Exploring Cognitive and Behavioral Dynamics of Smoking among Medical Students: A National Cross-sectional Study

Abstract Background Assessment of smoking behaviors and their dynamics is a crucial domain, particularly among medical students who serve as future healthcare providers. However, the association between smoking behaviors and academic progression remains understudied in Jeddah, Saudi Arabia. Objectives This study aims to determine smoking patterns, prevalence, and associated factors among medical students in Jeddah, focusing on experimentation, daily smoking, cessation efforts, awareness of health risks, and attitudes towards quitting. Methods A cross-sectional study was conducted in Jeddah, Saudi Arabia, from September to November 2023. Male and female medical students from the second to sixth year, enrolled in specific universities, were included. Data collection utilized a comprehensive questionnaire, adapted from the World Health Organization's questionnaire and enhanced with additional relevant items by the researchers. The questionnaire, comprising of eight sections, was administered online over a three-month period. Descriptive statistics were used for analysis. Results About 30.8% reported ever smoking, with 21.6% currently smoking. Among ever-smokers, 43.1% began smoking during college, mostly in the second year. Stress, exploration, and peer influence were frequent reasons for initiating smoking during college years. About 32.3% never considered quitting, while 67.7% thought about it. Regarding quit attempts, 46.2% did not try, 53.8% attempted seriously, and 5.3% quit in the last year. Protective factors against smoking included health concerns and setting a good example. Most participants recognized smoking-related health hazards, with strong consensus on the effectiveness of anti-smoking measures. Notably, many participants expressed proactive attitudes towards smoking cessation interventions. Conclusion Smoking is prevalent among Saudi medical students, often starting in college due to stress, new experiences, and peer influence. Many consider quitting, probably supported by the educational environment and a sense of responsibility towards personal and public health. Strengthened educational frameworks, including stress management training, are crucial for fostering a health-focused professional identity.