Knowledge, beliefs, attitude, and practices of E-cigarette use among dental students: A multinational survey

Mohammed Nasser Alhajj; Sadeq Ali Al-Maweri; Morenike O Folayan; Esam Halboub; Yousef Khader; Ridwaan Omar; Abdullah G Amran; Ola B Al-Batayneh; Asja Celebić; Sanja Persic; Humeyra Kocaelli; Firas Suleyman; Abdulaziz A Alkheraif; Darshan D Divakar; Abdulbaset A Mufadhal; Mohammed A Al-Wesabi; Wadhah A Alhajj; Mokhtar A Aldumaini; Saadika Khan; Thiyezen A Al-Dhelai; Ahmed Shaher Alqahtani; Ali H Murad; Joseph E Makzoumé; Shivani Kohli; Tareq A Ziyad

doi:10.1371/journal.pone.0276191

Knowledge, beliefs, attitude, and practices of E-cigarette use among dental students: A multinational survey

PLoS One. 2022 Oct 27;17(10):e0276191. doi: 10.1371/journal.pone.0276191. eCollection 2022.

Authors

Mohammed Nasser Alhajj¹, Sadeq Ali Al-Maweri², Morenike O Folayan³, Esam Halboub^{4

5}, Yousef Khader⁶, Ridwaan Omar⁷, Abdullah G Amran⁸, Ola B Al-Batayneh⁹, Asja Celebić¹⁰, Sanja Persic¹⁰, Humeyra Kocaelli¹¹, Firas Suleyman¹², Abdulaziz A Alkheraif¹³, Darshan D Divakar¹³, Abdulbaset A Mufadhal¹⁴, Mohammed A Al-Wesabi¹⁵, Wadhah A Alhajj^{8

16}, Mokhtar A Aldumaini¹⁷, Saadika Khan¹⁸, Thiyezen A Al-Dhelai^{19

20}, Ahmed Shaher Alqahtani⁴, Ali H Murad²¹, Joseph E Makzoumé²², Shivani Kohli²³, Tareq A Ziyad²⁴

Affiliations

¹ Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen.
² College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
³ Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
⁴ Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
⁵ Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
⁶ Department of Public Health, Community Medicine and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
⁷ Division of Prosthodontics, Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait.
⁸ Department of Periodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen.
⁹ Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
¹⁰ Department of Removable Prosthodontics, School of Dental Medicine and Clinical Hospital Centre, University of Zagreb, Zagreb, Croatia.
¹¹ Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
¹² Department of Prosthodontics, Faculty of Dentistry, University of Health Sciences, İstanbul, Turkey.
¹³ Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
¹⁴ Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
¹⁵ Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Taiz, Yemen.
¹⁶ Department of Dentistry, Faculty of Medical sciences, Civilization University, Sana'a, Yemen.
¹⁷ Department of Fixed and Removable Prosthodontics, Faculty of Dentistry, University of Ibb, Ibb, Yemen.
¹⁸ Department of Restorative Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa.
¹⁹ Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Saudi Arabia.
²⁰ Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Ibb, Ibb, Yemen.
²¹ Department of Oral Diagnosis, College of Dentistry, University of Al-Qadisiyah, Al-Diwaniya, Iraq.
²² Department of Removable Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
²³ Division of Clinical Dentistry, School of Dentistry, International Medical University (IMU), Kuala Lumpur, Malaysia.
²⁴ Private Dental Clinic, Sana'a, Yemen.

Abstract

Background: E-cigarette use is a trend worldwide nowadays with mounting evidence on associated morbidities and mortality. Dentists can modify the smoking behaviors of their patients. This study aimed to explore the knowledge, beliefs, attitude, and practice of E-cigarette use among dental students.

Materials and methods: This multinational, cross-sectional, questionnaire-based study recruited undergraduate dental students from 20 dental schools in 11 countries. The outcome variable was current smoking status (non-smoker, E-cigarette user only, tobacco cigarette smoker only, dual user). The explanatory variables were country of residence, sex, age, marital status, and educational level. Multiple linear regression analysis was performed to explore the explanatory variables associated with E-cigarette smoking.

Results: Of the 5697 study participants, 5156 (90.8%) had heard about E-cigarette, and social media was the most reported source of information for 33.2% of the participants. For the 5676 current users of E-cigarette and/or tobacco smoking, 4.5% use E-cigarette, and 4.6% were dual users. There were significant associations between knowledge and country (P< 0.05), educational level (B = 0.12; 95% CI: 0.02, 0.21; P = 0.016) and smoking status (P< 0.05). The country of residence (P< 0.05) and smoking status (P< 0.05) were the only statistically significant factors associated with current smoking status. Similarly, there were statistically significant associations between attitude and country (P< 0.05 for one country only compared to the reference) and history of previous E-cigarette exposure (B = -0.52; 95% CI: -0.91, -0.13; P = 0.009). Also, the practice of E-cigarettes was significantly associated with country (P< 0.05 for two countries only compared to the reference) and gender (B = -0.33; 95% CI: -0.52, -0.13; P = 0.001).

Conclusion: The knowledge of dental students about E-cigarette was unsatisfactory, yet their beliefs and attitudes were acceptable. Topics about E-cigarette should be implemented in the dental curriculum.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Electronic Nicotine Delivery Systems*
Health Knowledge, Attitudes, Practice
Humans
Students, Dental
Surveys and Questionnaires
Vaping*

Grants and funding

The authors are grateful to the Deanship of Scientific Research, King Saud University, for funding through the Vice Deanship of Scientific Research for Research Chairs. The authors are also thankful to the Qatar National Library for the open access funding. The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.