Effectiveness of smoke-free policy among elementary students in Nanjing, China Open Access
Chang, Joo Hye (2014)
Abstract
Research on smoking among elementary students is lacking, particularly in China where youth smoking is becoming a growing public health issue. One way to address youth smoking is implementing anti-smoking policies in schools, but the literature is inconsistent in their effectiveness. A randomized cluster design was utilized in the current study to better understand how implementing a smoke-free policy contributes to smoking experimentation among elementary students. Sixteen schools in Nanjing were selected into the intervention group where smoke-free policy was implemented and eight schools were selected into the control group where smoke-free policy was not implemented. Self-administered surveys were given to a random selection of students a year and a half after policy implementation, and a total of 3,023 students in grades five and six were included in the analysis. Gender, age, parental educational level, and both pro-smoking and anti-smoking influences in homes, schools, and the media were controlled for in the analysis. Results indicated that there was no difference in smoking experimentation between the intervention group and the control group. But when assessing by gender, there was a significant association between policy implementation and smoking among females but not among males. Additionally, predictors of smoking experimentation of both genders included exposures to smokers at home, exposures to smokers in schools, and not discussing harmful effects of smoking at home. The data suggests that smoke-free policy is generally an effective strategy for females, and is helpful for males only if policy was followed by stringent enforcement. Limiting visibility of smokers in schools and thereby sending consistent anti-smoking messages appear to be critical particularly among elementary school boys. Comprehensive implementation and enforcement of smoke-free policy in addition to multipronged anti-smoking interventions in the contexts of homes and schools are recommended to curb adolescent smoking in China.
Table of Contents
Background...............................1
Methods....................................8
Results....................................13
Discussion...............................17
References..............................24
Tables.....................................30
Table 1................................30
Table 2................................32
Table 3................................34
Table 4................................36
Table 5................................38
Figures....................................40
Figure 1................................40
Figure 2................................41
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