Introduction:
We aimed to determine the smoking prevalence and related factors among 1,2,3 and 6th grade students at Ege University Faculty of Medicine.

Methods:
This cross-sectional survey was a part of a multi-centre study throughout Turkey and the data were collected in May-June 2018. The target group of this study was 1537 medical students studying in the first, second, third and sixth grades. Questionnaires were applied to 1040 students (67.7%) who agreed to participate in the study. The coverage was 94.5%, 78.6%, 57.4%, 36.7% for the first, second, third and sixth grades, respectively.

Results:
The overall prevalence of smoking was 18.4%, with 18.1%, 18.6%, 17.0% and 22.1% in the first, second, third and sixth grades, respectively. The mean age at starting to smoke was 16.5±2.3 yrs (min.8, max.23). Current smoking was more prevalent in males compared to females (24.3% vs. 11.7%, p<0.001). Among current smokers, 27.4% had started smoking during medical school. The most common reasons for starting to smoke were the effects of close friends (37.1%) and stress (19.2%). Current smokers spend 201±139 Turkish Liras (min.0, max.800) monthly for cigarettes. Among smokers, 60.4% have tried to quit smoking at least once, and 78% of them thought of smoking cessation. Among e-cigarette users, 93.6% were ever-smokers. According to univariate analyses; male students, students whose parents, partners or best friends were ever-smokers, students living alone and the ones who have smoked hookah at least once have significantly higher prevalence of being ever-smokers compared to their counter-parts. In multivariate analyses; having the hookah use (OR:12.4), living alone at home (OR:3.4), partner (OR:2.3) or best friend (OR:1.9) smoking, and were found to be independent risk factors related to being an ever-smoker.

Conclusions:
The present study shows that the prevalence of smoking in especially male medical students was high (24.3%) in Turkey, and nearly one third of the students started smoking during medical faculty. Therefore, there is a need to include intensive education programs regarding smoking-related health problems and smoking cessation at an early stage in the medical curriculum.