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Objective@#To investigate the associations between smoking and literacy on health among 4-6 grade primary school students.@*Methods@#A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy.@*Results@#A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father’s education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level.@*Conclusions@#Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.
RESUMEN
Objective To study the smoking status and influence of the families on pupils regarding smoking-related knowledge,attitudes and behavior,in Shandong province.Methods A multi-stage stratified-cluster random sampling method was used to investigate 6 050 students and their families in 3 different cities.A self-administered anonymous questionnaire survey was conducted by trained investigators.Results The overall passive smoking rate at households of the pupils was 49.7％ in Shandong province and appeared the highest in separate families,followed by in re-organized families and multiple-generation families under the same roofs.Major smokers in the families were fathers and grandfathers,with 43.4％ of the fathers and 74.0％ of the grandfathers had smoking histories for more than 10 years.The main smoking places at home were "elsewhere" or in the "living room".Attempting and current smoking rates of the families were 7.7％ and 1.7％ respectively,significantly higher than those families with no smokers.There was significant difference in smoking associated behavior and attitude between pupils whose family members with smoking habits or without.Conclusion The status of smoking in the families of the pupil' s family was not optimistic in Shandong province,especially in the families of the male students.Since smoking status of the families played an important role on their children,it is necessary to explore suitable health education model to improve the smoking associated behaviors in the families.