Experimentation with and knowledge regarding water-pipe tobacco smoking among medical students at a major university in Brazil.
OBJECTIVE
Water-pipe tobacco smoking is becoming increasingly more common among young people. The objective of this study was to estimate the prevalence of the use of water pipes and other forms of tobacco use, including cigarette smoking, among medical students, as well as to examine the attitudes, beliefs, and knowledge of those students regarding this issue.


METHODS
We administered a questionnaire to students enrolled in the University of São Paulo School of Medicine, in São Paulo, Brazil. The respondents were evaluated in their third and sixth years of medical school, between 2008 and 2013. Comparisons were drawn between the two years.


RESULTS
We evaluated 586 completed questionnaires. Overall, the prevalence of current cigarette smokers was low, with a decline among males (9.78% vs. 5.26%) and an increase among females (1.43% vs. 2.65%) in the 3rd and 6th year, respectively. All respondents believed that health professionals should advise patients to quit smoking. However, few of the medical students who smoked received physician advice to quit. Experimentation with other forms of tobacco use was more common among males (p<0.0001). Despite their knowledge of its harmful effects, students experimented with water-pipe tobacco smoking in high proportions (47.32% and 46.75% of the third- and sixth-year students, respectively).


CONCLUSIONS
The prevalence of experimentation with water-pipe tobacco smoking and other forms of tobacco use is high among aspiring physicians. Our findings highlight the need for better preventive education programs at medical schools, not only to protect the health of aspiring physicians but also to help them meet the challenge posed by this new epidemic.
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Stella Regina
SR
Martins
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Renato Batista
RB
Paceli
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Marco Antônio
MA
Bussacos
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Frederico Leon Arrabal
FL
Fernandes
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Gustavo Faibischew
GF
Prado
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Elisa Maria Siqueira
EM
Lombardi
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Mário
M
Terra-Filho
Heart Institute, Hospital das Clínicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
Ubiratan Paula
UP
Santos
D000328:Adult; D001294:Attitude to Health; D001938:Brazil / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D013337:Students, Medical / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000145:classification; D014495:Universities; D055815:Young Adult