'I'm not a smoker…yet': a qualitative study on perceptions of tobacco control in Chinese high schools.

objectiveChinese adolescents' perceptions about tobacco control at schools are rarely researched. We explored how current antismoking strategies work in middle school environments, as well as the attitudes towards these strategies held by students and teaching staff members.

methodsFour focus groups (24 eleventh graders;

resultsWith educational approaches and practical strategies, antismoking education reported in the middle schools had limited effectiveness. Although smoking is banned in schools, students can circumvent schools' controls easily. Notably salient is the pessimistic attitude towards school-based antismoking strategies at school. Detrimental influences within (teachers' smoking) and beyond schools (high societal smoking prevalence) largely challenged the efforts to manage students' smoking.

conclusionsCurrent antismoking approaches in schools fail to curb smoking among Chinese high school students. Their effectiveness is undermined by both within-campus and off-campus influences. Students' perceptions of smoking should be valued as their knowledge of smoking is actively constructed. Future antismoking education at school should incorporate interactive sessions rather than merely didactic approaches about the harms of smoking. Although stricter rules for teachers' smoking are needed, complementary strategies such as population-level interventions and policy measures in wider society will assist in efforts within schools.