al., ). No studies of nurses’ use of ATPs have been published to date.…”

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…Two hundred and fifty articles 153,192–194,197,203,239,265,271,304,323–326,329,332,333,335–339,341–344,346,348,350,351,353–362,365,367–369,372,374–376,378–381,384,388,390,393–396,404–406,408,414–416,418,420–422,425,426,432,434,436,440,441,444–450,453–456,459–462,465,468,472,475,476,478,488,489,491,494,496–498,500,502,504,506–646 have been published on vaping patterns.…”

A Content Analysis of Unique Selling Propositions of Tobacco Print Ads

“…20 In line with this finding, recent data indicates that even among U.S. medical school students, there is a belief that alternative tobacco products contribute less than cigarettes to various diseases. 21 Highlighting the need to understand advertising surrounding alternative tobacco products, a prior study on tobacco advertising from 2009 to 2013 indicated that cigarette magazine advertising did not influence cigarette demand while e-cigarette TV advertising did influence demand. 20 …”