Objective: To study the smoking status and influence of the families on pupils regarding smoking-related knowledge, attitudes and behavior, in Shandong province.
Methods: A multi-stage stratified-cluster random sampling method was used to investigate 6 050 students and their families in 3 different cities. A self-administered anonymous questionnaire survey was conducted by trained investigators.
Results: The overall passive smoking rate at households of the pupils was 49.7% in Shandong province and appeared the highest in separate families, followed by in re-organized families and multiple-generation families under the same roofs. Major smokers in the families were fathers and grandfathers, with 43.4% of the fathers and 74.0% of the grandfathers had smoking histories for more than 10 years. The main smoking places at home were "elsewhere" or in the "living room". Attempting and current smoking rates of the families were 7.7% and 1.7% respectively, significantly higher than those families with no smokers. There was significant difference in smoking associated behavior and attitude between pupils whose family members with smoking habits or without.
Conclusion: The status of smoking in the families of the pupil's family was not optimistic in Shandong province, especially in the families of the male students. Since smoking status of the families played an important role on their children, it is necessary to explore suitable health education model to improve the smoking associated behaviors in the families.