Abstract

Background: Third-hand tobacco smoke (THS) refers to tobacco smoke residues that remain on surfaces and in dust and can be released back into the air. Exposure to THS has been linked to various pathological conditions. This study aims to assess medical students’ beliefs regarding third-hand smoke and their levels of nicotine dependence, and to examine the relationship between these variables.

Methods: This cross-sectional study was conducted with 684 medical students between November and December 2025. Data were collected via a face-to-face questionnaire covering sociodemographic characteristics, smoking behavior, the Turkish version of the Beliefs About Third-Hand Smoke Scale (BATHS-T), and the Fagerström Test for Nicotine Dependence (FTND). Statistical analyses included descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman’s correlation analysis.

Results: Of the participants, 53.7% were women, and the mean age was 22.44 ± 1.77 years. The prevalence of current smoking was 27.0%, while 12.3% of participants were former smokers. The mean total BATHS-T score was 36.61 ± 7.83, with female students and nonsmokers showing significantly higher scores (p<0.001). Among current smokers, the mean FTND score was 2.48 ± 1.86. A significant negative correlation was found between BATHS-T and FTND scores. Students with high third-hand smoke awareness (THSA) were more likely to avoid smoking in environments where children were present and to take protective measures.

Conclusion: Medical students’ awareness of third-hand smoke is above average and differs significantly by gender and smoking status. Greater awareness of third-hand smoke is associated with lower nicotine dependence. Educational interventions targeting awareness of third-hand smoke should be integrated into the medical curriculum to strengthen tobacco control efforts and promote healthier behaviors among future health professionals.

Keywords: third-hand smoke, nicotine addiction, medical students, tobacco control, health behavior

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Copyright and license

Copyright © 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

Saraç, İ. A., & Meydan, N. (2026). An assessment of beliefs regarding third-hand cigarette smoke and levels of nicotine dependence among medical students. Turkish Journal of Tobacco Control, 6(2), 99-113. https://doi.org/10.64511/TJTC.2026.55