The Investigation Of Tobacco Use Among Medical College Students And The Evaluation Of Intervention Effect

Objective:To explore the current situation of tobacco use and tobacco-related knowledge,attitudes and behaviors of students in a local medical college and a military medical college in Xi'an.To discusses the influence of intervention measures on the current situation of tobacco use of medical students and tobacco-related knowledge,attitudes and behaviors,providing scientific data for the deployment of tobacco control policies and implementation of effective tobacco control propaganda.Methods:1.Cross-sectional study:students in military medical college were all included ascluster samplingand students from local medical collegewere proportional sampled(12%of all students).2.Intervention study:the subjects were the first year students of the military medical college and the public health department students of the local medical college.The subjects were numbered in class,and were randomly divided into general intervention group and intensive intervention group.The general intervention group received education of tobacco-related knowledge for only once,and the strengthened intervention group received the education for twice.3.The baseline data of tobacco use,tobacco-related knowledge,attitudes and behaviors of college students were obtained through anonymous self-filling questionnaire.Data integrity and logical review were conducted by random sampling of 10%of the questionnaires.4.Take Foxpro6.0 to establish a database and a double entry,SPSS20.0 software for data processing,statistical methods using descriptive analysis,x~2 test,t test,analysis of variance,and Logistic regression,P<0.05 for the difference was defined as statistically significant.Results:1.Results of baseline surveyIn the aspect of smoking status and influence factors of smoking,the rate of the students in a local medical college in Xi'an who have tried to smoke rate is 25.20%,and current smoking rate was 6.15%.The current smoking rate was 15.76%for boys and 1.73%for girls.The smoking rate of college students who have tried to smoke in a military medical university in Xi'an was 38.31%,and the current smoking rate was 10.92%.The current smokingrate of boys and girls were 11.72%and 2.46%,respectively.Analysis showed that the current smoking rate of male students in local medical colleges was 15.76%(67/425)higher than 1.73%(16/924)of female students(P<0.01).Current smoking rate of college students whose pocket money more than or equal to 1000 yuan per month was 10.38%(19/183)higher than 5.49%(64/1166)of college students whose pocket money less than 1,000 yuan per month(P<0.05).The current smoking rate of grade two and grade three were 8.17%(51/624)and 8.00%(18/225)higher than that of grade one and grade four current smoking rates 2.92%(12/411)and 2.25%(2/89)(P<0.01);The current smoking rate of 4-year students was 7.80%(40/513)higher than 5.14%(43/836)of 5-year students(P<0.05).The current smoking rate of the only child was 9.89%(35/354)higher than 4.82%(48/995)of non-only children(P<0.01).The current smoking rate of students in small and medium-sized cities and above was 11.74%(33/281)higher than that of in county cities and below 4.68%(50/1068)(P<0.01).The current smoking rate was 10.21%(24/235)of the students whose fathers have a bachelor degree or above,higher than the students whose fathers have received a high school education or below with the smoking rate of 5.30%(59/1114)(P<0.01).The current smoking rate was 13.22%(23/174)of the students whose mothers have received a high school education or below higher than whose mothers have a bachelor degree or above with the smoking rate of 5.11%(60/1175)(P<0.01).The current smoking rate of male students in military medical colleges was 11.72%(153/1306)higher than that of female students 2.46%(3/122)(P<0.01).The current smoking rate of 4th and 5th grade students were 20.42%(49/240)and 14.38%(22/153)higher than that of grade one,grade two and grade three of 7.85%(19/242),6.84%(27/395)and 9.80%(39/398)(P<0.01);The current smoking rate of college students whose pocket money more than or equal to 1000yuan per month was 17.43%(38/218),which is higher than that of college students whose pocket money less than 1,000 yuan per month9.75%(118/1210)(P<0.01).The current smoking rate of the only one-child was12.70%(105/827)higher than that of non-only children 8.39%(50/596);the current smoking rate of students in small and medium-sized cities and above was 12.84%(90/701)higher than that of in county cities and below 9.10%(66/725)(P<0.05).The adjustment of gender,parents'educational background,family location factors such as multivariable logistic regression results showed that male,4-year course,being the only child,lower positive attitude score,the smoking of closed friends were major influencing factors of local medical colleges'smoking behavior;male,senior college,lower positive attitude score,being the only child,the smoking of closed friends were major influencing factors of military medical colleges'smoking behavior.Different characteristics of college students'knowledge,positive attitude and positive behavior score show that girls'scores were higher than boys'.Among them,the tobacco related-knowledge of local medical college girls'scores(20.33±4.87),positive attitude scores(13.67±2.21),positive behavior scores(8.76±1.73)which were higher than the score of boys'tobacco-related knowledge(19.25±6.72),positive attitude score(11.84±3.41),positive behavior score(7.16±2.38)(P<0.01).Tobacco-related knowledge of military medical college girls scores(22.75±3.77),positive attitude scores(13.66±2.49),positive behavior scores(9.21±1.86)which were higher than boys'tobacco related-knowledge score(20.53±6.26),positive attitude score(12.37±3.12),positive behavior score(7.91±2.29)(P<0.01).Tobacco-related knowledge scores of grade 2 and 3 students(20.82±5.22)and(20.60±5.37)higher than those of grade 1and 4(18.43±5.93)and(19.24±5.96)in the local medical college(P<0.01).The 4-year score(20.38±5.09)was higher than the 5-year(19.76±5.80)(P<0.05).The scores of other majors(20.28±5.38)was higher than that of the prevention and clinical specialties(19.94±5.92)and(19.16±5.69)(P<0.05).Tobacco-related knowledge scores of grade 4 students(22.17±5.37)were higher than those of other grade students(P<0.01).The number of students with a home location in small and medium-sized cities(21.21±5.78)was higher than those at the county level and below(20.24±6.41)(P<0.01).The score of the mother's bachelor degree and above(21.30±5.61)was higher than that of high school and below(20.44±6.33)(P<0.01).Local medical colleges students'positive attitude score(13.22±2.68)with home location in cities at the county level was higher than the students with home location in small and medium-sized cities(12.60±3.11)(P<0.01);The score of students with a father's degree in high school and below(13.18±2.66)was higher than those of the father with a bachelor's degree or above(12.66±3.29)(P<0.05).The score of students with a mother's degree in high school and below(13.22±2.64)was higher than those of mothers with a bachelor's degree or above(12.21±3.46)(P<0.01).The score of students whose pocket money less than 1,000yuan per month(13.17±2.73)was higher than those whose pocket money more than or equal to 1000yuan(12.61±3.05)(P<0.05).The Positive attitude score of military medical college students in grade 1(13.09±2.83),which was higher than the otheisr grades(P<0.01).Students whose pocket money of less than 1,000yuan(12.57±3.07)were higher than those whose pocket money more than or equal to 1000yuan(12.00±3.21)(P<0.05).The local medical college students positive behavior score of non-only children(8.35±2.05)was higher than that of only child(7.97±2.19)(P<0.01).The students with home location in the county-level cities and below(8.39±2.00)was higher than those in small and medium-sized cities and above(7.74±2.34)(P<0.01).The scores of students with a father's degree in high school and below(8.35±2.00)were higher than those of the father with a bachelor's degree or above(7.79±2.45)(P<0.01).The scores of students with a mother's degree in high school and below(8.37±2.01)were higher than those of mothers with a bachelor's degree or above(7.46±2.45)(P<0.01).The military medical college students positive behavior score of grade 1 grade 2 and grade3(8.54±2.14),(8.25±2.18)and(8.05±2.31)were higher than grade 4 and 5(7.34±2.49)and(7.58±2.13)(P<0.01);The academic system was the 4-year score(8.61±2.21),higher than the 5-year score(7.99±2.28)(P<0.05).The number of students with home location in the county-level cities and below(8.17±2.12)was higher than those in small and medium-sized cities(7.88±2.43)(P<0.05).Students whose pocket money less than1,000 yuan(8.11±2.28)were higher than whose pocket money more than 1,000 yuan(7.56±2.25)(P<0.01).2.Study on the intervention of tobacco-related knowledge,attitudes and behaviors.The comparison results of general intervention group and the strengthened intervention group showed that tobacco-related knowledge awareness had increased significantly after the strengthened education once again,with 26 of 27 items in the local medical colleges had been increased;with 25 of 27 items in the military medical school had been improved.But in the aspect of the change of college students'tobacco-related attitudes and behavior,the impact was less obvious.The positive attitude rate of 2 items in the 16 entries of the local medical school had been improved and 1items in 16 entries in a military college had been improved(P<0.05).The positive behavior rate of 2 items in the 12items of the local medical college had been improved and 3of 12 items in the military medical university had been improved(P<0.05).In the comparison of the total score of tobacco related-knowledge,positive attitude,and positive behavior,the score of active smoking knowledge of the strengthened intervention group of local medical colleges(8.93±1.93)was higher than that of ordinary intervention group(8.46±2.41),the score of passive smoking knowledge of the strengthened intervention group(8.39±1.38)was higher than that of ordinary intervention group(8.08±1.92),the score of tobacco-related knowledge of the strengthened intervention group(23.12±4.05)was higher than that of ordinary intervention group(22.18±4.97)(P<0.05);The score of positive behavior(8.93±2.18)was higher than that in normal intervention group(8.09±2.11)(P<0.01).In both schools,the knowledge,positive attitude and positive behavior ratings of the intensive intervention group were higher than those of the general intervention group(P<0.05).The comparison before and after the intervention showed that he scores of tobacco basic knowledge,active smoking hazard knowledge,passive smoking hazard knowledge,tobacco related knowledge,tobacco positive attitude and tobacco positive behavior in local medical colleges were higher than those before intervention(P<0.05).After the intervention of local medical college,the score of the tobacco related level score was higher than before the intervention(P<0.01).The score of active smoking hazard knowledge,passive smoking hazard knowledge,tobacco-related knowledge after the intervention was higher than before and there was a statistical difference between the tobacco related level score and the pre-intervention(P<0.01).Conclusions:1.It doesn't look optimistic of the smoking status and tobacco-related attitudes of medical college students,especially male students.College students with different characteristics had different smoking rates.Male,4-year course,being the only child,lower positive attitude score,the smoking of closed friends were major influencing factors of local medical colleges'smoking behavior;male,senior college,lower positive attitude score,being the only child,the smoking of closed friends were major influencing factors of military medical colleges'smoking behavior.College students'knowledge of tobacco-related knowledge was not comprehensive enough,which leads to insufficient awareness of the harm of smoking,weak awareness of tobacco control and lack of positive attitude towards tobacco control.The positive attitude and positive behavior score were different among students with different characteristics.The suggestion could be aimed at carrying out targeted tobacco control propaganda among students with different characteristics and of the weak knowledge of tobacco use.2.Through the intervention study,tobacco control education can increase the level of students'tobacco-related knowledge,which was slightly inadequate in changing the students'attitudes and behaviors of tobacco.The strengthened intervention group was better than that of ordinary intervention group,which proves that several times of tobacco control propaganda was better than the only one time education,and it was suggested that the school should pay more attention to the times and stages of health education for achieving the best educational effect.3.Because of different gender proportion and different methods of school management,the use of tobacco and tobacco-related knowledge,attitudes and behaviors among students of local medical college and the military medical university were different.In the intervention study,the tobacco-related knowledge,attitudes and behaviors of the students of the local medical college had changed more obviously than those of the military medical university which might be due to the difference of tobacco control education and the control environment.It was suggested that we should take corresponding measures according to the different characteristics of the targets of tobacco control education so as to achieve better results.