Purpose: The purpose of this study was to investigate the effect of designating a medical school environment as smoke-free on the smoking behavior of medical students.
Methods: The total environment of a medical school in Japan was designated as smoke-free in 2004. Smoking behavior was surveyed among approximately 640 students in each year during the period 2001-2007 (response rate 91.2%). Smoking rates were also monitored among each year's freshmen during their time at the school, before and after 2004. Attitudes to smoking among both current smokers and those who had quit smoking were also investigated. RESULTED: Smoking rates among all students declined after the medical school was declared smoke-free in 2004; the rates were highest in 2002 (41.2%) and lowest in 2007 (22.1%) among men. Smoking rates among each year's freshmen tended to increase as the school year progressed before 2004, but they tended to decrease after 2004. Comparison of smoking rates among identical students showed a decline from 36.0% in 2003 to 25.6% in 2004 (P < 0.05). The rate of smokers wishing to quit smoking increased significantly from 39.1% in 2003 to 60.2% in 2004 (P < 0.01). 20.8% of students who had quit smoking and 50.0% of students who had continued to smoke felt that they would not be confident about educating their patients in smoking cessation (P < 0.01).
Conclusions: Making a medical school environment smoke-free could be very effective means to motivating medical students to change their attitudes to smoking and to quit.