Increasing Prevalence of Electronic Cigarette Use among Medical Students. Repeated Cross-Sectional Multicenter Surveys in Germany and Hungary, 2016-2018.

Use of electronic cigarettes (e-cigarettes) is gaining popularity among young adults. Medical students' nicotine use behavior is of particular interest because of their impending role in health promotion. Aim of our study is to assess changes that occurred between 2016 and 2018 in the prevalence of e-cigarette use among medical students and to explore associations between e-cigarette use, demographic characteristics, and cigarette smoking. Self-administered questionnaire surveys were used to obtain cross-sectional data of medical students in Budapest and Pécs, Hungary, and Dresden, Germany. Sample sizes for 2016 and 2018 were 2297 and 1514, respectively. In the whole sample, past-30-day use of e-cigarettes increased from 4.5% to 8.0% ( < 0.001). The increase in e-cigarette use was significant in both genders (from 3.6% to 5.6% among females,  = 0.028, and from 5.9 to 11.4% among males,  < 0.001). Prevalence of e-cigarette use was higher among Hungarian students than among German students (2.2% versus 5.7% in 2016, and 4.1% versus 10.5% in 2018,  < 0.05 for both years). There was no significant difference in e-cigarette use among different academic years. The ratio of e-cigarette users increased significantly among current cigarette smokers but not among nonsmokers. We could not detect a decrease in cigarette smoking. Prevalence of e-cigarette use increased significantly among medical students without a reduction in cigarette smoking. Medical schools should add the topic of e-cigarettes to their curricula and need to develop cessation programs to help their students quit both cigarettes and e-cigarettes.