Smoking status and attitudes toward tobacco control among students in a vocational school in Lanzhou, China: A crosssectional study

INTRODUCTION Tobacco use remains one of the leading preventable causes of premature death worldwide, and adolescents who initiate smoking early are at a heightened risk of persistent nicotine dependence and long-term tobaccorelated morbidity.Smoking behavior among vocational college students, many of whom enter an integrated secondary and higher vocational education system during a high-risk developmental window, is therefore particularly concerning.The aim of this study was to estimate the prevalence of current smoking, to characterize nicotine dependence, and to assess attitudes toward tobacco-control policies among students at a vocational college in Lanzhou, Gansu Province.METHODS A cross-sectional study was conducted at a single vocational school in Lanzhou, Gansu Province, China.All eligible first-and second-year students who volunteered to participate and provided written informed consent were invited to complete a self-administered, self-reported questionnaire between June and July 2025.Descriptive statistics and chi-squared tests were used to examine associations between exposure variables (sociodemographic characteristics and tobacco-control-related attitudes) and the outcome variable (smoking behavior). RESULTSOf the 1683 questionnaires distributed, 1365 valid responses from 654 male and 711 female students were retained (effective response rate 81.11%).Descriptive statistics and chi-squared tests were used to compare smoking behavior and tobacco-control attitudes across student subgroups.The overall smoking rate among students was 11.21%, with males (22.63%) significantly more likely to smoke than females (0.70%) (p<0.05).Using female students as the reference category, being male was associated with higher odds of current smoking (OR=41.30;95% CI: 16.82-101.43).Students with urban residence reported a higher smoking rate (15.76%) than those from rural areas (10.50%), and current smoking increased with monthly disposable allowance (7.19%, 11.99%, and 28.16% for <1000, 1000-2000, and >2000 RMB, respectively).Most smokers had mild nicotine dependence (75.16%), and smoking most often occurred at home (57.52%) and in dormitories (22.22%).A total of 1142 students (83.66%) supported the implementation of campus tobaccocontrol policies, and 1074 (78.68%) were willing to participate in school-based tobacco-control education.However, only 64.98% considered the current school measures effective, and 142 students (10.40%) considered smoking in public places acceptable.CONCLUSIONS The smoking prevalence among students at this Lanzhou vocational school is relatively high and is strongly concentrated among male students.