Self-esteem, Self-efficacy, and Smoking Prevalence: A Cross-sectional Study Among Military and Civilian Medical Students

"Background: The prevalence of smoking among students is a growing concern, particularly among medical students. Being associated with stress, competitiveness, and various social influences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to student’s well-being and academic performance outcomes. We aimed to investigate the relationship between self-esteem, self-efficacy, and smoking habits among medical students and their sociodemographic correlates. Methods: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. Results: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male students having slightly higher scores than female students on self-esteem and self-efficacy, military students had higher self-esteem scores than civilians with physical activity having a positive correlation with non-smoking behavior. Conclusion: According to our results, selfesteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions empowering students towards an overall better quality of life, addressing, among others, smoking behaviors."