Differences in Smoking Related Beliefs between Chinese Current Smokers with Different Educational Levels

Theoretical Background and research questions/hypothesis:  Despite continuous tobacco control efforts in China, the quit rate among smokers remains low compared to other countries. Lower educated Chinese smoke more often than higher educated Chinese. This study is to explore potential new ways to improve smokers' quitting intention through a better understanding of their attitude towards smoking and smoking cessation. 

Methods:  There were 201 adult male current smokers involved in 35 focus groups and 19 semi-structured interviews from three cities in China. 

Results:  Most smokers had heard about the risks of tobacco use. However, higher educated smokers with college and above education questioned the credibility of the information; lower educated smokers simply denied the messages, because they did not relate to their own experience. The different educational groups also had different beliefs about the “benefits” of smoking. The higher educated believed that smoking helps them cope with work pressure, while lower educated smokers regarded it important to recover from physical fatigue. Both groups mentioned to use “safe” smoking habits such as “only smoking low tar cigarettes” and “not inhaling the smoke into the lung”. 

Conclusions:  Regarding the intention to quit smoking, the higher educated tended to weigh the benefits and risks of smoking, while such a consideration is not mentioned by lower educated smokers. 

Implications for research and/or practice:  Different health communication strategies should be adopted for different educational groups. Higher educated smokers would be better served with more robust scientific evidence. while smoking cessation campaigns for lower educated smokers would need to include more real life stories.