Investigating the prevalence of tobacco or other substance use (TOSU) and factors associated among the medical students: a nationwide cross-sectional survey from Bangladesh

Background Globally, undergraduate students exhibit a higher tendency towards of tobacco and other substance use. Although there are almost 50,000 undergraduate medical students studying in Bangladesh currently, evidence regarding the prevalence of tobacco & other substance use among them, let alone the predictors of substance use, is very limited. Aim This research aims to investigate the prevalence of tobacco or other substance use among the medical students in Bangladesh and to investigate the factors associated with tobacco or other substance use. Methods This cross-sectional study was conducted between May 2023 and August 2024 in sixteen medical colleges in Bangladesh. A total of 1,129 medical students were selected by convenience sampling, and data were collected using an online self-reported semi-structured questionnaire. Descriptive statistics, chi-square test, t-test, and multiple logistic regression model were used to report the study findings. Results The mean age of the students was 22.3 (±2) years, with slightly higher female preponderance (52.3%). Out of 1129 medical students, tobacco or other substance use was prevalent in 154 (13.6%) students. The students most commonly used tobacco products (54.5%) followed by non-medical use of sedatives (26%) and cough syrup (18.8%). The odds of using substances increased with age and academic year. Male students (AOR: 1.41, 95%CI: [1.26, 1.59], p<0.001), living at an off campus housing without family (AOR: 2.25, 95% CI: [1.02, 4.94], p=0.043) and living in a medical college hostel (AOR: 2.1, 95% CI: [1.20, 3.67], p=0.009), having tobacco or other substance use in family (AOR: 3.97, 95% CI: [2.64, 5.98],p<0.001), and not willingly admitted to medical college (AOR:3.61, 95%CI: [2.20, 5.90],p<0.001) were significant predictors of substance use. Conclusion This study observed a high prevalence of substance use among medical students. Therefore, the factors associated with their tobacco or other substance use related behavior should be mitigated, and necessary provisions should be made available to help with the cessation of such use among the current users.