# Prevalence and Risk Factors of Alcohol, Tobacco, and Substance Use among Medical Students in Southern Iran in 2024: A Growing Concern

## TL;DR

This study found high rates of alcohol, tobacco, and substance use among medical students in southern Iran, with risk factors including family and friend use, being male, and mental health issues.

## Contribution

The study provides new prevalence data and identifies specific risk factors for substance use among medical students in southern Iran.

## Key findings

- 27.5% of students reported lifetime alcohol use, 26.7% tobacco use, 14.4% sedative use, and 15.8% e-cigarette use.
- Having a substance-using friend or family member, being male, and mental illness history were significant risk factors for cigarette use.
- The findings highlight the need for targeted interventions to address substance use in this population.

## Abstract

Alcohol, smoking, and substance use among medical students are significant health concerns that impact their well-being and their future roles as health advocates. This study aimed to investigate the prevalence of these behaviors and related risk factors among medical students in southern Iran.

This cross-sectional study was conducted among medical students in Shiraz, in southern Iran, in 2024. Data were collected using the World Health Organization’s alcohol, smoking, and substance involvement screening test (ASSIST), supplemented with questions on demographic details, family and friend substance use, mental health, and major satisfaction. The sample was selected using the stratified random selection method. Logistic regression models were used to identify factors associated with substance use, controlling for potential confounders. P<0.05 was considered statistically significant. All analyses were performed using SPSS software (version 26, SPSS Inc., USA).

The study included 360 medical students, of whom 51.9% were men, with a mean age of 22.62±3.02 years. The lifetime prevalence was 27.5% for alcoholic beverages, 26.7% for tobacco products, 14.4% for sedatives or sleeping pills, and 15.8% for electronic cigarettes and vapes. Logistic regressions analysis revealed that having a family member who uses substances (OR=1.8, 95% CI: 1.01-3.5),
having a friend who uses substances (OR=3.9, 95% CI: 2.0-7.8), being male (OR=1.8, 95% CI: 1.03-3.2), and having a recent history of mental illnesses (OR=2.8, 95% CI: 1.1-7.1) were
positively associated with lifetime cigarette use.

The prevalence of alcohol, smoking, and substance use among medical students in southern Iran is concerning. These findings emphasized the significance of targeted interventions to reduce and prevent use within this population.