Objective To understand the knowledge,attitude and behavior on health hazards of haze and secondhand smoke exposure among middle school students in Beijing,and provide us with guidance to carry out effective health education for middle school students.Methods A total of 1 294 students were selected randomly using stratified cluster sampling method;1 085 valid questionnaires were recovered.Among them,739 were junior high school students and 346 were senior high school students.The questionnaire included questions on middle school students' knowledge on haze and secondhand smoke exposure,their attitudes towards the judgement of severity of haze and secondhand smoke exposure and their utilization of protective measures when they are exposed to haze or secondhand smoke.Pearson's chi-squared test was performed to assess differences in knowledge,attitude and behavior between junior middle school students and senior high school students,boys and girls.Results Middle-school students' awareness rate on "the haze and exposure to secondhand smoke may cause respiratory disease" was the highest,which was 93.55％ and 95.76％ respectively.The awareness rate of the fact that haze,secondhand smoke exposure can cause cardiovascular disease was 38.99％ and 55.85％ respectively;while the rate of their awareness on the haze and exposure to secondhand smoke can lead to cancer was the lowest,which was 54.10％ and 69.95％ respectively.The differences was significant in the awareness rate of the fact that respiratory disease,cardio-cerebrovascular disease and cancer can be caused by the haze (x2=732.539,P＜0.05),likewise the differences were significant in the awareness rate of the above three kinds of diseases can be caused by secondhand smoke exposure (x2=460.291,P＜0.05).In the comparison between the severity of haze and smoking hazards,35.94％ of students believe that haze hazards is heavier than tobacco;48.02％ of the students think that the dangers of smoking is greater than haze;16.04％ of the students cannot determine the extent of damage of the haze and smoke.The proportion of students who think smoking was more harmful than haze was higher in junior high school group than in senior high school group.The two groups had a significant difference in the understanding of the severity comparison between haze and smoking (x2=13.014,P＜0.05).The differences between boys and girls in the view of the severity comparison between haze and smoking are also statistically significant,more boys believed smoking was more harmful than haze (x2=9.650,P＜0.05).In the aspect of protection from haze and secondhand smoke exposure,86.36％ of the students would like to protect themselves from haze,while 55.94％ of the students would take measures to prevent the secondhand smoke exposure initiatively,the junior high school students performed better than the senior high school students in this two aspects(x2=17.125,P＜0.05;x2=45.785,P＜0.05).Conclusion While middle school students have a certain understanding of the impact of haze and secondhand smoke exposure on health hazards,their understanding is limited.They have not paid enough attention to the harm of secondhand smoke exposure and their awareness of active refusal to secondhand smoke exposure needs to be improved.Schools should strengthen the health education for students and educate them not only to stay away from haze but also should be far away from secondhand smoke exposure.%目的 了解北京市某中学学生对雾霾与二手烟暴露对健康造成危害的知识、态度、行为,进而为对该人群开展有效的健康教育提供指导依据.方法 采用分层整群抽样的方法,在北京市某中学随机抽取1 294名中学生进行问卷调查,最终收回有效问卷1 085份,其中初中学生739名,高中学生346名.问卷内容包括中学生对雾霾与二手烟暴露相关知识的知晓情况、对雾霾与吸烟危害程度对比所持的态度以及对雾霾与二手烟暴露的防护措施采取情况.利用Pearson卡方检验评估初、高中学生以及男生、女生之间的知识、态度与行为差异.结果 该校中学生对雾霾与二手烟暴露能够引发呼吸系统疾病的知晓率最高,分别为93.55％与95.76％;对雾霾、二手烟暴露可引发心脑血管疾病的知晓率分别为38.99％与55.85％;对二者能够引起肿瘤的知晓率最低,分别为54.1％与69.95％,对雾霾可引发呼吸系统疾病、心脑血管疾病与肿瘤这三类疾病的知晓率差异具有统计学意义(x2=732.539,P＜0.05);对二手烟暴露可引发上述三类疾病的知晓率差异也具有统计学意义(x2=460.291,P＜0.05).在雾霾与吸烟对健康危害严重程度对比上,35.94％的学生认为雾霾的危害比烟草危害重;48.02％的学生认为吸烟的危害比雾霾的危害大;16.04％的学生不确定两者的危害程度.初中组中认为吸烟比雾霾危害大的学生比例高于高中组,两组在雾霾与吸烟对健康危害严重程度对比的认识上差异有统计学意义(x2=13.014,P＜0.05).男生与女生对雾霾与吸烟对健康危害严重程度对比的认识差异也有统计学意义,男生中认为吸烟比雾霾危害大的学生比例高于女生(x2=9.650,P＜0.05).在雾霾与二手烟暴露防护方面,主动拒绝雾霾、二手烟暴露的中学生比例分别为86.36％、55.94％.与高中生相比,初中生在雾霾与二手烟暴露防护方面做的更好(x2=17.125,P＜0.05;x2=45.785,P＜0.05).结论中学生对雾霾与二手烟暴露对健康危害的影响有一定的了解,但是了解程度不全面与深入,对“二手烟暴露”的危害重视程度不足;主动拒绝二手烟暴露的意识有待提高,建议学校加强开展健康教育,教育中学生不仅要远离“雾霾”,也要远离“二手烟”.
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