Prevalence and determinants of cigarette smoking among undergraduate medical students in Tanzania: a cross-sectional study

TL;DR

This study finds that cigarette smoking is rare among medical students in Tanzania, with living off-campus being a key risk factor.

Contribution

The study provides the first data on smoking prevalence and its determinants among medical students in Tanzania.

Findings

The smoking prevalence among medical students was 2.9%, with all smokers being men.

Living off-campus was strongly associated with higher odds of smoking.

Receiving parental advice against smoking was a significant protective factor.

Abstract

Cigarette smoking is a common problem among university students globally and it is one of the leading causes of preventable morbidity and premature mortality globally. It is associated with several risk factors that predispose some individuals to smoke more than others. Medical students play an important role as future health professionals and execute pivotal role models in tobacco control. There has been also a growing burden of smoking-related diseases in Tanzania, not only at the global level, but also among health professionals. However, there is a lack of data on cigarette smoking among university students in Tanzania. This study aimed to determine the prevalence and determinants of cigarette smoking among undergraduate medical students in Tanzania.

A cross-sectional study was conducted among 410 undergraduate medical students at the University of Dodoma, Tanzania from July to August 2025 using a structured questionnaire. Data analysis was performed descriptively, and chi-square test and logistic regression were conducted using Statistical Package for Social Sciences (SPSS) version 25. Statistical significance was set at 0.05.

A total of 410 students participated in this study and the smoking prevalence was 2.9% (All smokers being men accounting for 100% of smokers). Those living off-campus were significantly more likely to smoke than those on-campus (OR = 12.744; 95% CI = 3.243–50.075; p < 0.001), having friends who smoked (OR = 2.326; 95% CI = 0.533–10.146; p = 0.261), drinking alcohol (OR = 1.650; 95% CI = 0.306–8.892; p = 0.560), being in the fourth year (OR = 1.677; 95% CI = 0.126–22.364; p = 0.696), living in urban area (OR = 0.351; 95% CI = 0.066–1.859 p = 0.218) and good family relationship (OR = 15.659; 95% CI = 0.557–440.193; p = 0.106) were associated with higher odds of smoking though not statistically significant. However, receiving parental advice against cigarette smoking was a significant protective factor (OR = 0.174; p = 0.029).

Cigarette smoking is less prevalent among medical students at the University of Dodoma. However, being in the fourth year of study, living off campus, residing in an urban area, consuming alcohol, living with parents, having good family relationships, and having friends who smoke were identified as predictors of cigarette smoking among university students. There is a need to include plans to reduce smoking among university students that can be incorporated into courses or special university programs.