Journal of Community Health

, Volume 36, Issue 6, pp 966–974 | Cite as

Do Smoking Knowledge, Attitudes and Behaviors Change with Years of Schooling? A Comparison of Medical with Non-Medical Students in China

  • Min-Yan Han
  • Wei-Qing Chen
  • Xinguang Chen
Original Paper


This study aimed to compare the tobacco-related knowledge, attitudes and smoking behavior among Chinese medical and non-medical students across three grades from freshmen to juniors. Survey data were collected among 8,138 students using a paper-and-pencil questionnaire. Study findings indicate that compared to non-medical students, medical students in the sophomore and junior years reported significantly higher levels of knowledge regarding tobacco toxicants and tobacco-related diseases, and had stronger attitudes against smoking as personal rights and stronger attitudes in favor of smoking ban. The differences between medical and non-medical students remained after controlling for a number of covariates. However the prevalence rates of cigarette smoking were similar between medical and non-medical students across grades even after adjusted smoking initiation before entering college. Despite increases in tobacco related knowledge, approximately 40% of junior-year medical students did not recognize carbon monoxide as a toxicant from tobacco, and 30–40% of them were unknown of tobacco smoking as a risk factor for several diseases, including hypertension, stroke, and gastric ulcer. Findings of this study suggest the need for immediate action to enhance tobacco-related education in formal medical training in China to prepare future doctors for smoking prevention and to assist millions of smokers to quit.


Cigarette smoking College students Medical education China 



This work was supported by Chinese Medicine Board in New York (Grant #: CMB 00-729). The authors gratefully acknowledge the contributions of Zhang Cai-xia, Luo Yi-juan, and Deng Xue-qing for their dedicated work in assessing us for data collection.

Conflict of interest statement

None declared.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.The Sixth Affiliated HosptialSun Yat-Sen UniversityGuangzhouChina
  2. 2.School of Public HealthSun Yat-Sen UniversityGuangzhouChina
  3. 3.Pediatric Prevention Research CenterWayne State UniversityDetroitUSA

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