Susceptibility to smoking and determinants among medical students: A representative nationwide study in China
Sihui Peng+ 1
Lingwei Yu+ 1
Tingzhong Yang# 2  
Dan Wu 3
Ross Barnett 5
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Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, China
Children's Hospital/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou, China
Department of Psychology, Guangdong Medical University, Dongguan, China
School of Nursing, University of British Columbia, Kelowna, Canada
Department of Geography, University of Canterbury, Christchurch, New Zealand
School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
Tingzhong Yang#   

Children's Hospital/Center for Tobacco Control Research, Zhejiang University School of Medicine, Hangzhou 310052, China
Shuhan Jiang#   

School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou 310053, China
Publish date: 2019-04-24
Tob. Induc. Dis. 2019;17(April):36
+Co-first authors #Co-correspondence authors
The rationale behind why the majority of medical students are non-smokers, but some initiate smoking after becoming physicians is not fully understood in China. Exploring factors that may increase susceptibility to smoking initiation among medical students is an essential first step in assessing preventative actions.

Participants were 11954 students, who were identified through a multistage survey sampling process that included 50 universities in China. Subsequent analysis focused on 8916 non-smokers among medical students. Both unadjusted and adjusted logistic methods were considered in the data analyses.

The prevalence of susceptibility to smoking was 23.0%. Multivariate logistic regression analyses found that exposure to secondhand smoke (SHS) in domestic places (OR= 1.63) and in public places (OR=1.78), cigarette advertising (OR=1.91) and promotional activities on campus (OR=1.90) were positively associated with susceptibility to smoking. In contrast, positive attitudes toward tobacco control on the part of health professionals, HPs, (OR=0.52) were negatively associated with susceptibility to smoking. Those who received information about the dangers of smoking (OR=0.75) and did not agree that light cigarettes are less harmful to health (OR=0.79) were less susceptible to smoke. Caring about exposure to secondhand smoke (OR=0.68 care, and OR=0.33 very) and advising family members to stop smoking (OR=0.81) were negatively associated with susceptibility to smoking.

These findings underscore the importance of tobacco control training and establishing smoke-free campuses for reducing susceptibility to smoking among medical students.

We thank local teams from the ‘Building advocacy capacity for tobacco control in medical universities in China’ programme for organizing the data collection.
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
This study was partly funded by the National Nature Science Foundation of China (71490733) and Global Bridges/IGLC, 2014SC1 (13498319).
TY and SJ conceived the study design, conceptualized the ideas, and supervised the data management and analyses. SP, LY and DW conducted the data collection. TY wrote the preliminary draft, while BJ and BR revised and edited the manuscript. All authors reviewed earlier drafts and approved the final version.
Not commissioned; externally peer reviewed.
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