title: Effectiveness of school-based smoking intervention in middle school students of Linzhi Tibetan and Guangzhou Han ethnicity in China.
abstract: OBJECTIVE
  The purpose of this paper is to assess the effectiveness of school-based intervention aimed to increase knowledge, to change attitudes and to reduce smoking-related behavior in both Linzhi Tibetan and Guangzhou Han middle school students in China.
  
  
  METHODS
  A concurrent intervention study was conducted in both Linzhi and Guangzhou. Two schools were randomly chosen and one was randomly assigned to the intervention group and the other to the control group in both settings.
  
  
  METHODS
  Participants were grade one and grade two middle school students drawn from two schools in Linzhi, Tibet Autonomous Region (southwest China) and two schools in Guangzhou, Guangdong Province (south China).
  
  
  METHODS
  The intervention program lasted for one year and covered three aspects: health policies in school, health environment in school and personal health skills.
  
  
  METHODS
  Primary outcomes were smoking-related knowledge, attitudes and behavior (including ever smoking, daily smoking, weekly smoking and current smoking) and were measured by a self-administered questionnaire before and after the intervention.
  
  
  RESULTS
  This intervention increased smoking-related knowledge in both Tibetan (β=1.32, 95% CI (0.87-1.77)) and Han ethnic groups (β=0.47, 95% CI (0.11-0.83)). It changed attitudes toward smoking in Tibetan (β=1.47, 95% CI (0.06-2.87)) but not so in Han (β=-0.33, 95% CI (-1.68-1.01)). The intervention changed the prevalence of smoking in neither ethnic groups (P>0.05).
  
  
  CONCLUSIONS
  The impact of school-based smoking intervention is different among Tibetan and Han students. This intervention was more effective for Tibetans when compared with the Han ethnic group. More research is needed on how intervention can be adapted to address ethnic and cultural differences.
authors.affiliation: Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Long
authors.initials: L
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Yuantao
authors.initials: Y
authors.lastname: Hao
authors.forename: Jing
authors.initials: J
authors.lastname: Gu
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.forename: Wenhua
authors.initials: W
authors.lastname: Ling
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D002681:China; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D008297:Male; D012572:School Health Services; D012907:Smoking / Q000208:ethnology / Q000628:therapy; D000074606:Smoking Prevention; D013334:Students; D011795:Surveys and Questionnaires; D018609:Tibet / Q000208:ethnology; D016896:Treatment Outcome
keywords: China; Han; Middle school students; School-based smoking intervention; Tibetan