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Health knowledge and perception of risks among Chinese smokers and non-smokers: findings from the Wave 1 ITC China Survey
  1. Jilan Yang1,
  2. David Hammond1,2,
  3. Pete Driezen2,
  4. Geoffrey T Fong3,4,
  5. Yuan Jiang5
  1. 1Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Canada
  2. 2Propel Centre for Population Health Impact, University of Waterloo, Waterloo, Canada
  3. 3Department of Psychology, University of Waterloo, Waterloo, Canada
  4. 4Ontario Institute for Cancer Research, Canada
  5. 5National Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
  1. Correspondence to Dr David Hammond, Department of Health Studies and Gerontology, University of Waterloo, 200 University Ave West, Waterloo, Canada N2L 3G1; dhammond{at}


Background Awareness of health risks of smoking is strongly associated with smoking behaviour. However, there are no population-based studies of smoking-related health knowledge in China.

Objective The aim of current study was to use a population-based sample from the International Tobacco Control China Wave 1 survey to examine variations between current, former and never smokers' health knowledge about smoking and the impact of health knowledge awareness on smokers' intention to quit.

Methods A face-to-face interview was conducted with 5986 adult smokers and non-smokers from six cities in China. Respondents were asked whether they believed smoking causes heart disease, stroke, impotence, lung cancer, emphysema, stained teeth, premature ageing in smokers and lung cancer in non-smokers. Current smokers were also asked additional questions on how smoking affects their current and future health as well as whether they had plans to quit smoking and if they believe they would have health benefit from quitting.

Findings The overall awareness of health risks of smoking in China was low compared to developed countries. Current smokers in China were less likely than non-smokers and former smokers to acknowledge the consequences of smoking. Current smokers who were more aware of the health consequences of smoking were more likely to intend to quit smoking.

Conclusion These findings highlight the need to increase awareness about the health effects of smoking in China, particularly among current smokers to increase quitting.

  • Health Knowledge
  • Smoking
  • China
  • ITC
  • public policy

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  • Funding The ITC China Project was supported by grants from the US National Cancer Institute (R01 CA125116 and the Roswell Park Transdisciplinary Tobacco Use Research Center (P50 CA111236)), Canadian Institutes of Health Research (79551), Chinese Center for Disease Control and Prevention, and the Ontario Institute for Cancer Research. Additional support was provided by the Propel Centre for Population Health Impact with funds from the Canadian Cancer Society of the National Cancer Institute of Canada/Canadian Cancer Society. The funding sources had no role in the study design, in collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the paper for publication.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval All materials and procedures used in the ITC China Survey were reviewed and cleared for ethics by the Research Ethics Board at the University of Waterloo and by the Institutional Review Board at China National Center for Disease Control and Prevention.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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