Influence of medical students'cognition and attitude towards electronic cigarettes on their use behavior based on structural equation model
Objective To analyze the relationships of electronic cigarette(e-cigarette)use behavior with knowledge and cognition among medical students by structural equation model,and to provide new strategies for e-cigarette control activity.Methods From May to November 2022,a stratified multi-stage cluster random sampling method was used to select 4,126 medical students from 3 medical universities in Guizhou Province to conduct a questionnaire survey.The questionnaire was designed based on the China Youth Tobacco Epidemic Survey Questionnaire-2019 and related literatures,and the structural equation model was constructed and evaluated by AMOS 26.0 software.Results A total of 4,126 students were surveyed in this study,including 2,052(49.73%)males and 2,074(50.26%)females.There were 1,613(39.09%)studeuts in the group aged 18 years and younger,1,966(47.65%)in the group aged 19-21 years,547(13.26%)in the group aged 22 years and above,1,031(24.99%)in the urban area group and 3,095(75.01%)in the rural area group.The utilization rate of e-cigarette attempts among the medical students was 6.54%,the awareness rate of e-cigarette 89.99%,and the awareness rates of knowledge about different e-cigarettes were between 54.89%and 74.29%.As for attitude towards use of different e-cigarettes,the rates of positive attitude were between 4.56%and 21.43%.The goodness-of-fit effect of the final model was better.Results of the structural equation model displayed that factors influencing the medical students'e-cigarette use behavior were knowledge(β=0.073,P<0.05),cognition(β=0.051,P<0.05)and attitude(β=-0.150,P<0.05).The direct effect of knowledge on e-cigarette use behavior was higher than the indirect effect.Cognition and attitude had a direct effect on e-cigarette use behavior.Conclusion The levels of knowledge and cognition on e-cigarettes among the medical students need to be improved.The medical students'status of knowing knowledge regarding e-cigarettes can directly affect the use behavior of e-cigarettes,and also indirectly affect the use behavior of e-cigarettes through cognition and attitude.Comprehensive interventions should be conducted from three aspects of knowledge,cognition and attitude so as to promote the formation of anti-smoking awareness and reduce e-cigarette use behavior.
electronic cigarettemedical studentinfluencing factorstructural equation model