Increasing Prevalence of Electronic Cigarette Use among Medical Students. Repeated Cross-Sectional Multicenter Surveys in Germany and Hungary, 2016–2018

Abstract

Background

Use of electronic cigarettes (e-cigarettes) is gaining popularity among young adults. Medical students' nicotine use behavior is of particular interest because of their impending role in health promotion. Objectives: Aim of our study is to assess changes that occurred between 2016 and 2018 in the prevalence of e-cigarette use among medical students and to explore associations between e-cigarette use, demographic characteristics, and cigarette smoking. Self-administered questionnaire surveys were used to obtain cross-sectional data of medical students in Budapest and Pécs, Hungary, and Dresden, Germany. Results: Sample sizes for 2016 and 2018 were 2297 and 1514, respectively. In the whole sample, past-30-day use of e-cigarettes increased from 4.5% to 8.0% (p < 0.001). The increase in e-cigarette use was significant in both genders (from 3.6% to 5.6% among females, p = 0.028, and from 5.9 to 11.4% among males, p < 0.001). Prevalence of e-cigarette use was higher among Hungarian students than among German students (2.2% versus 5.7% in 2016, and 4.1% versus 10.5% in 2018, p < 0.05 for both years). There was no significant difference in e-cigarette use among different academic years. The ratio of e-cigarette users increased significantly among current cigarette smokers but not among nonsmokers. We could not detect a decrease in cigarette smoking. Conclusions: Prevalence of e-cigarette use increased significantly among medical students without a reduction in cigarette smoking. Medical schools should add the topic of e-cigarettes to their curricula and need to develop cessation programs to help their students quit both cigarettes and e-cigarettes.

Keywords:

• Electronic cigarettes
• cigarette smoking
• medical students
• cross-sectional studies

Acknowledgements

We would like to thank the students for participating in this study and assistants who enabled the data collection at all study sites.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

According to the ethical requirements in our ethics approval, the recorded data are stored at the Department of General Practice at Technische Universität Dresden and at the Department of Public Health Medicine, University of Pécs Medical School. Following German and Hungarian data protection laws, only authorized persons have access to the data. Requests for more detailed information regarding the data and the survey instrument can be addressed to the corresponding author.

Additional information

Funding

This work was supported by the Statutory Health Insurance Saxony (Kassenärztliche Vereinigung Sachsen).