Knowledge about and sources of smoking-related knowledge, and influencing factors among male urban secondary school students in Chongqing, China

Objectives: This study examined smoking-related knowledge, sources of smoking-related knowledge and its influencing factor among male urban secondary school students. Methods: We conducted a cross-sectional survey, using a self-administered questionnaire, among 1297 male secondary school students in municipal areas of Chongqing, China. Results: Non-smokers had a better knowledge of smoking hazards than smokers. Less than 20% of students knew that smoking can cause heart disease, peptic ulcer, and cerebral stroke. Sources of smoking-related knowledge differed between smokers and non-smokers, respectively: TV (76.5 vs. 76.7%), teacher (70.1 vs. 62.4%), social network (66.6 vs. 73.1%), parents (57.0 vs. 59.2%), newspaper (55.4 vs. 61.6%), and friends (37.7 vs. 33.9%). Non-smokers' hobbies of reading were significantly higher than smokers' (chi(2) = 11.5845, p = 0.0007). Smokers' hobbies of online games (chi(2) = 14.9106, p = 0.0001), and sports (chi(2) = 4.8609, p = 0.0275) were significantly higher than non-smokers'. Generalized estimating equations (GEE) found that students whose both father and mother smoke were unable to receive tobacco-related knowledge. GEE also found that students in high school, with affluent family economic condition and with an opposing attitude towards father smoking possessed a better smoking-related knowledge. However, male students with disagreement or neutral attitude towards friends smoking were negatively associated with the knowledge of smoking hazards. Conclusions: The findings of the present study suggest that a significant proportion of male secondary school students in urban Chongqing lack specific knowledge about smoking-related diseases. Targeted educational programs for secondary school students in China are needed to promote tobacco control and tobacco use reduction and cessation among students.