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.

研究背景 全球范围内，本科大学生的烟草及其他物质使用倾向普遍更高。尽管当前孟加拉国在读医学生规模近5万名，但针对该群体烟草与其他物质使用流行率的相关研究证据尚且匮乏，更遑论物质使用的预测因素相关研究。

研究目的 本研究旨在调查孟加拉国医学生的烟草及其他物质使用流行率，并分析与该群体物质使用相关的影响因素。

研究方法 本横断面研究于2023年5月至2024年8月在孟加拉国16所医学院校开展。采用便利抽样法共纳入1129名医学生，通过线上自行报告式半结构化问卷收集研究数据。研究采用描述性统计、卡方检验、t检验及多元logistic回归模型分析并汇报研究结果。

研究结果 受试学生的平均年龄为22.3±2岁，女性占比略高（52.3%）。在1129名医学生中，共有154名（13.6%）存在烟草或其他物质使用行为。其中最常见的使用类型为烟草制品（54.5%），其次是非医疗用途使用镇静剂（26%）与止咳糖浆（18.8%）。物质使用风险随年龄与学年增长而升高。男性学生（调整后比值比（Adjusted Odds Ratio, AOR）：1.41，95%置信区间（95% Confidence Interval, 95%CI）：[1.26, 1.59]，p<0.001）、校外独居（无家人陪同住宿，AOR：2.25，95%CI：[1.02, 4.94]，p=0.043）、住校（医学院校宿舍，AOR：2.1，95%CI：[1.20, 3.67]，p=0.009）、家庭成员存在烟草或物质使用史（AOR：3.97，95%CI：[2.64, 5.98]，p<0.001）以及非自愿考入医学院校（AOR：3.61，95%CI：[2.20, 5.90]，p<0.001）均为物质使用的显著预测因素。

研究结论 本研究发现孟加拉国医学生的物质使用流行率较高。因此，应针对性干预其烟草及其他物质使用相关行为的影响因素，并为现有使用者提供必要的戒断支持措施。