Prevalence of tobacco use and nicotine dependence among medical interns in Nepal: A cross-sectional study.

This study was conducted to assess the prevalence of tobacco consumption, nicotine dependence and factors associated with tobacco use among medical interns in Nepal. Data was collected from February to April 2023 using an online questionnaire distributed through multiple platforms, with weekly reminders for five weeks. The questionnaire included demographic characteristics, tobacco use status, type of tobacco, age at initiation, and the six-item Fagerström Test for Nicotine Dependence. A minimum sample of 324 participants was required, and 389 participants were targeted to allow for potential non-response. Of the 798 interns who received the questionnaire, 381 completed it, for a response rate of 47.74%. The majority of participants were male, 54.33% (n = 207) and studying Bachelor of Medicine and Bachelor of Surgery, 64.57%(n = 246). The prevalence of tobacco use was 18.11% (n = 69), including 13.12% smokers (n = 50) and 4.99% smokeless tobacco users (n = 19). Smoking was significantly more common among male and MBBS interns. Exploratory, post-hoc multivariable logistic regression showed that female interns had lower odds of tobacco use than male interns (OR = 0.18; 95% CI: 0.09-0.36). Among the 50 smokers, one participant did not complete the nicotine dependence questionnaire; therefore, 49 smokers were included in the nicotine dependence analysis. Among smokers, nicotine dependence was low in 73.47% (n = 36), moderate in 24.49% (n = 12), and high in 2.04%(n = 1). Among the tobacco users, 44.93%(n = 31) responded that the reason for the initiation of tobacco products was self-interest, followed by peer pressure, 23.19%(n = 16). Tobacco use was less common among medical interns than in the general population, likely reflecting their higher educational attainment. Among those who smoked, most exhibited low levels of nicotine dependence. Self-interest and peer pressure were the primary reasons for tobacco initiation. The exploratory associations should be interpreted cautiously and considered hypothesis-generating.