Possibility and predictors of successful cigarette purchase attempts by 201 primary school students in Guangzhou, China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the access to tobacco and exam the predictors of successful tobacco purchase attempts among Chinese minors.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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'.</p><p><b>CONCLUSION</b>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.</p>

Process evaluation on a health promotion model regarding smoking prevention among Chinese secondary school students / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the process of smoking prevention and control among Chinese adolescent with a model on health promotion in junior high school.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSION</b>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.</p>

Study on the determinants of 'signing agreements' to establish smoke-free homes among 2019 parents of the secondary school students / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the determinants of 'signing a agreement for establishing smoke-free homes' among the parents of secondary school students.</p><p><b>METHODS</b>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'.</p><p><b>RESULTS</b>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).</p><p><b>CONCLUSION</b>Changing parental cognition and attitude toward smoking was beneficial to promote parental participation in tobacco control campaign and to establish 'smoking-free homes'.</p>

Analysis on factors influencing the smoking behaviors among male secondary school students under the structural equation model / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the direct and indirect outcomes of influencing factors on smoking behaviors among adolescents.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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%).</p><p><b>CONCLUSIONS</b>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.</p>