Research Article: Attitudes, beliefs, and dependence related to electronic cigarettes among medical students at an eastern Anatolian university: a cross-sectional study
Abstract:
E-cigarette use has risen among young adults, and the attitudes, beliefs, and dependence of future physicians are relevant both to their own health and to their prospective role in patient counselling. This cross-sectional study assessed e-cigarette-related attitudes and beliefs, dependence among current users, and their correlates among medical students at the ?nönü University Faculty of Medicine (Malatya, Türkiye) during 2025–2026. Using term-stratified random sampling, 366 students were analysed. The 18-item E-cigarette Attitude and Belief Scale in Adolescents (ECABA) was administered to all participants and the 22-item E-cigarette Dependence Scale (EDS-22) to current users. Data were analysed with non-parametric tests, Spearman correlation, and multivariable logistic regression. Ever and current e-cigarette use were 32.8 and 17.5%, respectively. ECABA scores increased significantly across non-users, occasional users, and regular users (medians 33, 39, and 48; p <?0.001). Male sex [adjusted odds ratio (aOR) 2.45, 95% CI 1.27–4.75] and a higher ECABA score (aOR 2.72 per 10 points, 95% CI 2.08–3.54) independently predicted current use, whereas age, cigarette smoking, and household smoking did not. Among current users, ECABA correlated with EDS-22 dependence ( r =?0.561, p <?0.001). Pro–e-cigarette attitudes and beliefs were thus the strongest correlate of both use and dependence among medical students. Because these attitudes are modifiable, integrating structured, e-cigarette-specific education into medical curricula—particularly in the preclinical years—may help shape healthier attitudes in future physicians and strengthen their future role in tobacco counselling.
Introduction:
Electronic cigarettes (e-cigarettes) have become one of the most rapidly diffusing nicotine products worldwide and are now regarded as a substantial public-health concern, particularly among adolescents and young adults ( 1 ). A recent systematic review and meta-analysis reported a global e-cigarette use prevalence of 22.7%, with the highest rates among males and in high-income settings ( 2 ). In Türkiye, where the sale and importation of e-cigarettes and their liquids are prohibited, these products nonetheless…
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