Peer tobacco use, media exposure, and support for tobacco control policies among medical and public health students in Georgia: A cross-sectional study.

INTRODUCTION: Health professional students are potential tobacco users and future advocates for tobacco control. Evidence from the Caucasus on factors associated with tobacco use and policy support remains limited. This study examined tobacco use and support for tobacco-control policies among medical and public health students in Georgia. METHODS: A cross-sectional survey was conducted from June to December 2022 among students at Tbilisi State Medical University using a self-administered online questionnaire; all data were self-reported. Of 1078 randomly invited students, 667 completed the survey. Any past 30-day use of cigarettes, electronic cigarettes, heated tobacco products, cigars, bidis, or hookah was assessed, together with tobacco-related media exposure, peer and household tobacco use, and support for five tobacco-control policies. Multivariable logistic and linear regression examined factors associated with current use and policy support, adjusting for sociodemographic characteristics, media and retail exposures, and social exposures. RESULTS: Overall, 18.6% of students reported past 30-day tobacco or nicotine product use, and mean policy support was 5.45 on a 7-point scale. In adjusted analyses, the number of friends who used tobacco was the factor most strongly associated with current use (adjusted odds ratio, AOR=2.49; 95% CI: 1.81-3.43). Anti-tobacco media exposure was modestly associated with higher odds of use (AOR=1.07; 95% CI: 1.02-1.11), whereas pro-tobacco exposure was inversely associated (AOR=0.92; 95% CI: 0.87-0.97). Current use (adjusted regression coefficient, B= -0.65; 95% CI: -0.94 - -0.35) and male sex (B= -0.41; 95% CI: -0.64 - -0.18) were independently associated with lower policy support. CONCLUSIONS: Peer tobacco use was the factor most strongly associated with current tobacco or nicotine product use among medical and public health students in Georgia. Although policy support was generally high, current users expressed weaker support. Additional longitudinal and multi-institutional studies are needed to provide sufficient evidence to inform tobacco-use prevention and the promotion of tobacco-control engagement during health professional training.