Demographics

Table 1: Demographics
Characteristic	N = 60¹
Age	29.7 +/- 2.3
Sex
Female	18 (30.0%)
Male	42 (70.0%)
PGY
1	12 (20.0%)
2	12 (20.0%)
3	14 (23.3%)
4	12 (20.0%)
5	10 (16.7%)
Do not use nicotine products	21 (35.0%)
Have used nicotine in the past year	26 (43.3%)
¹ Mean +/- SD; n (%)

Nicotine

Table 2: Nicotine use among overall cohort
Characteristic	N = 60¹
Have used nicotine in the past year	26 (43.3%)
Have smoked cigarettes in the past year	8 (13.3%)
Have used a vape in the past year	23 (38.3%)
Have used dip in the past year	3 (5.0%)
Have used nicotine pouches in the past year	14 (23.3%)
¹ n (%)

Table 3: Nicotine habits among users
Characteristic	N = 26¹
Frequency of vape use
Daily or almost daily	2 (10.0%)
Less than daily, but at least once a week	3 (15.0%)
Less than weekly, but at least once in the last 30 days	4 (20.0%)
Occasionally, but did not use in the last 30 days	11 (55.0%)
Frequency of nicotine pouch use
Daily or almost daily	4 (33.3%)
Less than daily, but at least once a week	1 (8.3%)
Less than weekly, but at least once in the last 30 days	1 (8.3%)
Occasionally, but did not use in the last 30 days	6 (50.0%)
Started using nicotine
Before residency	17 (73.9%)
During residency	6 (26.1%)
Change in nicotine use during residency
Decreased	4 (17.4%)
Increased	15 (65.2%)
Stayed about the same	4 (17.4%)
Tried to quit nicotine
I have tried to quit 2 or 3 times	2 (9.1%)
I have tried to quit 4 or 5 times	1 (4.5%)
I have tried to quit 6 or more times	1 (4.5%)
I have tried to quit once	3 (13.6%)
No, I do not feel the need to quit	14 (63.6%)
No, I have never tried to quit but I feel that I should quit	1 (4.5%)
Planning to quit
After residency	7 (31.8%)
I do not anticipate quitting	7 (31.8%)
Longer than a year	3 (13.6%)
Within the next 30 days	2 (9.1%)
Within the next 6 months	2 (9.1%)
Within the next year	1 (4.5%)
Nicotine cravings in the past 30 days	9 (40.9%)
¹ n (%)

Table 4: Nicotine habits among users
Characteristic	N = 60¹
Does your frequency of nicotine use change based on your current service?
Yes	15 (60.0%)
No	10 (40.0%)
On which service do you use nicotine the most?
Trauma	14 (53.8%)
Joints	0 (0.0%)
Sports	0 (0.0%)
Hand	0 (0.0%)
Shoulder/Elbow	0 (0.0%)
Pediatrics	0 (0.0%)
Spine	0 (0.0%)
F&A	0 (0.0%)
Tumor	0 (0.0%)
No change	12 (46.2%)
¹ n (%)

Figure 1: Service with highest self-reported nicotine use

According to the CDC, 4.5% of US adults are e-cigarette/vape users. Our results demonstrate that 38.3% of surveyed orthopedic residents are e-cigarette/vape users, which represents a significantly greater proportion of users compared to general US adults (χ^2 = 32.0, p < 0.001).

Figure 2: Comparison of Vape Use Between US Adults and Orthopedic Residents

PGY dichotomized to junior/senior resident

Table 5: Nicotine use among overall cohort (PGY level dichotomized to junior/senior)
Characteristic	Level of Resident		p-value²
Characteristic	Junior, N = 38¹	Senior, N = 22¹	p-value²
Have used nicotine in the past year	20 (52.6%)	6 (27.3%)	0.056
Have smoked cigarettes in the past year	6 (15.8%)	2 (9.1%)	0.698
Have used a vape in the past year	17 (44.7%)	6 (27.3%)	0.180
Have used dip in the past year	2 (5.3%)	1 (4.5%)	>0.999
Have used nicotine pouches in the past year	10 (26.3%)	4 (18.2%)	0.473
¹ n (%)
² Pearson's Chi-squared test; Fisher's exact test

Table 6: Nicotine habits among users (PGY level dichotomized to junior/senior)
Characteristic	Level of Resident		p-value²
Characteristic	Junior, N = 20¹	Senior, N = 6¹	p-value²
Frequency of vape use			0.331
Daily or almost daily	2 (14.3%)	0 (0.0%)
Less than daily, but at least once a week	2 (14.3%)	1 (16.7%)
Less than weekly, but at least once in the last 30 days	4 (28.6%)	0 (0.0%)
Occasionally, but did not use in the last 30 days	6 (42.9%)	5 (83.3%)
Frequency of nicotine pouch use			>0.999
Daily or almost daily	2 (25.0%)	2 (50.0%)
Less than daily, but at least once a week	1 (12.5%)	0 (0.0%)
Less than weekly, but at least once in the last 30 days	1 (12.5%)	0 (0.0%)
Occasionally, but did not use in the last 30 days	4 (50.0%)	2 (50.0%)
Started using nicotine			0.279
Before residency	14 (82.4%)	3 (50.0%)
During residency	3 (17.6%)	3 (50.0%)
Change in nicotine use during residency			0.776
Decreased	3 (17.6%)	1 (16.7%)
Increased	10 (58.8%)	5 (83.3%)
Stayed about the same	4 (23.5%)	0 (0.0%)
Tried to quit nicotine			0.300
I have tried to quit 2 or 3 times	0 (0.0%)	2 (33.3%)
I have tried to quit 4 or 5 times	1 (6.2%)	0 (0.0%)
I have tried to quit 6 or more times	1 (6.2%)	0 (0.0%)
I have tried to quit once	2 (12.5%)	1 (16.7%)
No, I do not feel the need to quit	11 (68.8%)	3 (50.0%)
No, I have never tried to quit but I feel that I should quit	1 (6.2%)	0 (0.0%)
Planning to quit			0.581
After residency	4 (25.0%)	3 (50.0%)
I do not anticipate quitting	6 (37.5%)	1 (16.7%)
Longer than a year	3 (18.8%)	0 (0.0%)
Within the next 30 days	1 (6.2%)	1 (16.7%)
Within the next 6 months	1 (6.2%)	1 (16.7%)
Within the next year	1 (6.2%)	0 (0.0%)
Nicotine cravings in the past 30 days	7 (43.8%)	2 (33.3%)	>0.999
¹ n (%)
² Fisher's Exact Test for Count Data with simulated p-value (based on 2000 replicates); Fisher's exact test

Alcohol

Table 7: Alcohol use among overall cohort
Characteristic	N = 60¹
Frequency of alcohol use over the past year
Nearly every day	1 (1.9%)
Once a week	10 (19.2%)
2 times a week	16 (30.8%)
3 to 4 times a week	8 (15.4%)
Once a month	5 (9.6%)
2 to 3 times a month	10 (19.2%)
3 to 6 times in the last year	1 (1.9%)
None	1 (1.9%)
Average drinks per week	3.5 +/- 2.5
Drinks per day of drinking
1	4 (8.5%)
2	20 (42.6%)
3	12 (25.5%)
4	7 (14.9%)
5	1 (2.1%)
6	1 (2.1%)
7	1 (2.1%)
8	1 (2.1%)
Frequency of 6+ drinks in a day
Weekly	1 (2.0%)
Monthly	21 (42.0%)
Less than monthly	19 (38.0%)
Never	9 (18.0%)
Change in frequency of alcohol use during residency
Decreased	25 (51.0%)
Stayed about the same	18 (36.7%)
Increased	6 (12.2%)
Change in frequency based on service
No	44 (89.8%)
Yes	5 (10.2%)
¹ n (%); Mean +/- SD