Investigation on knowledge, attitude and behavior on health hazards of haze and secondhand smoke exposure to middle school students in Beijing

Abstract

Objective To understand knowledge, attitude and behavior on health hazards of haze and secondhand smoke exposure among middle school students in Beijing, and provide us with guidance to carry out effective health education for middle school students. Methods A total of 1 294 students were selected randomly using stratified cluster sampling method; 1 085 valid questionnaires were recovered. Among them, 739 were junior high school students and 346 were senior high school students. The questionnaire included questions on middle school students' knowledge on haze and secondhand smoke exposure, their attitudes towards judgement of severity of haze and secondhand smoke exposure and their utilization of protective measures when they are exposed to haze or secondhand smoke. Pearson's chi-squared test was performed to assess differences in knowledge, attitude and behavior between junior middle school students and senior high school students, boys and girls. Results Middle-school students′ awareness rate on the haze and exposure to secondhand smoke may cause respiratory was highest, which was 93.55% and 95.76% respectively. The awareness rate of fact that haze, secondhand smoke exposure can cause cardiovascular disease was 38.99% and 55.85% respectively; while rate of their awareness on haze and exposure to secondhand smoke can lead to cancer was lowest, which was 54.10% and 69.95% respectively. The differences was significant in awareness rate of fact that respiratory disease, cardio-cerebrovascular disease and cancer can be caused by haze (χ2=732.539, P<0.05), likewise differences were significant in awareness rate of above three kinds of diseases can be caused by secondhand smoke exposure (χ2=460.291, P<0.05). In comparison between severity of haze and smoking hazards, 35.94% of students believe that haze hazards is heavier than tobacco; 48.02% of students think that dangers of smoking is greater than haze; 16.04% of students cannot determine extent of damage of haze and smoke. The proportion of students who think smoking was more harmful than haze was higher in junior high school group than in senior high school group. The two groups had a significant difference in understanding of severity comparison between haze and smoking (χ2=13.014, P<0.05). The differences between boys and girls in view of severity comparison between haze and smoking are also statistically significant, more boys believed smoking was more harmful than haze (χ2=9.650, P<0.05). In aspect of protection from haze and secondhand smoke exposure, 86.36% of students would like to protect themselves from haze, while 55.94% of students would take measures to prevent secondhand smoke exposure initiatively, junior high school students performed better than senior high school students in this two aspects(χ2=17.125, P<0.05; χ2=45.785, P<0.05). Conclusion While middle school students have a certain understanding of impact of haze and secondhand smoke exposure on health hazards, their understanding is limited. They have not paid enough attention to harm of secondhand smoke exposure and their awareness of active refusal to secondhand smoke exposure needs to be improved. Schools should strengthen health education for students and educate them not only to stay away from haze but also should be far away from secondhand smoke exposure. Key words: Air pollution; Tobacco smoke pollution; Knowledge, attitude and behavior