Differences in students' smoking-related knowledge, attitudes, and behaviors among public, factory, and private secondary schools in Guangzhou, China

BACKGROUND: The prevalence of smoking among Chinese adolescents has dramatically increased in recent years. The purpose of this study was to examine the differences in smoking-related knowledge, attitudes, and behaviors among Chinese students in 3 types of secondary schools. METHODS: This cross-sectional study was conducted among 3957 students of seventh, eighth, and ninth grades and 2870 student parents from 3 public, 1 factory, and 2 general-paid private secondary schools at Guangzhou in 2004. Participants were asked to complete self-administered questionnaires about sociodemographic characteristics, smoking-related family and school environments, smoking-related knowledge and attitudes, and smoking behaviors. RESULTS: The average scores of students' smoking-related knowledge and attitudes (higher score, more against smoking) were highest in the factory school, followed by public schools and private schools. The differences among them were statistically significantly (P < .05). The lifetime smoking prevalence was also significantly different (P < .001) among 3 types of schools: 35.4% in private schools, 17.4% in public schools, and 13.2% in the factory school. The prevalence of students' weekly smoking was also higher in private schools (6.2%) than in public schools (4.9%) or the factory school (4.0%). Similar disparity was observed in the prevalence of daily smoking (3.9% private, 3.5% public, and 2.7% factory). However, differences in weekly and daily smoking were not statistically significant (P > .05). CONCLUSIONS: Compared with students in public and factory schools, those in general-paid private schools had poorer smoking-related knowledge, more supportive attitudes toward smoking, and more popular smoking behaviors. Therefore, more intensive smoking prevention programs should be implemented among them.