Asli Gorek Dilektasli ^* Ozge Aydin Guclu Arzu Ozpehlivan Vahide A. Durak Izzet Gezmis Anil Ozgur Burak Cinar Ezgi Demirdogen Nilüfer Aylin Acet Öztürk Guven Ozkaya Funda Coskun Ahmet Ursavas Esra Uzaslan Mehmet Karadag

• Faculty of Medicine, Bursa Uludağ University, Bursa, Türkiye

Background: A major public health hazard is youth e-cigarette use. Although new, ecigarette health hazards are becoming well-known in the literature. E-cigarette sales restrictions and laws differ globally. In this cross-sectional study, we studied medical university students' tobacco and e-cigarette use and characteristics in a country where sales and import of e-cigarettes are banned. The primary objective is to determine the prevalence of electronic cigarette use and understand consumption patterns among medical faculty students in this setting.Material and Methods: The questionnaire was sent using a web-based student information system. Sociodemographic features, tobacco and e-cigarette use, consumption patterns, and e-cigarette risk perceptions were covered in 54 questions.Results: The study comprised 1054 students (48.7% male) aged 21.5 ± 2.6 years who completed the questionnaire. 37.7%, 20.9%, and 23.6% have smoked cigarettes, e-cigarettes, or water pipes. Current cigarette smokers were 17.0%, e-cigarette users 4.0%, and water pipe smokers 4.5%. E-cigarette users were 52.3% dual smokers. The most common symptoms reported by e-cigarette users were cough (58.4%) and dyspnea (54.2%). Multivariable models showed that the male sex, greater monthly income, and a current smoker friend were independent risk factors for e-cigarette ever use, while the male sex, paternal current smoking, and close friends' current smoking status were risk factors for dual use among medical trainees. Many medical students who used electronic cigarettes underestimated nicotine's health hazards and harmful chemicals in e-cigarettes. Despite e-cigarette sales being prohibited in our country, 56.4% and 25.4% of e-cigarette users provided e-cigarettes from tobacco shops and through online sales, respectively. Conclusion: Medical university students use tobacco most often by smoking cigarettes. Despite medical university students being aware of the health hazards of ecigarettes, the current use of electronic cigarettes is 4.0%. Male sex, greater monthly income, and having current smoker friends are independent risk factors for e-cigarette use, while paternal smoking is a risk factor for dual use among medical trainees. Although in the country, sales of e-cigarettes are banned, ever-use rates for e-cigarettes were remarkably high at 20.9%, and the ease of accessing e-cigarettes was striking.