Alcohol and Tobacco Use Among Undergraduate and Postgraduate Medical Students in India: A Multicentric Cross-sectional Study

Nidhi Goel, Vivek Khandelwal, Kapil Pandya, Atul Kotwal


Background: Substance use among medical fraternity is a well-known phenomenon among both undergraduate (UG) and postgraduate (PG) medical students. Yet, there have been very few multi-centric studies to estimate the actual burden of this problem in this important population group in India. This study was conducted to estimate the prevalence of alcohol and tobacco use, assess the knowledge and attitudes towards this issue, and identify factors associated with substance use among UG and PG medical students in India.

Methods: A pre-tested, self-report, anonymous questionnaire was administered to medical undergraduates and post graduate medical residents of eight medical colleges across India. This study used a convenience sample of medical colleges with random selection of study participants within each college for each group, UG and PG.

Results: Prevalence of alcohol and tobacco use among UG students was 16.6%, 95% CI [14.5, 18.9] and 8.0%, 95% CI [6.4, 9.6], respectively, whereas prevalence was 31.5%, 95% CI [26.3, 37.0] and 14.5%, 95% CI [10.7, 18.9], respectively for PGs. For both substances, males had a higher prevalence of use compared to females in both groups (p < 0.001). Positive family history of substance use (p < 0.001 for both groups) and early age of initiation (p = 0.011 for tobacco; p > 0.05 for alcohol) were associated with a greater difficulty to quit the habit. Over 90% of study participants felt that substance use adversely affected their skills and reported not using substances prior to managing their patients.

Conclusions: Since substance use is a relatively common phenomenon among UG and PG medical students in India, future prospective studies and interventions are required to better understand the pattern of substance use and reduce its prevalence. 


alcohol; tobacco; undergraduate medical students; postgraduate medical students; cross-sectional

Full Text:



Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: From medical students to doctors. Drug Alcohol Depend. 2001;64(3):265-270.

Domenighetti G, Tomamichel M, Gutzwiller F, Berthoud S, Casabianca A. Psychoactive drug use among medical doctors is higher than in the general population. Soc Sci Med. 1991;33(3):269-274.

Kumar P, Basu D. Substance abuse by medical students and doctors. J Indian Med Assoc. 2000;98(8):447-452.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV. Washington D. C.: American Psychiatric Association; 1994.

Holtman MC. Disciplinary careers of drug-impaired physicians. Soc Sci Med. 2007;64(3):543-553.

Baptista T, Uzcàtegui E. Substance use among resident doctors in Venezuela. Drug Alcohol Depend. 1993;32(2):127-132.

Ghosh S, Samanta A, Mukherjee S. Patterns of alcohol consumption among male adults at a slum in Kolkata, India. J Health Popul Nutr. 2012;30(1):73-81.

Neufeld KJ, Peters DH, Rani M, Bonu S, Brooner RK. Regular use of alcohol and tobacco in India and its association with age, gender, and poverty. Drug Alcohol Depend. 2005;77(3):283-291.

Murthy P, Manjunatha N, Subodh BN, Chand PK, Benegal V. Substance use and addiction research in India. Indian J Psychiatry. 2010;52(5):189-199.

Ramakrishna GS, Sankara Sarma P, Thankappan KR. Tobacco use among medical students in Orissa. Natl Med J India. 2005;18(6):285-289.

Seshadri S. Substance abuse among medical students and doctors: A call for action. Natl Med J India. 2008;21(2):57-59.

World Health Organization (WHO). Global Health Observatory: Prevalence of alcohol use disorders. 2012; Accessed July 8, 2012.

Agrawal A, Lynskey MT. Tobacco and cannabis co-occurance: Does route of administration matter. Drug Alcohol Depend. 2009;99(1-3):240-247.

Deepa M, Pradeepa R, Anjana RM, Mohan V. Noncommunicable diseases risk factor surveillance: Experience and challenge from India. Indian J Community Med. 2011;36(Suppl 1):S50-S56.

World Health Organization (WHO). Global Health Observatory: Prevalence of tobacco use. 2012; Accessed July 10, 2012.

British Medical Association. The Misuse of Alcohol and Other Drugs by Doctors. London: British Medical Association; 1998.

Ray R. The Extent, Pattern and Trends of Drug Abuse in India: National Survey. Ministry of Social Justice and Empowerment, Government of India & United Nations Office on Drugs and Crime, Regional Office for South Asia; 2004.

Boland M, Fitzpatrick P, Scallan E, et al. Trends in medical student use of tobacco, alcohol and drugs in an Irish university, 1973-2002. Drug Alcohol Depend. 2006;85(2):123-128.

Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. Lancet. 2005;366(9498):1744-1749.

Smith DR, Leggat PA. An international review of tobacco smoking among medical students. J Postgrad Med. 2007;53(1):55-62.



  • There are currently no refbacks.