[Process evaluation on a health promotion model regarding smoking prevention among Chinese secondary school students]

To evaluate the process of smoking prevention and control among Chinese adolescent with a model on health promotion in junior high school.

A cluster-randomized, controlled and schooled-based trial on smoking prevention was conducted among 2343 students at four secondary schools in Huangpu District of Guangzhou. Students 'reports and investigators' daily records were used to evaluate the intervention measures.

During the one-year period of intervention (Dec. 2004 through Dec. 2005), eighteen activities had been implemented among students, teachers, parents and cigarette retailers. Ranked by the rate of awareness, the top six activities were shown as follows: "the nicotine toxicity experiment" (90.7%), "agreement of building families free of smoking"(77.7%), "a letter to parents" (77.1%), "no-smoking signs" (76.5%), "Blackboard information about health and smoking" (75.0%), and "signature on the 18th World Day of No Smoking" (70.2%). Among all the activities, "the nicotine toxicity experiment" had the highest rate of participation (88.5%), followed by "a letter to parents" (73.6%), "agreement of building families free of smoking" (69.8%), "health education through experiments"(68.6%), "health education through multimedia" (65.7%) and "signature on the 18th World Day of No Smoking" (65.6%). The top seven activities in which students showed greatest interests were "the nicotine toxicity experiment" (64.5%), "signature on the 18th World Day of No Smoking" (33.0%), "health education through experiments" (31.2%), "health education through multimedia" (29.8%), "class meetings with a thesis of smoking" (26.8%), "health pamphlets" (26.6%), "specific textbooks" (25.9%). The extent of students' general satisfaction to the work of tobacco control in school during the last year was 52.4%. The biggest perceived shortcoming for the intervention plan was the low participation of students.

Some intervention measures had not been fully carried out among the students and only covered part of them. It is necessary to adjust the previous intervention measures through keeping the nicotine toxicity experiment, health education through multimedia and other measures with extensive participation of students and at the same time, to avoid literal materials, exhibition boards and traditional single-way health education program.