Challenges for school-based, anti-smoking education in China

As the world’s largest tobacco consumer, China has over 300 million current smokers. If this trend continues, there will be 3 million people dying annually from tobacco-related diseases by 2050. These diseases are a huge financial burden for the country and impair people’s quality of life. In the past three decades, adolescent smoking rates have remained at high levels among males and increased in females. The current (30-day) smoking prevalence rate is estimated to be 17.4% and 3.2% for male and female adolescents (12-17 years), respectively. Smoking prevention for this age is an important public health goal. Due to the large number (84 million) of secondary school students in China, school-based anti-smoking education could be an inexpensive and effective approach to implement. Current anti-smoking education in Chinese schools is in its infancy. In Yunnan Province (a leading tobacco producing Province), for instance, the only available official resource in secondary schools (known to the authors) is one lesson in a health education textbook. The dominant content of this lesson is the physical harms of smoking, while social skills (e.g., refusal skills) that have been shown as effective way to reduce and prevent adolescent smoking are not emphasised. Fieldwork in secondary schools (students’ Mage=16 years) reveals several tobacco management methods that have been used to establish smoking-free campuses. By simply regarding smoking on campus as disobedience, discipline-based approaches are often used in schools. However, although schools implement comprehensive tobacco control strategies (e.g., bag checking, patrolling, inter-class competitions, antismoking themed class meetings), these strategies are unlikely to curb students’ smoking..