NYMC Faculty Publications

Medical Trainees' Knowledge and Attitudes Towards Electronic Cigarettes and Hookah: A Multinational Survey Study

Fernando P. Bruno, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil. fernando.bruno@touro.edu.
Luiza Helena Degani-Costa, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Kesava Lakshmi Kandipudi, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Fernanda Gushken, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Claudia Szlejf, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Ana B. Tokeshi, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Yasmin F. Tehrani, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Daniel Kaufman, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Pentapati Siva Kumar, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.Follow
Limalemla Jamir, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Matthew Gk Benesch, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Morag G. Ryan, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Hardeep Lotay, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Jonathan P. Fuld, Drs Bruno, Tehrani, and Mr Kaufman are affiliated with the Touro College of Osteopathic Medicine, Middletown, New York. Dr Bruno is affiliated with the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Valhalla, New York. Drs Degani-Costa, Tokeshi, and Fidalgo are affiliated with the Department of Psychiatry, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein - Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil. Dr Kandipudi is affiliated with the Andhra Medical College, Vishakhapatnam, India. Dr Szlejf is affiliated with the Department of Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil. Dr Kumar is affiliated with the All India Institute of Medical Sciences, Mangalagiri, India. Dr Jamir is affiliated with the All India Institute of Medical Sciences, Guwahati, India. Drs Benesch and Ryan are affiliated with Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. Drs Lotay and Fuld are affiliated with the Department of Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Dr Fidalgo is affiliated with the National Academy of Medicine, Rio de Janeiro, Brazil.
Thiago M. Fidalgo

Author Type(s)

Faculty

DOI

10.4187/respcare.11042

Journal Title

Respiratory Care

First Page

306

Last Page

316

Document Type

Article

Publication Date

2-28-2024

Department

Public Health

Abstract

BACKGROUND: The rising prevalence of electronic cigarette (e-cigarette) and hookah use among youth raises questions about medical trainees' views of these products. We aimed to investigate medical trainees' knowledge and attitudes toward e-cigarette and hookah use. METHODS: We used data from a large cross-sectional survey of medical trainees in Brazil, the United States, and India. We investigated demographic and mental health aspects, history of e-cigarettes and tobacco use, knowledge and attitudes toward e-cigarettes and hookah, and sources of information on e-cigarettes and hookah. Although all medical trainees were eligible for the original study, only senior students and physicians-in-training were included in the present analysis. RESULTS: Of 2,036 senior students and physicians-in-training, 27.4% believed e-cigarette use to be less harmful than tobacco smoking. As for hookah use, 14.9% believed it posed a lower risk than cigarettes. More than a third of trainees did not acknowledge the risks of passive e-cigarette use (42.9%) or hookah smoking (35.1%). Also, 32.4% endorsed e-cigarettes to quit smoking, whereas 22.5% felt ill equipped to discuss these tobacco products with patients. Fewer than half recalled attending lectures on these topics, and their most common sources of information were social media (54.5%), Google (40.8%), and friends and relatives (40.3%). CONCLUSIONS: Medical trainees often reported incorrect or biased perceptions of e-cigarettes and hookah, resorted to unreliable sources of information, and lacked the confidence to discuss the topic with patients. An expanded curriculum emphasis on e-cigarette and hookah use might be necessary because failing to address these educational gaps could risk years of efforts against smoking normalization.

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