Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

BACKGROUND: Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. PURPOSE: This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. METHODS: Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. RESULTS: There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. CONCLUSIONS: Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

[Determinants of attempt and success in smoking cessation among male secondary school students].

OBJECTIVE: To investigate the prevalence of smoking cessation in schoolboys and the possibility of success, and examine the predictors of quitting attempt and success. METHODS: In a cross-sectional survey, self-administered questionnaires were answered by 4658 schoolboys to collect the information including their demographic characteristics, school conditions, smoking and health related knowledge and attitudes, and smoking related behaviors. RESULTS: Of the respondents, 7.6% were identified as regular smokers, and 68.6% of the regular smokers declared having tried to quit smoking in past twelve months but only 17.2% of them had succeeded in quitting. The two most popular motivations of quitting were "worrying about cigarettes harm to health" and "others persuading them to quit". Four influencing factors had significant association with the attempt to quit smoking, including ever having been persuaded to quit, health consideration, smoking mostly in bad mood, parents opposition of smoking. Concerning the possibility of success, ever having ever been exposed to anti-smoking propaganda predicted successful cessation while the boys who always smoked outside of schools tended to fail quitting. CONCLUSION: Most of the smoking adolescents have ever tried to quit although the possibility of success is quite low. It' s necessary and important to combine the power of schools, families and communities in helping adolescents quit smoking with suitable methods considering their physical and psychological characteristics.

Interaction between maternal passive smoking during pregnancy and CYP1A1 and GSTs polymorphisms on spontaneous preterm delivery.

OBJECTIVE: The present study aimed to examine the association between maternal passive smoking during pregnancy and the risk of spontaneous PTD and to explore the potential interaction of the single or joint gene polymorphism of CYP1A1 and GSTs with maternal passive smoking on the risk of spontaneous PTD. METHOD: We investigated whether the association between maternal passive smoking and PTD can be modified by 2 metabolic genes, i.e. cytochrome P4501A1 (CYP1A1) and glutathione S-transferases (GSTs), in a case-control study with 198 spontaneous preterm and 524 term deliveries in Shenzhen and Foshan, China. We used logistic regression to test gene-passive smoking interaction, adjusting for maternal socio-demographics and prepregnancy body mass index. RESULTS: Overall, maternal passive smoking during pregnancy was associated with higher risk of PTD (adjusted odds ratio = 2.20 [95% confidence interval: 1.56-3.12]). This association was modified by CYP1A1 and GSTs together, but not by any single genotype. For cross-categories of CYP1A1 Msp I and GSTs, maternal passive smoking was associated with higher risk of PTD among those women with CYP1A1 "TC/CC"+ GSTs "null", but not among women with other genotypes; and this interaction was significant (OR = 2.66 [95% CI: 1.19-5.97]; P-value: 0.017). For cross-categories of CYP1A1 BsrD I and GSTs, maternal passive smoking was associated with higher risk of PTD only among those women with CYP1A1"AG/GG"+ GSTs "null", but not among women with other genotypes; and this interaction was significant (OR = 3.00 [95% CI: 1.17-7.74]; P-value: 0.023). CONCLUSIONS: Our findings suggest that the combined genotypes of CYP1A1 and GSTs can help to identify vulnerable pregnant women who are subject to high risk of spontaneous PTD due to passive smoking.

Associations of CYP2A6 genotype with smoking behaviors in southern China.

AIMS: To investigate the association of CYP2A6 genetic polymorphisms with smoking-related phenotypes in Chinese smokers. DESIGN: Case-only genetic association study. SETTING: Southern China. PARTICIPANTS: A total of 1328 Han Chinese smokers who participated in a community-based chronic disease screening project in Guangzhou and Zhuhai from 2006 to 2007. MEASUREMENTS: All participants answered a structured questionnaire about socio-demographic status and smoking behaviors and informative alleles were genotyped for the cytochrome P450 2A6 (CYP2A6) gene (CYP2A6*4,*5,*7,*9 and *10). FINDINGS: The frequencies of CYP2A6*4, *5, *7, *9 and *10 alleles were 8.5, 1.2, 6.3, 13.5 and 2.4%, which corresponded to 48.9, 15.4, 24.2 and 11.5% of participants being classified as normal, intermediate, slow and poor metabolizers, respectively. Multivariate analyses in male smokers demonstrated that compared with normal metabolizers, poor metabolizers reported smoking fewer cigarettes per day [adjusted odds ratio (OR) = 0.49; 95% confidence interval (CI): 0.32-0.76], started smoking regularly later in life (adjusted OR = 1.55; 95% CI: 1.06-2.26) and, among former smokers, reported smoking for a shorter duration prior to quitting (adjusted OR = 0.33; 95% CI: 0.12-0.94). However, poor metabolizers were less likely to quit smoking and remain abstinent than normal metabolizers (adjusted OR = 0.54; 95% CI: 0.34-0.86). CONCLUSIONS: Reduced metabolism function of cytochrome P450 2A6 in smokers appears to be associated with fewer cigarettes smoked, later initiation of smoking regularly, shorter smoking duration and lower likelihood of smoking cessation.

[Possibility and predictors of successful cigarette purchase attempts by 201 primary school students in Guangzhou, China].

OBJECTIVE: To explore the access to tobacco and exam the predictors of successful tobacco purchase attempts among Chinese minors. METHODS: A simulative trial of purchasing cigarettes was participated by 201 sixth grade students to assess the prevalence of illegal cigarette sales to minors in Guangzhou. Methods of Chi-square and unconditional logistic regression were used to identify the significant predictors,with the result of tobacco purchase as the dependent variable and the characteristics of stores, retailers and minors as the independent variables. RESULTS: A total of 165 students succeeded in purchasing cigarettes but 36 failed, and the percentage of successful purchase attempts was 82. 1% . Data from univariate analysis indicated that 9 factors were significantly associated with students' success in purchasing cigarettes. They were age and height of the purchasers, types of stores, seller's gender and age, posting cigarette advertisements,showing warning signs of 'no cigarette selling to minors' ,asking buyer's age,and asking whom you buy the cigarettes for. The results of multivariable analysis showed that only three variables entering the final logistic regression: the age of students, the type of stores, and showing warning signs of 'no cigarette selling to minors'. CONCLUSION: Chinese minors have easy access to purchasing cigarettes, especially in groceries and small markets. Selling cigarettes by sellers to minors should be monitored and managed in the future.

[Study on the determinants of 'signing agreements' to establish smoke-free homes among 2019 parents of the secondary school students].

OBJECTIVE: To explore the determinants of 'signing a agreement for establishing smoke-free homes' among the parents of secondary school students. METHODS: 2019 parents were surveyed with self-administered questionnaires on their socio-demographic characteristics, smoking behaviors, attitude toward tobacco control at home and related data of their children. At the same time, parents were asked to sign an agreement for making the 'home as smoking-free'. 'Parents signing the agreement' was defined as dependent variable (0=no, 1=yes), and parent's age, gender, educational level, etc. were defined as independent ones. Multi-variant logistic regression analysis was conducted for identifying the determinants of the parents to sign an agreement for establishing 'smoking-free homes'. RESULTS: Of the 2019 surveyed parents, 1047 (51.86%) had signed the agreement including 49.25% of the fathers and 55.73% of the mothers. The results from multi-variant logistic regression analysis indicated that father's 'signing action' was significantly associated with (a) their intention of carrying out the agreements (OR = 3.37), (b) to teach their children about the consequence between smoking and health (OR = 2.10), (c) knowing tobacco control program at school (OR = 1.38), (d) reading tobacco control material provided by school (OR = 1.38), (e) being current smoker (OR = 0.53) compare to that the mother's 'signing action' was significantly associated to (a) intention to carrying out agreements (OR = 2.36), (b) teaching children not to smoke (OR = 2.22), (c) reading tobacco control material provided by school (OR = 1.57). CONCLUSION: Changing parental cognition and attitude toward smoking was beneficial to promote parental participation in tobacco control campaign and to establish 'smoking-free homes'.

[Process evaluation on a health promotion model regarding smoking prevention among Chinese secondary school students].

OBJECTIVE: To evaluate the process of smoking prevention and control among Chinese adolescent with a model on health promotion in junior high school. METHODS: A cluster-randomized, controlled and schooled-based trial on smoking prevention was conducted among 2343 students at four secondary schools in Huangpu District of Guangzhou. Students 'reports and investigators' daily records were used to evaluate the intervention measures. RESULTS: During the one-year period of intervention (Dec. 2004 through Dec. 2005), eighteen activities had been implemented among students, teachers, parents and cigarette retailers. Ranked by the rate of awareness, the top six activities were shown as follows: "the nicotine toxicity experiment" (90.7%), "agreement of building families free of smoking"(77.7%), "a letter to parents" (77.1%), "no-smoking signs" (76.5%), "Blackboard information about health and smoking" (75.0%), and "signature on the 18th World Day of No Smoking" (70.2%). Among all the activities, "the nicotine toxicity experiment" had the highest rate of participation (88.5%), followed by "a letter to parents" (73.6%), "agreement of building families free of smoking" (69.8%), "health education through experiments"(68.6%), "health education through multimedia" (65.7%) and "signature on the 18th World Day of No Smoking" (65.6%). The top seven activities in which students showed greatest interests were "the nicotine toxicity experiment" (64.5%), "signature on the 18th World Day of No Smoking" (33.0%), "health education through experiments" (31.2%), "health education through multimedia" (29.8%), "class meetings with a thesis of smoking" (26.8%), "health pamphlets" (26.6%), "specific textbooks" (25.9%). The extent of students' general satisfaction to the work of tobacco control in school during the last year was 52.4%. The biggest perceived shortcoming for the intervention plan was the low participation of students. CONCLUSION: Some intervention measures had not been fully carried out among the students and only covered part of them. It is necessary to adjust the previous intervention measures through keeping the nicotine toxicity experiment, health education through multimedia and other measures with extensive participation of students and at the same time, to avoid literal materials, exhibition boards and traditional single-way health education program.

[Analysis on factors influencing the smoking behaviors among male secondary school students under the structural equation model].

OBJECTIVE: To analyze the direct and indirect outcomes of influencing factors on smoking behaviors among adolescents. METHODS: Self-administered questionnaires were used to collect smoking-related information from 2021 respondents. Measurement models were built by confirmatory factor analysis and parameters were estimated by ERLS method. The final structural equation model was determined by comprehensive evaluation and necessary modification. RESULTS: Three latent variables were extracted from 10 manifest variables of environment, while only one latent variable was identified from 9 manifest variables of attitudes. The goodness of fit for the structural equation model was satisfactory that all indices had met corresponding requirements. The final model could explain 38.8% of the variance of smoking behaviors. Four factors (smoking environment, smoking restriction from parents and teachers, determination of cigarette refusal and attitudes toward smoking) were directly affecting the smoking behaviors, while another three factors (grade, health knowledge and school environment) had indirect impacts. According to the percentages of their contribution, the risk factors were ranked as follows: smoking environment (45.76%), attitudes toward smoking (19.88%) and grade at school (0.44%). Similarly, the top protective factor were: determination of cigarette refusal (16.61%), followed by smoking restriction from parents and teachers (10.51%), health knowledge (3.89%) and school environment (2.92%). CONCLUSIONS: Heath knowledge had minor effect on smoking in adolescents but could indirectly affect their smoking behaviors through changing their belief. Grade at school had a doubled influence on smoking, but mainly served as a risk factor. Tobacco control measures for adolescents should not only be limited to health education but environment factors as well.