Knowledge and Attitudes Among Medical Students Toward the Clinical Usage of e-Cigarettes: A Cross-Sectional Study in a University Hospital in Saudi Arabia

Abstract

Background: To assess knowledge and attitudes about e-smoking among undergraduate medical students, specifically focused on favorable view of therapeutic e-cigarette use for smoking cessation or harm reduction. Methods: This cross-sectional study included medical students at King Abdulaziz University, Saudi Arabia. A six-item subscale was used to explore knowledge and attitudes about the therapeutic use of e-cigarettes, measuring participants' likelihood of favoring such use. A four-item questionnaire measured confidence and importance of being educated about smoking and e-smoking, in addition to sources of knowledge about e-cigarettes. Results: A total of 399 students participated. Smoking history included current smokers (19.8%) and ex-smokers (6.5%), while e-cigarettes were tried by 36.6% and are currently used by 11.5%. A minority (13.5%) believed that e-cigarettes are FDA-approved for smoking cessation, while approximately one-third believed e-smoking lowers cancer risks (31.1%) and could help with smoking cessation (31.1%). Further, 35.9% agreed or strongly agreed that e-cigarettes are better for patients than tobacco products, and 17.5% were likely to recommend e-smoking to their patients for smoking cessation. Reliability of the six-item scale showed Cronbach's alpha = 0.676, which was enhanced to 0.746 after deletion of one item about addictiveness. Using the corrected five-item scale, 23.6% of the participants would favor therapeutic use of e-cigarettes. Conclusion:We observed several misconceptions about addictiveness and inadequate awareness about e-cigarettes' harmful effects, leading to non-scientific opinions about its therapeutic use for harm reduction or in smoking cessation. Academic programs around this topic should be updated in accordance with majority expert recommendations.

Prevalence, Knowledge, and Attitudes among Health Professions Students toward the Use of Electronic Cigarettes

“…In fact, to date of this publication, e-cigarettes products have not been approved by the FDA as smoking cessation aids [ 22 ]. Those findings are comparable to the results reported at a Saudi university where the majority of medical students didn’t know that e-cigarettes were not approved by the FDA as a smoking cessation aid [ 18 ]. Moreover, a meta-analysis of 26 studies has shown that the probability of adult smokers quitting smoking is lower in smokers who use e-cigarettes for smoking cessation compared to non- e-cigarette users [ 21 ].…”

“…Compared to the prevalent results reported in the previously cited studies and taking into consideration that the methods used in those studies may not be similar, the prevalence reported in this study indicates an increase in the e-smoking rate among university students in Jordan which could be an alarming sign of the increase of e-cigarettes smoking popularity among young adults in Jordan. Looking at neighboring countries, a study from Saudi Arabia has shown that the prevalence of e-cigarette smoking was more at 11.5% among medical students [ 18 ].…”

“…A cross-sectional questionnaire was developed based on an intensive review of the available literature [ 11 , 13 , 17 , 18 ]. The tool was constructed to study the prevalence of e-cigarette use as well as the knowledge about and attitude toward e-cigarettes among the students from health professions at the University of Jordan (UJ).…”

Prevalence, knowledge and attitude toward electronic cigarette use among male health colleges students in Saudi Arabia—A cross-sectional study

“…With respect to the health colleges students' attitude toward ECs, 46.2% supported using them as a smoking cessation product without any scientific basis. This reiterates the results re-ported by Alzahrani et al, where one-third of medical students agreed on using ECs as a smoking cessation method ( 39 ). Despite that, a study from China reported that only 9.5% EC users had successfully quit smoking ( 14 ).…”

“…According to the students' perception toward ECs, 62.8% confirmed that ECs are used as a fashionable alternative of conventional cigarettes, and 59% agreed on ECs being potentially a gateway to smoking for non-smokers and smoking addiction for conventional cigarette smokers, which goes hand in hand with the previous report by Alzahrani et al on medical students where 50.6% agreed that ECs were addictive ( 39 ). Similarly, Almutham and colleagues showed that 49.6% of medical students believed ECs were addictive ( 19 ).…”