Behavioral aspects of cigarette smoking among industrial college men of Shanghai, China.

A questionnaire survey was conducted among 7,665 students and staff in the factory-operated industrial colleges in Shanghai, China. Response rate was 95.7 per cent. The proportion of smokers among the men was 50.5 per cent; only 0.33 per cent of the women reported they were smokers. Male smokers began smoking upon entering the work force, where social interaction encourages cigarette smoking. Seventy per cent of the male smokers smoked fewer than 10 cigarettes per day. Only 4.3 per cent perceived themselves as very addicted; 3.4 per cent reported they had no confidence in their ability to control the amount they smoke. The Chinese smokers are more likely to succeed in giving up cigarette smoking for at least one day, as well as for longer periods, compared to US smokers. The number of cigarettes smoked may be related to the individual's purchasing power. For China, strategic timeliness in legislative action and education is urgently needed to combat the high prevalence of cigarette smoking in males, at extremely high risk.     

Effect of medical education on smoking behaviour

At Manchester University medical students (n = 658) had more knowledge than law students (n = 245) about the hazards of smoking, were more convinced by the relevant evidence, and assessed the risk to health more highly. However, there was no significant difference in their smoking behaviour. Among medical students 61% were non-smokers, 10% ex-smokers, and 29% smokers, of whom three-fifths smoked regularly. During their training they were more likely to start smoking than to give it up, and more likely to increase their consumption than decrease it. Expansion of smoking occurred especially in the early years of the course, whereas the main increase in knowledge was in the clinical period. Students' knowledge and their opinion of the evidence were related to their stage of education, whereas their assessment of the risk was linked with their smoking behaviour. Expansion of smoking at medical school may be forestalled by providing information about the hazards as early as possible, although some smokers will continue the habit irrespective of knowledge.     

Smoking: How medical students see thedoctor''s role

To examine their view of the doctor's role in relation to smoking and how it is influencedboth by their medical training and their own smoking behaviour, a postal questionnaire was sent to 1163 medical studients at Manchester University, of whom 1112 replied (96%). Only a small minority of students were themselves cigarette smokers (17%) but they were poorly informed about the smoking behaviour of their future profession. Nearly half were not aware that doctors are less likely to be smokers than the general public and only four in 10 were able to estimate accurately the proportion of cigarette smokers among teaching staff. Students were almost unanimously agreed that it was appropriate for a doctor to advise a pregnant woman, a chronic bronchitic or a patient with a history of myocardial infarction not to smoke, but only seven in 10 took this view about a healthy young man. Nevertheless, they increasingly saw the relevance of the preventive approach as they progressed through their education, although smokers were less likely to do so. The smoking behaviour of patients was seen to be an important concern for the doctor and this opinion, uninfluenced by their own smoking behaviour, grew stronger as students progressed through their course. However, they were more equivocal in their view of the implications of the professional role for private behaviour, particularly the smokers among them. Thus most students were aware of the potential influence of a doctor's smoking behaviour but just under two-thirds took the next step of accepting the professional responsibility to set a good example, and seven in 10 regarded it ultimately as a purely personal decision.     

护理专业学生控烟知识、态度、行为及控烟需求调查

目的 了解护理专业学生的控烟现状和需求,为在护理专业学生中开展控烟工作提供科学依据。方法 采用整群抽样的方法,对重庆市主城2所公立医学高等学校的5 382名在校护理专业学生进行问卷调查。结果 护理专业学生现在吸烟率4.3%,尝试吸烟率为22.6%,未来有吸烟意向者为13.2%;男生和女生吸烟行为有统计学差异。44.7%的护理专业学生否认低焦油、低尼古丁烟对身体危害小;14.3%知晓网吧应禁烟,11.3%知晓酒吧应禁烟。92.1%的学生反对恋人吸烟,85.3%的学生认为护理人员应该主动为病人提供戒烟服务。28.7%的学生向身边的人交流过烟草对健康的影响,45.2%学生劝过他人不吸烟。8.1%人表示在他们的劝说下,吸烟者戒烟了。护理专业学生获取控烟知识主要(73.3%)通过新闻媒体,75.4%的学生希望通过控烟教育获取戒烟方法相关知识。结论 护理专业学生的控烟相关知识知晓率低,参与控烟的积极性不高,建议对护理专业学生加强控烟责任感教育的同时,开展形式多样的控烟知识和技能培训。     

Smoking patterns at a British and at an American medical school

Cigarette smoking among medical students at the University of Bristol (Bristol) and the New York University School of Medicine (NYU) was investigated and differences were subjected to statistical analysis.
At Bristol 34–6% and at NYU 14–3% of respondents classified themselves as regular smokers. Among students in the pre-clinical phase of training the difference between the number of smokers at Bristol and at NYU was not significant. At both schools more clinical students smoked than preclinical students, but only at Bristol did the difference between the number of smokers in the two grade levels reach statistical significance.
There are fewer heavy smokers (consumers of more than twenty cigarettes per day) among the pre-clinical students at Bristol than among preclinicals at NYU. In the clinical year, however, there were slightly (insignificantly) fewer heavy smokers at NYU while there were significantly more at Bristol.
Smokers at NYU acquired the habit at a somewhat earlier age than the smokers at Bristol.
The majority of students at both schools indicated that medical education had not influenced their decision to smoke or not to smoke.
Most smokers—more among the clinical than the pre-clinical students—reported that they were displeased with their habit and that they wished to give it up. Somewhat fewer smokers at Bristol gave that response than students at NYU.
Factors contributing, at least in part, to the differences between smoking patterns observed may be variables of age and years of education.
The widely held but untested belief that precept and example by medical school teachers may be a potent force for modifying the smoking behaviour of health professionals, is in need of research.     

A comparison of smoking behaviors among medical and other college students in China

A survey of students' smoking in China (n = 1896), comparing medical students with college students in non-medical majors, was carried out to determine whether a medical education has a preventive effect on smoking uptake. The survey, sampling students from 12 universities in three cities, found no significant differences between medical and non-medical students in smoking prevalence (40.7% versus 45.1% for males, 4.4% versus 6.0% for females), in 'ever smoked' groups, in 'ever smoked 100 cigarettes' groups or in years of smoking. For both student groups, smoking prevalence increased with age and with years of college. However, one significant difference was found among the smokers: medical students were more likely to be occasional smokers than were non-medical students (75.3% occasional smokers among medical students who smoked versus 60.6% among non-medical students). These results suggest that a medical education had little effect on these students' decisions to smoke, but that it may have modified their consumption level. Future studies are needed to ascertain factors affecting the decision to smoke and to identify possible early adopters of a non-smoking culture in China. Action on a societal level is urgently needed to change Chinese social norms regarding smoking.     

Personality scores and smoking behaviour. A longitudinal study.

The personality scores at 16 years of age of 2753 people, all members of the National Survey of Health and Development, were related, in a follow-up study, to cigarette smoking behaviour in their young adult years. Survey members who recorded high neuroticism scores were found to be more likely to smoke than those with low scores and, among the smokers, deep inhalers formed the most neurotic group. Extraverts were more likely to smoke than introverts, the mean extraversion score being greatest for the male smokers with a high daily consumption of cigarettes. The personality scores were found to have some power in predicting changes in smoking behaviour. Neurotics and extraverts who had not started to smoke by the time of completing the personality inventory at 16 were more likely than the stable and introverted to take up the habit subsequently. Among survey members who were regular smokers at the time of completing the personality inventory the proportion giving up smoking by the time they reached the age of 25 years was related to consumption level recorded at 20 years and the personality scores recorded at 16, stable extraverts among the men being most likely to stop smoking.     

某医科大学学生吸烟现状及其影响因素

目的了解医学院在校大学生的吸烟现状及其影响因素,为制定有效的控烟措施提供依据。方法采取分层随机抽样方法,对中国医科大学500名在校大学生进行问卷调查。收回有效问卷496份,有效率99.2%。结果被调查的496名医学生的现在吸烟率为6.5%。男生的现在吸烟率明显高于女生(χ2=30.799,P=0.000)。低年级与高年级本科生的现在吸烟率无明显差异,且均明显低于研究生(χ2=7.738,P=0.021)。被调查的32名现在吸烟者平均每日吸烟量为(6.31±2.45)支,平均起始吸烟年龄为(18.01±3.15)岁。好友吸烟人群的现在吸烟率明显高于好友不吸烟人群(χ2=198.948,P=0.000)。父母吸烟人群的现在吸烟率明显高于父母不吸烟人群(χ2=89.271,P=0.000)。医学生对吸烟与疾病关系的认知率较高,医学生吸烟的主要原因是心理压力。结论医学生的吸烟现状不容乐观,应积极采取有效措施控制医学生的吸烟行为。     

Tobacco smoking habits,attitudes and beliefs among nurse and medical students in Tuscany

In this study we evaluated the smoking habits, beliefs and attitudes of nurse and medical students at the University of Siena and Florence, Italy. Students who entered the 1st year of school in 1998 were asked to complete a self-administered anonymous questionnaire. Two hundred medical students completed the questionnaire; they had a mean age (±SD) of 19.8 ± 1.7 years and 68% were females. A total of 205 nurse respondents answered to the questionnaire; they had a mean age of 21.8 ± 4.1 years and females were 83% of the total. The overall response rate among students always remained higher than 85%. Thirty per cent of medical students were current smokers, and 5% former-smokers. A total of 43% of nurse students were current smokers and 11.5% former-smokers. Nurse students were more likely to smoke than medical students (p= 0.001). Among current smokers, the number of daily cigarettes smoked and the degree of nicotine addiction did not differ between groups. The prevalence of maternal smoking were higher among nurse students. In spite of students' beliefs the knowledge about smoking remained generic in both groups. Nurse students were less aware than medical students of their special responsibility towards people about tobacco smoking. Such a difference remained significant also after adjustment for smoking status (p< 0.01). Students overestimated the prevalence of current smokers among health caregivers of the local hospitals, and Italian people and adolescents. Targeted and continuous training about smoking prevention should be mandatory in Italian medical and nurse schools.     

Cigarette smoking and stages of change among men and women in Kiev,Ukraine

BACKGROUND: Assisting current smokers to progress towards stopping smoking entails identifying their readiness to stop and understanding the factors that may influence their readiness. Relations were established between certain predictor variables (intensity of smoking, age at initiation, duration of smoking, and gender) and stages of readiness to change smoking behaviour in Kiev, Ukraine. METHODS: Analysis was based on a convenient sample of 536 current smokers who completed a stages-of-change questionnaire in a public square in the centre of Kiev's business district, between 22 and 25 July 2000. Frequency distributions, odds ratios, the Kolmogorov-Smirnov test and the Wilcoxon rank-sum test were used to summarize and describe the data. Tests of significance were based on the 0.05 level. RESULTS: The majority of participants (56.1%) were categorized as precontemplative. Less than 20% of the subjects were prepared for action to change smoking behaviour. Later age at smoking initiation was associated with fewer cigarettes smoked per day. Females were more likely then males to seriously consider cutting down the number of cigarettes they smoked. However, males were more likely to have intentionally quit smoking for at least one day within the past year. CONCLUSION: Information on stages of readiness to stop smoking provided by this study may be useful for improving the effectiveness of smoking cessation programmes in Kiev.     

Does parental smoking cessation discourage adolescent smoking?

BACKGROUND: We examined the relationship of smoking cessation in parents to smoking and uptake and cessation by their adolescent children. METHODS: We analyzed a cross-sectional sample of 4,502 adolescents, ages 15-17 years, who lived in two-parent households that were interviewed as part of the 1992-1993 Tobacco Supplement of the Current Population Survey, which questioned householders 15 years of age and older about their smoking history. Ever smokers reported smoking at least 100 cigarettes in their lifetime. Former smokers were ever smokers who had quit. RESULTS: Multivariate analyses, adjusted for demographic characteristics of adolescents, as well as father's age, education, and family income, found that adolescents whose parents had quit smoking were almost one-third less likely to be ever smokers than those with a parent who still smoked. Furthermore, adolescent ever smokers whose parents quit smoking were twice as likely to quit as those who had a parent who still smoked. Parental quitting is most effective in reducing initiation if it occurs before the child reaches 9 years of age. CONCLUSION: Encouraging parents to quit may be an effective method for reducing adolescent smoking, through decreased uptake and increased cessation. The earlier parents quit, the less likely their children will become smokers.     

Changes in the smoking behaviour, knowledge and opinion of medical students, 1972–1981

To examine changes in medical students' smoking behaviour, knowledge and opinion over the last decade, a survey first conducted at the University of Manchester Medical School in 1972 was repeated in 1981.A postal questionnaire was sent to 1163 students, of whom 1112 (96%) replied. A substantial decline in cigarette smoking among medical students has occurred. This largely follows trends in the general population, medical education itself having made little contribution to the change. In 1972, 29% of students were cigarette smokers compared with 17% in 1981. The fall in cigarette smoking was more marked among men students rather than women, older rather than younger students, clinical rather than pre-clinical students. Cigarette consumption had also decreased as had the use of cigars and pipes among male students. The decline was already evident prior to students beginning their medical studies. A smaller expansion of smoking experience at medical school had occurred among the 1981 students, but, as in 1972, those who took up smoking or increased their consumption exceeded those who gave up or cut down. In 1981 the likelihood of taking up smoking or becoming a regular smoker at medical school was somewhat greater for women students than for men, although the numbers concerned were small. The survey reconfirmed the importance of the social environment in smoking behaviour.Modest changes had occurred in knowledge and opinion about smoking. Both the accuracy and scope of knowledge of students about the health hazards increased between 1972 and 1981, particularly among clinical students, who remained considerably better informed than their pre-clinical colleagues. As in 1972, knowledge had little impact on smoking behaviour. By 1981 nine out of ten students regarded smoking as a major risk to health, both clinical students and smokers being more likely to take this view than in 1972. Almost all students, irrespective of their smoking behaviour, found the evidence linking smoking to serious illness to some extent convincing, and by 1981 a somewhat greater proportion, 60%, found it very convincing, the tendency to do so increasing as they progressed through their course.     

Risks of lung cancer, chronic bronchitis, ischaemic heart disease, and stroke in relation to type of cigarette smoked.

In a case control study of over 12 000 inpatients aged 35-74, risk of lung cancer, chronic bronchitis, and, particularly in those aged 35-54, ischaemic heart disease was positively associated with the number of manufactured cigarettes smoked daily and was negatively associated with long term giving up. Risk of stroke was not clearly related to smoking. Among manufactured cigarette smokers, lung cancer risk tended to be lowest in those who had always smoked filter cigarettes. This pattern was, however, evident only in men who additionally smoked pipes, cigars or handrolled cigarettes and in women, not being seen in men who smoked only manufactured cigarettes. Risk of lung cancer was not clearly related to time of switch to filter cigarettes. A markedly lower risk of chronic bronchitis was seen in men, but not women, who smoked filter rather than plain cigarettes. Heart disease risk did not vary by type of cigarette smoked 10 years before admission, but, compared with those who had never smoked filter cigarettes, those who had ever smoked filter cigarettes had a higher risk in men and a lower risk in younger women. Compared with the general population, markedly more controls were ex-smokers, suggesting incipient disease, whether or not smoking related, may alter smoking habits, thus affecting the interpretability of the findings. Control smokers were also relatively much more likely to report smoking plain cigarettes than expected. This comparison, not made in other studies relating risk to type of cigarette smoked, indicates that great care must be taken in verifying validity of reported smoking habits. While our findings are compatible with other evidence that risk of lung cancer and chronic bronchitis is probably reduced by switching from plain to filter cigarettes, they underline the difficulties in obtaining valid evidence from epidemiological studies.     

Influence of maternal active and passive smoking during pregnancy on birthweight in newborns

Many studies have documented a strong association of active smoking during pregnancy with fetal growth retardation. Increasing interest has also been focused on whether there is an association between exposure of pregnant women to environmental tobacco smoke (ETS) and low birthweight of their babies. In the intervention controlled study "Healthy Pregnancy--Healthy Child", mothers after delivery were interviewed by medical students who collected data about their smoking and nutrition. Students were also trained to stimulate non-smoking behaviour and to explain the risks related to smoking and exposure to ETS. Data from 1147 mothers after delivery were collected but only single births were included in the analysis of birthweight. In our study, 63.4% women never smoked and 32.2% women reported they had stopped smoking either before pregnancy or during the first trimester. Only 4.4% of mothers (n = 50) smoked during the whole pregnancy. Women with the history of smoking were exposed to ETS more often than mothers who never smoked (51.6% vs 17.4%; p < 0.001). The number of heavily exposed both at home and workplaces was more than twice higher among former smokers compared with never smokers (22.4% versus 9.4%, p < 0.01). The average birthweight of babies born to women who had stopped smoking was higher than that born to never smokers. The average birthweight of babies born to women who smoked during pregnancy was lower by 119 g and 171 g than that of the babies born to never smokers and former smokers, respectively. When pre-term neonates were excluded, differences in birthweight between babies born to never smokers and either formerly smoking or still smoking mothers were slightly lower. The greatest effect of ETS exposure on birthweight was recorded in never smoking mothers; an average reduction in birthweight was 88 g. A strong dose-effect was observed; in mothers heavily exposed to ETS both at home and at work, the babies' birthweight was lower by 189 g in comparison with the group of non-exposed, never smoking mothers and even by 70 g compared with mothers smoking during pregnancy.     

Smoking-related behaviour and attitudes among medical students in Alexandria

As a preliminary step toward incorporating a tobacco education and intervention program into our undergraduate medical curriculum, this study was designed to assess students' smoking-related behaviour, knowledge and attitudes towards tobacco, and perceptions of their future role as doctors in smoking intervention. A cross-sectional, study was conducted in the university year 2001/2002 on a representative sample of male medical students enrolled in 4th and 5th years at Alexandria University. A total of 320 students across the 2 years completed the survey. The smoking rate among medical students was 17.5% (10.9% smoked daily and 6.6% occasionally). The awareness of harmful effects of smoking and knowledge about the causal role of tobacco in the development of specific diseases were deficient. The intention to perform smoking intervention in the future as doctors seemed unsatisfactory. About 85% of the students thought that doctors should carry out smoking cessation advice depending on the disease, while the rate of those who thought so irrespective of the disease did not reach 44%. Current smokers thought less actively about smoking intervention than non-smokers. Nearly two-thirds of students (65.3%) felt they were not sufficiently prepared for caring or counseling smokers, and only 31.9% of students were convinced of the effectiveness of the doctor's advice to stop smoking. Seventy-seven and half percent of them desired specific training in smoking intervention. Non-smokers were more in favour of legislative actions to discourage tobacco use than current smokers. These findings suggest that medical school authorities should design and implement an appropriate basic training aimed at better preparing medical students for their future role in prevention of smoking. Specific teaching of medical students about smoking-related diseases and a patient-centered smoking cessation intervention is required to provide future medical practitioners with the knowledge and skills they need to effectively intervene with smokers.     

Do Dutch 11-12 years olds who never smoke,smoke experimentally or smoke regularly have different demographic backgrounds and perceptions of smoking?

BACKGROUND: Most adolescent smokers start smoking before the age of twelve. Little is known about the behavioural smoking determinants of Dutch primary school children. METHODS: A cross-sectional study was carried out on a sample of students from the final year of 143 Dutch primary schools. A total of 3700 students (mean age = 11.6 years) completed a questionnaire based on the ASE model, measuring the attitude, social influences and self-efficacy expectations concerning smoking. RESULTS: Students were categorized as never smokers (64.3%), experimental smokers (28.0%), and regular smokers (7.8%). Multinomial logistic regression analyses showed that never smokers were younger, and were more often female, religious and from two-parent families than experimental smokers. Never smokers perceived more disadvantages, long-term physical consequences, more negative social norms and less pressure regarding smoking, higher self-efficacy expectations towards non-smoking, and had fewer parents, siblings or best friends who smoked. Looking at differences between experimental and regular smokers showed that experimental smokers received less pocket money. They also perceived more disadvantages, fewer advantages, more negative social norms and less pressure towards smoking, higher self-efficacy expectations towards non-smoking, and were less likely to be surrounded by friends, peers, family or teachers who smoked. Generally, the low scores for physical consequences and risk perception regarding addiction were striking. CONCLUSIONS: Smoking prevention aimed at primary schoolchildren should consider the different smoking categories, with their specific motives and influences. For instance, the influences on smoking initiation of parents, siblings and best friends suggest more comprehensive programmes aimed at the entire family. Youngsters' ignorance of addiction needs more attention.     

Middle school students' sources of acquiring cigarettes and requests for proof of age.

OBJECTIVES: To identify where and how middle school students acquire cigarettes and to describe factors associated with being asked for identification during their purchase. METHODS: A modified version of the Centers for Disease Control and Prevention's Youth Risk Behavior Survey was administered to 2227 sixth- through eighth-grade students attending 53 randomly selected middle schools in North Carolina in 1995. Data were analyzed with Chi-square tests, Cramer V, Kruskal-Wallis nalysis of variance, and multiple logistic regression using the likelihood ratio approach. RESULTS: Of the students who had smoked during the previous 30 days, 497 (22.8%) were the focus of the analyses. Fifty-eight percent of current smokers were male and 69% were white. The most frequent source of cigarettes was borrowing (32.1%). Only 16.9% of the students had purchased cigarettes from a store, and 3.9% had purchased cigarettes from a vending machine. Females were more likely (p < .006) than males to borrow or to have someone else buy cigarettes for them. Males were more likely (p < .006) than females to buy cigarettes from a store or vending machine or to steal them. Students who purchased cigarettes from a store or vending machine were more likely (p < .032) than other smokers to be 21 year older than expected for their school grade. Among the 197 students who had purchased cigarettes during the previous 30 days, only 14.2% had been asked for proof of age. Students who acquired cigarettes from a store were more likely than students who acquired them by other means not to have been asked for proof of age; while having been asked for proof of age was associated with acquiring cigarettes by other means (V = .44, p < .0001). Having been asked for proof of age was associated with earlier age of onset of smoking (V = .34, p < .0001), greater number of smoking days, and number of cigarettes smoked per day (V = .35, p < .0001). When analyzed with multiple logistic regression, only earlier age of onset of smoking remained a significant correlate of not having been asked for proof of age. CONCLUSION: In North Carolina, it was easy for young adolescents to purchase cigarettes illegally, especially for more experienced smokers. However, being asked for proof of age forced these youth to acquire cigarettes using other methods, and this was associated with less smoking. Prevention efforts should include enforcing existing laws requiring youth to provide proof of age when attempting to buy cigarettes.     

Cigarette smoking behavioral distinctions between experimental nonadopters and adopters in children and adolescents--a consideration of transitional smoking experience: the Bogalusa Heart Study

A cigarette-smoking questionnaire to examine behavior, attitudes, and beliefs related to cigarette use was administered to children, ages 8-17, in a biracial community. Children who experimented with cigarettes but did not adopt the habit (experimental nonadopters) and children who continued to smoke (adopters) were identified and characterized. Follow-up behavior was examined 2 years later. Adopters were more likely to have smokers as friends and family members, more likely to have purchased their first cigarettes, more likely to believe smoking to be pleasurable for themselves and others, and less likely to consider smoking harmful. Adopters who maintained smoking behavior 2 years later had, during the initial survey, reported having more friends who also smoked and were more likely to believe smoking to be enjoyable. Experimental nonadopters were more likely to try the first cigarette alone, reported having fewer friends and family members who smoked, and believed greater health risks to be associated with cigarette use. Experimental nonadopters who maintained nonsmoking behavior 2 years later, especially in the older cohort, exhibited higher agreement with the negative consequences of cigarette smoking (health beliefs) and theories concerning smoking behavior of others.     

A survey of cigarette smoking among middle school students in 1988

A survey of the prevalence of smoking in middle school students aged 13-21 years in Harbin city, China, was undertaken in the Spring of 1988. A random sample of 4712 students was selected using proportional stratified clustering. A self-administered confidential questionnaire relating to smoking habits and certain family and school factors was administered. The results showed that 1.29% of the students (2.21% boys and 0.38% girls) smoked regularly, 5.62% (10.52% boys and 0.76% girls) were light smokers and 13.77% (24.29% boys and 2.92% girls) smoked only occasionally. Smoking habits were related to the type of school and to age, there being a higher proportion of smoking in senior grade students. Students were significantly more likely to smoke if they were male and if their siblings smoked. Prevalence of regular smoking was not related to parental occupation or family income. It is suggested that anti-smoking education in the school curriculum should be directed towards students in middle school.