{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:26:57Z","timestamp":1789043217824,"version":"build-2803163510"},"reference-count":41,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T00:00:00Z","timestamp":1709078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>The rising prevalence of electronic cigarette (e-cigarette) and hookah use among youth raises questions about medical trainees\u2019 views of these products. We aimed to investigate medical trainees\u2019 knowledge and attitudes toward e-cigarette and hookah use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>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%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.11042","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T14:25:15Z","timestamp":1702391115000},"page":"306-316","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Medical Trainees\u2019 Knowledge and Attitudes Towards Electronic Cigarettes and Hookah: A Multinational Survey Study"],"prefix":"10.1177","volume":"69","author":[{"given":"Fernando P","family":"Bruno","sequence":"first","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Helena","family":"Degani-Costa","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesava Lakshmi Prasad","family":"Kandipudi","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Gushken","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Szlejf","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B","family":"Tokeshi","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin F","family":"Tehrani","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kaufman","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pentapati Siva Santosh","family":"Kumar","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limalemla","family":"Jamir","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew GK","family":"Benesch","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morag G","family":"Ryan","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardeep","family":"Lotay","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P","family":"Fuld","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago M","family":"Fidalgo","sequence":"additional","affiliation":[{"name":"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 S\u00e3o Paulo\/Escola Paulista de Medicina, S\u00e3o Paulo, Brazil. Drs Degani-Costa and Ms Gushken are affiliated with the Hospital Israelita Albert Einstein \u2013 Faculdade Israelita de Ci\u00eancias da Sa\u00fade Albert Einstein, S\u00e3o 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, S\u00e3o 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..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Global Vaping Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Helena","family":"Degani-Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Gushken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Szlejf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Roberto","family":"Resende Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago M","family":"Fidalgo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza 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