BACKGROUND: In 2023, the Tobacco Control Office of Chinese Center for Disease Control and Prevention (TCO) organized a nationwide paintings collection activity about tobacco control among primary and middle school. Under the guidance of the National Health Commission and the Ministry of Education, 100 of 2.6 million were selected. In order to further spread the voice of young people and promote the concept of smoke-free, TCO turned the paintings into brochures, exhibition boards and videos as tobacco control materials with knowledge of tobacco harms and carried out the two-step flow of communication nationwide.
METHODS: TCO conducted a study in Beijing, Zhejiang and Heilongjiang provinces to evaluate the effectiveness of this two-step flow of communication. The study subjects were primary and middle school students of different grades from urban and rural areas. The paper questionnaire surveys were conducted before (2798) and 2 weeks after (2911) the two-step flow of communication. We also collected qualitative data among students (216), teachers (72) and CDC staffs (6). The effectiveness of the two-step flow of communication activities was evaluated by the results of the quantitative and qualitative studies.
RESULTS: The study found that teenagers had rich ways to acquire knowledge about tobacco control. The two-step flow of communication provided abundant materials for health education courses. The knowledge of tobacco control had been improved. It helped the students form a correct understanding of E-cigarettes. The willingness to recommend the information of smoking cessation to others had improved after the two-step flow of communication.
CONCLUSIONS: The two-step flow of communication was effective. It provided useful experience and reference for the follow-up work. We should encourage teenagers to promote tobacco control actively and we should invite more departments from different fields to participate in the tobacco control publicity.