Vaping and Hookah use among medical trainees

Abstract

<b>Background:</b> Vaping and hookah use are increasing worldwide. Small studies suggest they have become popular among medical trainees. <b>Aims:</b> To investigate the frequency and patterns of use of e-cigarettes and hookah among medical trainees. <b>Methods:</b> Online survey of medical students and residents in Brazil (BR), United States (US) and India (IN), recruited via e-mails and social media. <b>Results:</b> We enrolled 6487 students (BR=2768, US=2523, IN=1169) and 1095 residents (BR=328, US=544, IN=197). 44%, 47%, and 4% of trainees in BR, US and IN tried vaping (ex-users: 7 %, 24%, and 1%; current users: 20%, 11%, and 0%). Median age at first use was 20y in BR and 21y in the US. They vaped nicotine (69%), flavors (50 %), and cannabis (23%). As for hookah, 47%, 37% and 8% of trainees in BR, US and IN tried it (ex-users:16%, 19%, and 4%; current users: 10%, 6%, and 1%). Median age at first use was 17y in BR and 20y in the US. They smoked tobacco (55%), flavors (60%), and cannabis (22%). Higher family income, smoking cigarettes and marijuana, and binge drinking were associated with e-cigarette and hookah use among students (Figure). Residents showed similar results. <b>Conclusions:</b> Vaping and hookah use are frequent among medical trainees in Brazil and the US, but not in India. Government policies do not fully explain between-country differences, as e-cigarettes are banned in Brazil and India. Understanding patterns of use is the first step to address the problem.