Medical Training Does Not Shield Students From Nicotine Use

A cross-sectional study conducted in southern Poland reveals that medical education does not significantly reduce the overall prevalence of nicotine product use among university students. Researchers compared the habits of physiotherapy students, who receive medical training, with those of humanities students, finding that both groups reported similar rates of current nicotine use. The study, published in Frontiers in Psychology, challenges the intuitive assumption that knowledge of physiology and pathophysiology automatically translates into healthier behavioral choices regarding nicotine consumption. Instead, the data suggest that while the specific products chosen may differ, the fundamental susceptibility to nicotine use remains comparable across these distinct academic disciplines.

The investigation involved 388 students aged 18 to 29 from medical and non-medical universities in the Katowice region. The sample included 268 females and 120 males, with the majority of participants falling within the 18 to 21 age bracket. Data were collected through in-person printed questionnaires administered to intact student groups during scheduled university classes. This method allowed researchers to gather detailed information on nicotine use status, product preferences, and the social contexts surrounding initiation and regular use. The study received ethical approval from the Bioethics Committee of the Medical University of Silesia, ensuring that all procedures adhered to relevant guidelines and regulations.

When analyzing the overall status of nicotine use, the researchers found that 27.58% of the total study group reported currently using nicotine-containing products. This proportion was nearly identical between the two groups: 28.04% of medical students and 27.14% of non-medical students were active users. Furthermore, 27.06% of all participants had never used nicotine products, while 26.29% had tried them once and stopped, and 19.07% were former users. These findings indicate that medical training does not serve as a protective barrier against initiating or maintaining nicotine use, as the rates of current and past use were statistically similar across both cohorts.

However, significant differences emerged in the types of nicotine products preferred by the two groups. Among those who regularly used nicotine products, medical students were more likely to use disposable and standard e-cigarettes. Specifically, 66.67% of medical students reported having ever used disposable e-cigarettes, compared to 55.28% of non-medical students. After adjusting for gender, medical students remained significantly more likely to use e-cigarettes, with an adjusted odds ratio of 1.61. In contrast, traditional cigarettes were significantly more popular among non-medical students, with 24.59% reporting their use, compared to only 5.00% of medical students. This divergence suggests that while medical education may not prevent nicotine use, it may influence the mode of consumption, steering users toward newer electronic devices rather than combustible tobacco.

The social environment played a crucial role in determining nicotine use patterns. The study found that peer influence significantly affected the likelihood of using nicotine products. Participants who used nicotine reported a higher median percentage of friends who also used these products compared to non-users. This aligns with the concept of social modeling, where peer behavior shapes individual habits. The data indicate that the immediate social circle is a more powerful determinant of nicotine use than academic discipline or theoretical health knowledge. Preventive strategies, therefore, may need to focus on social dynamics and peer influence rather than solely on individual health education.

Circumstances of use further highlighted the social nature of e-cigarette consumption. Among regular e-cigarette users, 81.71% reported using them most frequently when going to or being at a party. Additionally, 63.41% of respondents stated that they bought their first disposable e-cigarette for a social gathering. Other common reasons for first purchase included curiosity and the desire to fit in with social groups. This pattern suggests that disposable e-cigarettes function not only as a source of nicotine but also as a socialization tool. The attractive appearance and wide range of flavors of these devices may lower the perceived barriers to initiation, particularly in social settings where peer pressure and the desire for group belonging are prominent.

Nicotine dependence levels were assessed using the Fagerström Test for Nicotine Dependence, adapted for e-cigarette users. The test measures physical dependence on a continuous scale from 0 to 10 points, categorized as low, moderate, or high. Among the 67 e-cigarette users who completed the test, 46.27% demonstrated a low level of dependence, while 19.40% showed a high level. Although the percentage of individuals with high dependence was higher in the non-medical group (25.81%) than in the medical group (13.89%), this difference was not statistically significant. These results imply that high levels of nicotine dependence can develop regardless of medical knowledge, reinforcing the idea that health awareness alone is insufficient to prevent severe dependence.

The study also noted the environmental implications of disposable e-cigarettes, which are designed for single use and contain non-biodegradable plastics, heavy metals, and lithium-ion batteries. The rapid proliferation of these devices poses significant disposal challenges, as they can release toxic substances into soil and groundwater if improperly discarded. While the batteries are technically capable of multiple recharge cycles, their single-use design leads to resource depletion. This dual threat to public health and environmental sustainability underscores the need for targeted educational and regulatory initiatives, particularly among student populations who are primary users of these products.

The authors acknowledge several limitations of the study, including the use of convenience sampling and self-reported data, which may introduce selection and recall biases. The cross-sectional design also precludes causal inferences regarding the relationship between academic discipline and nicotine dependence. Nevertheless, the findings provide valuable comparative insights into product preferences and dependence patterns between medical and non-medical academic environments. The study highlights the need for more targeted preventive measures at the university level, addressing both the health effects of nicotine products and the social and psychological contexts that foster initiation. Future research should continue to explore the complex interplay between education, social factors, and nicotine use to develop effective prevention strategies.

Subject of Research: Does medical education protect against nicotine dependence? A comparison of e-cigarette use among physiotherapy and humanities students

Article Title: Does medical education protect against nicotine dependence? A comparison of e-cigarette use among physiotherapy and humanities students

Article References: Dąbek, J., Szynal, M., Brasse, P., Żerdka, J., Sierka, O., & Sierka, E. (2026). Does medical education protect against nicotine dependence? A comparison of e-cigarette use among physiotherapy and humanities students. Frontiers in Psychology, 17, Article 1842763. https://doi.org/10.3389/fpsyg.2026.1842763

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1842763

Keywords: Does, medical, education, protect, against, nicotine, dependence, comparison, e-cigarette, physiotherapy, humanities, students