BMC Public Health最新文献

{"title":"Impact of COVID-19 pandemic on Legionella testing and infection rates in Ontario.","authors":"Adriana Peci, Pauline Zhang, Ashleigh Sullivan, Ye Li, Yingli Bi, Allana Murphy, Keren Leibson, Jonathan B Gubbay, Anna Majury","doi":"10.1186/s12889-025-24620-0","DOIUrl":"https://doi.org/10.1186/s12889-025-24620-0","url":null,"abstract":"<p><strong>Background: </strong>The disruption of healthcare systems during the COVID-19 pandemic had widespread effects on patient care, including interruption of scheduled visits and diagnostic testing. Many diseases were under-investigated due to the focus on the SARS-CoV-2 virus and the redeployment of resources to the pandemic response. This study aimed to assess Legionella trends in Ontario during the COVID-19 pandemic years, by comparing the demographics of individuals tested for Legionella prior to pandemic (2018 and 2019) to those during the pandemic (2020, 2021 and 2022). Additionally, for individuals who underwent Legionella testing, testing for additional respiratory pathogens was examined in the context of Legionella co-detection.</p><p><strong>Methods: </strong>Two Poisson regression models were constructed to compare testing rate and positivity rate during the pre-pandemic years with the pandemic years, adjusted for age, sex, year, and Ontario population.</p><p><strong>Results: </strong>Relative to the pre-pandemic years, the testing rates significantly decreased by 8% in 2020, decreased by 8% in 2021 and increased by 14% in 2022. The positivity rate for Legionella decreased by 13% only in 2020 but did not reach significance for the other two years. Individuals older than 50 years of age and males remained the population with highest positivity rate of Legionella infection across all years. Co-detection of Legionella with SARS-CoV-2 or seasonal respiratory viruses was rare but present during the pandemic.</p><p><strong>Conclusions: </strong>Legionella testing rates decreased by 8% in 2020 and 8% in 2021 and increased by 14% in 2022, which was associated with a decrease in positivity rate only in 2020, at 13%, but not in the other two years. Maintaining vigilance for Legionella testing in future pandemics may support timely diagnosis and treatment, leading to improved patient outcomes. Co-detection of Legionella with SARS-CoV-2 or seasonal respiratory viruses was rare but present during the pandemic. Accordingly, Legionella testing remains essential among high-risk groups, such as the elderly with co-morbidities, critically ill patients, or those with severe or unresponsive pneumonia. Such an approach can aid in differential diagnosis, prompt appropriate treatment, and improve patient outcomes.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3603"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of insulin resistance among middle-aged adults in rural northern Ghana: an Awi-Gen cross-sectional study.","authors":"Mathilda A Tsifodze, Emmanuel K Ofori, Engelbert A Nonterah, William Dormechele, Patrick Ansah, Godfred Agongo","doi":"10.1186/s12889-025-24806-6","DOIUrl":"https://doi.org/10.1186/s12889-025-24806-6","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance (IR) is linked to several metabolic diseases including type 2 diabetes mellitus (T2DM), metabolic syndrome, and metabolic dysfunction-associated fatty liver disease (MAFD). The factors that contribute to IR in rural African populations remain largely unknown. Understanding the determinants of IR will contribute to the management of several non-communicable diseases (NCDs).</p><p><strong>Methods: </strong>A cross-sectional study was conducted in two rural districts in northern Ghana involving male and female participants, aged 40 to 60 years, who were recruited into the study between the years 2015 and 2016. Sociodemographic, lifestyle, anthropometric, ultrasound, blood lipid profile, blood glucose and insulin, urine creatinine and urine protein data were collected. Insulin resistance was determined using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) formula. Multivariable linear regression analyses were performed between log-transformed IR and several variables. All association analyses were considered significant at p < 0.05.</p><p><strong>Results: </strong>The median (log-transformed) IR among women (0.54) was significantly higher than that among men (0.43) (p < 0.001). The prevalence of IR was 7.6% in the study population with more women having IR (9.9%) than men (4.5%) (p = 0.007). Drivers of IR among women were unmarried status (β = 1.19, p = 0.037), smoking (β = 8.33, P = 0.001) and triglyceride (TG) (β = 2.09, p = 0.016) while that among men were body mass index (BMI) (β = 0.47, p = 0.013), right carotid intima median thickness (CIMT_right) (β = 5.08, p = 0.033), visceral adipose tissue (VAT) (β = 0.59, p = 0.031) and TG (β = 5.58, p < 0.001). Among the total population, vendor meal consumption (β = 0.41, p = 0.001), CIMT_right (β = 3.54, p = 0.028), low-density lipoprotein cholesterol (LDL-C) (β = 1.08, p = 0.012), and TG (β = 2.87, p < 0.001) were linked to IR.</p><p><strong>Conclusions: </strong>Lifestyle, adiposity, CIMT_right and lipid markers contribute to driving IR levels and that these factors are gender-specific in this northern rural Ghanaian population.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3595"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous youth mental health: an ecological approach to understanding risk and protective factors for Māori youth in Aotearoa New Zealand.","authors":"Terryann C Clark, Esther S Yao, Nicola Harrison, Bradley Drayton, Logan Hamley, Terry Fleming, Sue Crengle","doi":"10.1186/s12889-025-24845-z","DOIUrl":"https://doi.org/10.1186/s12889-025-24845-z","url":null,"abstract":"<p><strong>Background: </strong>Māori (Indigenous) youth of Aotearoa New Zealand are experiencing widening inequities in mental health when compared to Pākehā (New Zealand European/other European/\"White\"; cultural majority) youth. This study used an ecological approach to investigate key risk and protective factors for Māori to help prioritise actions.</p><p><strong>Methods: </strong>A subsample of Māori participants (N = 1,528) from a large representative cross-sectional secondary dataset on secondary school students' health and wellbeing (Youth'19) were used to examine the effects of explanatory variables selected from five domains (individual, and their wider social ecosystem, including whānau/family, school, and community) on four mental health outcomes (wellbeing, depressive symptoms, suicide thoughts, suicide attempts). Descriptive statistics (percentages and 95% CIs) were used to examine the equity of these variables between Māori and Pākehā/White youth.</p><p><strong>Results: </strong>Overall, individual risk factors included female sex, functional disability, and sexual abuse. Wider adverse social ecosystems included housing precarity, household deprivation, bullying, and racial discrimination. Key protective factors included the Indigenous concept of whanaungatanga (relationships/connection) with whānau (family), and feelings of safety in social ecosystems including home, school, and neighbourhoods. These risk and protective factors were broadly similar across the four mental health outcomes. Compared to Pākehā/White youth, Māori youth were exposed to greater risk-conferring ecosystems, including socioeconomic deprivation, discrimination, and violence-related harms.</p><p><strong>Conclusions: </strong>Addressing inequitable mental health harm requires not only intervening at the individual level, but also addressing the wider social ecosystems that disproportionately harm Māori youth, including colonial systems that consistently impact Indigenous youth mental health, particularly housing precarity, poverty, violence, bullying, and racism. Culturally and developmentally appropriate approaches with a focus on creating safe and inclusive societies are urgently required to reduce Indigenous youth mental health inequity.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3600"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal trends in mortality and its causes among migrant HIV/AIDS patients undergoing antiretroviral therapy compared to their counterparts: a cohort study, 2016-2022.","authors":"Jing Li, Xiaozhen Zhang, Jun Liu, Jinglin Wang, Binghui Wang, Zirui Zhang, Xiaomin Kang, Hanwen Fu, Mingmei Zhang, Xueshan Xia","doi":"10.1186/s12889-025-24546-7","DOIUrl":"https://doi.org/10.1186/s12889-025-24546-7","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3593"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological stress and physiological outcomes: investigating the impact of attention biases and emotional regulation in Chinese military service members.","authors":"Lian Wang, Yun Cai, Jinghui Zhao, Yan Ma, Jing Peng, Hong Gong, Yaotian Liu, Rui Chen, Rong Song, Yan Luo, Xiaotang Fan, Qingtao Xiao","doi":"10.1186/s12889-025-23924-5","DOIUrl":"https://doi.org/10.1186/s12889-025-23924-5","url":null,"abstract":"<p><p>Military service members are frequently exposed to high-stress situations that profoundly impact both their psychological and physiological health. Understanding the interplay between stress and its multifaceted impacts is crucial for designing targeted interventions to optimize the health and performance of this population. This study investigated the relationships among psychological stress, psychological resilience, attention biases (attention to positive information, API; attention to negative information, ANI), emotional regulation strategies (cognitive reappraisal, CR; expression inhibition, EI), and key physiological markers, including hemoglobin (HGB) levels and red cell distribution width (RDW), in a sample of 673 male Chinese military personnel. The results revealed significant associations between psychological stress and attention biases and emotional regulation strategies, with direct effects for physiological markers such as HGB and RDW. Notably, EI emerged as a complex mediator, significantly reducing RDW despite increased psychological stress. These findings highlight the imperative to incorporate comprehensive stress management into military training programs, thereby enhancing health and operational readiness of service members in high-stress contexts.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3589"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Know-do gaps in the clinical management of childhood illness: evidence from three countries in sub-Saharan Africa.","authors":"Emma Clarke-Deelder, Pablo Amor Fernandez, Salome Drouard, Eeshani Kandpal, Günther Fink, Gil Shapira","doi":"10.1186/s12889-025-24852-0","DOIUrl":"https://doi.org/10.1186/s12889-025-24852-0","url":null,"abstract":"<p><strong>Background: </strong>After neonatal conditions, the leading causes of child mortality in sub-Saharan Africa are malaria, lower respiratory infections, and dehydration. Many of these deaths could be averted with basic and widely-available health interventions, but quality of care remains low. We aimed to assess adherence to clinical guidelines for these conditions in Burundi, the Democratic Republic of the Congo (DRC), and Nigeria, and estimate the proportion of guideline non-adherence that is explained by gaps in health care provider knowledge versus other factors.</p><p><strong>Methods: </strong>We conducted an observational study in randomly-sampled health facilities in each study country, linking data from direct observations of under-5 sick child visits, knowledge assessments of the treating health care providers, and interviews with caregivers. For children diagnosed with malaria, severe respiratory infection, or dehydration, we defined the \"adherence gap\" as the percentage who did not receive correct treatment, and the \"know-do gap\" as the percentage who received incorrect care despite the provider knowing the correct treatment. We evaluated the portions of overall adherence gaps that were explained by know-do gaps, and described factors associated with know-do gaps.</p><p><strong>Results: </strong>A total of 2,212 sick child visits treated by 852 providers were analyzed. In the pooled sample, 87%, 75%, and 77% percent of providers were familiar with the main treatment recommendations for malaria, pneumonia, and dehydration, respectively. When observed by survey staff during consultations with sick children, compliance with the same guidelines was 76%, 74%, and 51%. Knowledge gaps explained between 0% of the total adherence gap for pneumonia treatment in Burundi and 40% of the gap for pneumonia treatment in the DRC.</p><p><strong>Conclusions: </strong>To improve quality of care, it is critical to understand why providers do not consistently follow clinical guidelines. Our findings suggest that adherence to protocols is low, but that knowledge is not the primary barrier. Interventions to improve quality must go beyond improving knowledge to also address other drivers of provider behavior such as motivation, workload, and systemic constraints.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3601"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual-related symptoms and absence from school among young people in Sweden: a stratified, randomized, population-based survey.","authors":"Klara Abrahamsson, Eva Åkerman, Sara Ström, Lisa Söderman, Henrik Källberg, Marie Klingberg-Allvin","doi":"10.1186/s12889-025-24705-w","DOIUrl":"https://doi.org/10.1186/s12889-025-24705-w","url":null,"abstract":"","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3602"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chlamydia and gonorrhea incidence and residential segregation: US spatiotemporal patterns (2013-2021).","authors":"M Naser Lessani, Arielle N'Diaye, Zhenlong Li, Xiaoming Li, Shan Qiao","doi":"10.1186/s12889-025-24798-3","DOIUrl":"https://doi.org/10.1186/s12889-025-24798-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Investigate the association between residential segregation and the incidence of chlamydia and gonorrhea from 2013 to 2021 at the county level in contiguous U.S. states.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;National-level secondary US data from 2013 to 2021 from the Centers for Diseases Control and Prevention Sexually Transmitted Infection surveillance dataset, American Community Survey, and Racial Segregation Index were analyzed using the Generalized Estimating Equation, and spatial regression. Analysis was divided into two periods (2013-2019; 2020-2021) to account for COVID-19 disruptions. Residential segregation was measured by dissimilarity index categorized into reference (&lt; 0.25), moderate (0.26-0.50), high (0.51-0.75), and extreme (&gt; 0.75) levels. Primary outcome measures were chlamydia and gonorrhea incidence rates. Residential segregation was the key independent variable with other social determinants of health covariates. 3,211 counties within the contiguous United States were included within this study. Counties with missing data, and not within the contiguous United States were excluded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For chlamydia, from 2013 to 2019, segregation coefficients (i.e.,13.77 and 15.84 for moderate and high segregation) indicated that greater residential segregation was associated with higher chlamydia incidence rates (P &lt; 0.0001). From 2020 to 2021, these coefficients increased (from 13 to 15 to 28.25 and 34.16), suggesting growing segregation-driven disparities. Gonorrhea followed a similar trend, with the coefficients increasing from 0.47 to 0.55 (P &lt; 0.001) to 1.53 and 1.62 (P &lt; 0.05), respectively. Spatial variation in the association between segregation and chlamydia incidence remained consistent, with more pronounced associations in the Southeastern, Midwest, and Western regions. Spatial variation in the association between segregation and gonorrhea incidence were more pronounced in the South and parts of the Midwest, with weaker associations in some Northern and Western regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Residential segregation remained associated with chlamydia and gonorrhea transmission. The spatial patterns varied over time for both diseases. Further research should extend post-COVID-19 analysis to assess evolving relationships between residential segregation and STI incidence across U.S. regions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;What is already known on this topic: Chlamydia and gonorrhea in 2023 were the most reported sexually transmitted infections in the United States, disproportionately affecting Black Americans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What this study adds: &lt;/strong&gt;This study found that residential segregation was associated with race-specific differences in chlamydia and gonorrhea transmission, especially during the COVID-19 pandemic.How this study might affect research, practice or policy: Study findings suggest that interventions aiming to reduce chlamydia and gonorrhea inc","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3594"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female homicides in Brazil before and during the COVID-19 pandemic: an interrupted time-series analysis.","authors":"Karen Raquel Ferreira do Nascimento, Rafael Tavares Jomar, Glauber Weder Dos Santos Silva, Eder Samuel Oliveira Dantas, Karina Cardoso Meira","doi":"10.1186/s12889-025-24814-6","DOIUrl":"https://doi.org/10.1186/s12889-025-24814-6","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has influenced violence against women worldwide, but its impact on female homicides in low- and middle-income countries remains poorly understood. Brazil, which records some of the highest female homicide rates globally, provides a critical setting to examine this association. This study assessed the temporal association between the pandemic and monthly female homicide rates in Brazil from January 2017 to December 2022.</p><p><strong>Methods: </strong>We applied an interrupted time series (ITS) design with quasi-Poisson regression to estimate changes in homicide levels and trends after the pandemic onset, adjusting for serial autocorrelation and seasonality. Pre-pandemic trend linearity was tested, and sensitivity and placebo analyses were performed. To address underreporting and deaths classified as undetermined intent, homicide counts were corrected for misclassification.</p><p><strong>Results: </strong>From 2017 to 2022, 23,727 female homicides were recorded, corresponding to an adjusted mortality rate of 5.09 per 100,000 women, a 16.0% increase after correction. Rates were highest in the North and Northeast. Domestic homicides exceeded those in public spaces (1.50 vs. 1.37 per 100,000 women), and firearms were the predominant method. The Northeast showed a significant level change with an abrupt increase (RR = 1.236; p = 0.002), followed by a progressive decline (RR = 0.9923; p < 0.001). In other regions, across age groups, and in blunt-related cases, no significant level change occurred (p > 0.05), although downward trends emerged during the pandemic (p < 0.05).</p><p><strong>Conclusions: </strong>Findings warrant cautious interpretation due to ITS constraints, sensitivity to the observation window, and omitted variables. Nonetheless, persistently high female homicide rates in Brazil, particularly in the Northeast, highlight the need to strengthen mortality surveillance, improve misclassification corrections, and adopt region-specific prevention strategies, including firearm control, protective services, and targeted social policies.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3597"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and associated factors of cigarette smoking among medical students in 2020: a cross-sectional study from a North African country.","authors":"Imen Zemni, Maha Abbes, Syrine Doghri, Meriem Kacem, Amani Maatouk, Cyrine Bennasrallah, Wafa Dhouib, Behaeddin Garrach, Houcine Azaza, Hela Abroug, Manel Ben Fredj, Inès Bouanene, Fouzia Trimeche, Asma Sriha Belguith","doi":"10.1186/s12889-025-23009-3","DOIUrl":"https://doi.org/10.1186/s12889-025-23009-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to describe patterns of cigarette smoking and to determine its associated factors among medical students in the university of Monastir, Tunisia.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire. We collected data on the students' smoking status, age of first cigarette use, intention to quit smoking and the level of nicotine dependence among smokers. Chicha, e-cigarette, alcohol, cannabis use and other addictive behavior were also investigated through the questionnaire. A multivariate logistic regression model was employed to identify associated factors with cigarette smoking. The threshold of statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>A total of 748 students participated in this study. Of all respondents, 12.6% (95% CI [10.22-14.98]) consumed at least one form of tobacco. The prevalence of cigarette smoking was 10.7% (95%CI [8.5-12.9]). Male sex (aOR = 5.12; 95%CI [2.39-10.99]), living alone or with colleagues (aOR = 3.90; 95%CI [1.49-10.23]), alcohol consumption (aOR = 20.03; 95%CI [8.66-46.32]) and a high stress level (aOR = 3.22; 95%CI [1.08-9.61]) were found to be independently associated with cigarette smoking. Conversely, smartphone addiction (aOR = 0.34; 95% CI [0.14-0.82]) was identified as being inversely associated with cigarette smoking.</p><p><strong>Conclusion: </strong>This study highlights a considerable prevalence of tobacco use among students. While several well-known factors were associated with cigarette smoking, an inverse association with smartphone addiction emerged as a novel finding. These results may help inform targeted interventions to address this public health concern among medical students.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"3599"},"PeriodicalIF":3.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}