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This study aimed to compare the tobacco-related knowledge, attitudes and smoking behavior among Chinese medical and non-medical students across three grades from freshmen to juniors. Survey data were collected among 8,138 students using a paper-and-pencil questionnaire. Study findings indicate that compared to non-medical students, medical students in the sophomore and junior years reported significantly higher levels of knowledge regarding tobacco toxicants and tobacco-related diseases, and had stronger attitudes against smoking as personal rights and stronger attitudes in favor of smoking ban. The differences between medical and non-medical students remained after controlling for a number of covariates. However the prevalence rates of cigarette smoking were similar between medical and non-medical students across grades even after adjusted smoking initiation before entering college. Despite increases in tobacco related knowledge, approximately 40% of junior-year medical students did not recognize carbon monoxide as a toxicant from tobacco, and 30-40% of them were unknown of tobacco smoking as a risk factor for several diseases, including hypertension, stroke, and gastric ulcer. Findings of this study suggest the need for immediate action to enhance tobacco-related education in formal medical training in China to prepare future doctors for smoking prevention and to assist millions of smokers to quit.

Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China.This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students.Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables.There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores.Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

To explore the relationship between psychological stress, fatigue and different smoking behaviors among undergraduate students.8138 undergraduate students in grade 1 to 3 were sampled with cluster sampling method from a comprehensive university in Guangzhou, and were studied on their psychological stress, peer and self smoking behaviors, as well as socio-demographic factors with a self-administered questionnaire. Physical and mental fatigue was measured by Chalder fatigue scale. A multinomial logistic regression analysis was performed to explore the association between psychological stress, fatigue and different smoking behaviors with 'non-smokers' defined as control group while 'triers' and 'current smokers' as case group, respectively.There were students trying to smoke or becoming current smokers on university campus. After adjusting the effect of relevant socio-demographic factors and peer smoking behavior, physical fatigue (OR = 1.044, 95% CI: 1.013-1.075) and 'worry about current academic and future work' (OR = 1.020, 95% CI: 1.001-1.040) were the risk factors of trying to smoke among male students, while 'study stress (OR = 1.063,95% CI: 1.012-1.117) was the risk factor for female students when start smoking. 'Personnel relationship and environment stress' (OR = 1.152, 95% CI: 1.012-1.312) were the risk factors for female students' current smoking behavior.Psychological stress and fatigue were moderately associated with smoking behavior among undergraduate students and the impact was different on different gender and smoking behaviors that suggesting that some specific psychological measures should be taken so as to control different smoking behaviors among undergraduate students.

To explore the influencing factors of smoking behavior transition at different stage of smoking among undergraduate students.8138 undergraduate students from grade 1 to 3 were selected using cluster sampling method from an university in Guangzhou with their smoking behaviors and relevant factors studied through a self-administered questionnaire. Beginners, un-regular smokers and regular smokers were defined as "case group", while non-smokers, beginners and un-regular smokers were defined as "control group" accordingly. Three multivariable logistic regressions were separately conducted to explore the influencing factors of behavioral transition at different stage of smoking.Of the 8138 students investigated, the prevalence rates of beginners, un-regular smokers and regular smokers were 19.6%, 2.0% and 1.1%, respectively; while all of the above said three rates increased with grades of the students. Some students might still try to smoke or become regular smoker in the university. In male undergraduate students, determinants for the transition from non-smokers to s mokers were: source of students, father' s educational level, smoking-related knowledge and belief, and smoking habit of the roommates. Risks that influencing the transition from beginners to un-regular smokers were: being non-medical students,smoking-related belief, roommates and classmates who were smokers and transition from un-regular smokers to regular smokers would include father' s educational level and average income of family. In female undergraduate students,influencing factors from non-smokers to beginners were mother's educational level, smoking-related belief, and roommates smokers, while father's educational level, roommates and classmates' smoking habits were significant associated with beginners' change to un-regular smokers.The influencing factors related to the transition of different stage on smoking would be different in undergraduate students,and some specific measures should be taken based on the different stage of smoking.