禁煙科学 6巻(2012)-04-P1【Original Article】

Research on Second-Hand Smoke Prevention Measures at Medical/
Welfare Related Universities
First Report: Actual Conditions of Second-Hand Smoke Prevention Measures and Knowledge andAwareness of Faculty Members
Tomomi Katayama1）, Yuko Takahashi2）, Izumi Matsumoto3）, Yutaka Hashimoto4）, Naoko Morisaki5）

Abstract[Background] There exists no simultaneous research examining actual conditions of second-hand smoke prevention measures at a number of universities and knowledge and awarenessof faculty members working there on them. Due to this, theactual situations of knowledge and awareness of faculty members on second-hand smoke prevention measures implemented
at universities have not been clarified. Thus, we researched
the current conditions of second-hand smoke prevention
measures at medical/welfare related universities and knowledge and awareness of faculty members on them.
[Methods] We sent requests for cooperation to the research
to the presidents of 21 universities with medical, nursing or
welfare departments in Hyogo Prefecture and conducted asurvey on anti-smoking conditions at 6 universities which
agreed to cooperate. At the same time, we also targeted 861
faculty members at the 6 universities and researched theirknowledge and awareness on second-hand smoke prevention
measures. For the survey, we adopted the placement method
utilizing anonymous automatic-recording questionnaires andconducted the survey from February to September 2011. The
survey was implemented after ethical review by the university
the researchers belonged to.
[Results] 502 of 861 faculty members (58.3%) at the 6 universities responded. For analysis, we only used valid responses
from 495 people (57.5%). According to the anti-smoking classification, 3 universities (285 members belonged to) were nonsmoking facilities and 3 universities (210 members belongedto) were smoking facilities. 73% of the faculty members at non-smoking facilities and 59.6% at smoking facilities properly
understood their anti-smoking classifications. 21.5% of respondents from non-smoking facilities and 47.9％ from smoking facilities answered that they were exposed to second-handsmoke, indicating a significant difference (p＜0.001).
[Conclusion] Although medical/welfare related universities aresupposed to have many faculty members with medical expertise, 30% faculty members at non-smoking facilities and 40% at
smoking facilities did not properly understand their universi1) Takarazuka University School of Nursing2) Nara Women's University3) Kio University
4) Toho University Omori Medical Center
5) University of KinDAI Himeji School of Nursing

ties’ anti-smoking classifications. In addition, even at nonsmoking facilities, where on-campus smoking is supposedly
prohibited, second-hand smoke existed too.
Keywords: Medical/welfare related universities, second-handsmoke prevention measures, faculty members

Introduction
Since the enforcement of Health Promotion Law in 2003,
schools have been designated as a place with a duty to takesecond-hand smoke prevention measures in order to protect
non-smoking individuals. Therefore, necessity of second-handsmoke prevention measures has further increased especially in
educational facilities with students including minors. Amidsuch situation, Hyogo prefecture has developed “Prefectural
guideline for second-hand smoke prevention measures” onMarch in 2004. With an explicit statement for non-smoking on
the premises such as universities and professional schools, theguideline has shown its concept that “Smoking on the premiseshall be prohibited in order to improve the circumstance forstudents to be able to take proper actions based on correct
information since university students make their way fromminors to adults during their school days and the period isexactly when many people start smoking habit 1)”. Further, agoal has been set up to achieve 100% non-smoking withinpremises of universities and professional schools by 2005 1). It
has been a pioneering effort nationally in an aspect that certain target values for achieving smoking prohibition on thepremises of universities were indicated mainly led by local
governments. According to a result of “Implementation statussurvey of second-hand smoke prevention measures” conducted by health promotion section of health division in healthand welfare department of Hyogo prefecture, however, theresult was far from the achievement of 100% smoking prohibition on the premises of universities showing smoking prohibition measures implementation ratios of 28.8% and 36.1% 2) asof 2005 and 2008 respectively in educational institutions such
Correspondence to:
Tomomi Katayama, Takarazuka
University School of Nursing,
1-13-16 shibata Kita-ku Osaka 530-0012 Japan
E-mail: t-katayama@takara-univ.ac.jp）

禁煙科学 6巻(2012)-04-P2

as universities and professional schools. In terms of smoking
prevention measures for minors, on the other hand, with education of health disturbance caused by smoking including second-hand smoke for early elementary grades, smoking prevention education has become to be implemented strenuously
based on enforcement of various policies 3) by individual local
governments and the curriculum guidelines specified by the
Ministry of Education 4). As the result, a lot of survey findings
have been reported that smoking ratios in minors have remarkably decreased 5, 6). However, disputed trend in students
to start smoking after enrollment in universities 7-10) has been
a common phenomenon observed in universities nationwide.
At present when the percentage of students who advance touniversities or junior colleges has reached more than 50%
level, it’s not an exaggeration to say that health promotion
activities at universities could make a great difference tohealth of graduates, i.e. citizens in the future 12). However,while various efforts for second-hand smoke prevention havebeen made at many universities, few reports have reviewed
current situation of second-hand smoke prevention measures
implemented at universities as well as knowledge and awareness on such measures of their faculty members simultaneously, resulting in insufficient clarification of recognition degree of faculty members relating to second-smoke prevention
measures implemented at universities.
Therefore, “actual conditions of second-hand smoke prevention measures” and “knowledge and awareness on them” were
simultaneously surveyed in the study at medical/welfare related universities which are supposed to take responsibilities
of education of students to actively work for medical welfare
field in the future and to have higher level of knowledge on
smoking.

Methods
1. Subjects and Methods of Survey
Based on data disclosed by the Ministry of Education, Culture, Sports, Science & Technology as of January 2011, survey cooperation requests were sent to presidents of 21 universities with medical, nursing, welfare faculties in Hyogo
prefecture and the survey was conducted for 6 universities
which agreed with the request and 861 of faculty members
who belonged to the universities. Placement method based onanonymous self-administered questionnaire was used for thesurvey.
Further, it was required to precisely comprehend actual
conditions of anti-smoking as well as second-hand smoke
prevention measures in order to understand how faculty members recognized the actual conditions of such measures implemented by universities they belonged to. Therefore, we asked
for answers about the actual conditions of second-hand smoke
prevention measures to one person for each university selected from among students and faculty members in charge ofhealth control of health control center or the like and those
who were in charge of second-hand smoke prevention measures and knew well about the activities. The surveillance period was from February to September in 2011.
2. Contents of Survey
Totally 20 items of questions were setup as the contents ofsurvey for faculty members including age, sex, occupation,
professional qualifications of medical or welfare field, basic

attributes including length of service, degree of recognition
about second-hand smoke prevention measures of universities
they belonged to, experience of second-hand smoke on thecampuses, awareness on smoking by students in medical/
welfare faculties as well by faculty members of medical/welfare-related universities, feeling at the time of second-handsmoke, knowledge on health effects caused by second-handsmoke, relationship between smoking trend in students andmeasures against smoking by students, stance for secondhand smoke prevention measures in the future, knowledge on
responsibility of facility managers to take steps for secondhand smoke prevention measures required by Health Promotion Law, degree of recognition about guidelines of Hyogo
prefecture for second-hand smoke prevention measures andtarget values indicated by them relating to smoking prohibition on the premises of universities, and interest in secondhand smoke prevention measures (Document 1). A question to
ask the condition of second-hand smoke prevention measures
implemented by universities was set up for the survey to understand the actual conditions of such activities of universities
including anti-smoking measures (Document 2). In addition,“universities with implementation of smoking prohibition on
the campus” in the study has been defined as “universities
which have publicly announced any and all smoking prohibitionon their premises including inside and outside of buildings”.
3. Methods of Analysis
Descriptive analysis of each survey item was conducted forage, sex, profession, professional qualification for medical andwelfare field, and length of service. Further, examination was
conducted on difference in proportions between two groups,
i.e. universities which have been implementing smoking prohibition on the premises (hereinafter refers to as on-thepremise smoking prohibition implementing school) and thosewhich have not been implementing smoking prohibition on thepremise (hereinafter refers to as on-the-premise smoking
prohibition non-implementing school) based on responses
from representatives of each university relating to the items ofdegree of recognition about second-hand smoke prevention
measures of universities they belonged to, experience of second-hand smoke on the campuses, relationship between
smoking trend in students and measures against smoking by
students, stance for second-hand smoke prevention measuresin the future. In addition, χ2 tests were conducted on differences in proportions based on sex and medical-related professional qualifications for each result. Each amount of statistics has been shown by average value ± standard deviation
with level of statistical significance at 0.05 or less. Missing
values have been eliminated and not included in the analysis.
SPSS 20.0J for Windows was used for the statistical analyses
mentioned above.
Furthermore, free descriptions relating to reasons forchoosing the direction for second-hand smoke prevention
measures in the future were quantified by categorizing theminto each group with similar descriptions. Subsequently, thesecond-hand smoke prevention measures were compared bytheir directions.
4. Ethical Consideration
With explicit description about outline, purpose and methodsof the study, securement of confidentiality and anonymity of禁煙科学 6巻(2012)-04-P3

data, and no disadvantage for rejection of participation in the
study or suspension thereof on the explanation and consent
documents distributed to universities and subjects for thesurvey, we regarded the collected consent forms from universities and survey slips from faculty members as their consents
to the study. With an explicit description that participants
may decline the study even along the way without any disadvantage, a copy of the survey response paper (consent form)
and request form for consent withdrawal were sent by mail touniversities which agreed with the survey. Further, analyses
were conducted by separating off any information that could
identify personal name based on the anonymous survey. The
survey was approved (on August 24, 2011) by Ethics Review
Committee of Kansai University of Social Welfare.

ResultAs a result of request of cooperation to the survey in writing
sent to presidents of 21 universities with a faculty of medicine, nursing or welfare in Hyogo prefecture, we received
responses from 10 of them (47.6%) over whether they accepted the cooperation or not. However, the request of cooperation to the survey was sent again to presidents of 11 universities which hadn’t responded previously. As the result,
we received responses from 5 universities anew by which thefinal number of respondent universities reached 15 (71.4%) in
total. We obtained consent from 6 universities (28.6%) among
the respondent universities. Then, survey slips were distributed to 861 faculty members of the 6 universities and thequestionnaire forms were collected from 502 respondents(58.3%) in total. Data of valid responses from 495 respondents(response ratio of 57.5%) were used for the analyses.
1. Outline of Subjects
Outline of subjects are shown in Table 1 separately by eachanti-smoking measure. As a whole, all subjects are divided
into 197 (40.1%) of men and 294 (59.9%) of women by sex, and133 (27.1%)
in their 40’s are classified as the most dominant group by age
followed by 118 in their 30’s and 105 in their 50’s. 219(44.7%), 261 (53.3%) and 10 (2.0%) were teachers, office staff
and others respectively by classification based on occupation.
In terms of qualification, 121 (25.1%) had medical/welfare
related professional qualifications, while 361 (74.9%) didn’t.
Further, 338 (69.4%) with three or more service years consists
more than half of all subjects, while those with less than threeservice years were 149 (30.6%).

Table1．Outline of Subjects
smoking ban status
total smoking ban
Not total smoking ban
n=285
n=210
sex
（unanswered＝4）
Male
99(35%)
98(47.1%)
Female184(65%)110(52.9%)Age（unanswered＝5）20-29
32(11.3%)
18(8.7%)30-39
62(22.0%)56(26.9%)40-4980(28.3%)
53(25.5%)
50-59
62(22.0%)43(20.7%)
0-941(14.5)
36(17.3%)705(1.8%)2(1.0%)
Occupation（unanswered＝5）
Teacher
125(44.6%)
94(44.8%)
Office worker
151(53.9%)110(52.4%)
Others4(1.4%)
6(2.9%)
Medical welfare employment qualification（unanswered＝13）
Yes77(28%)
44(21.3%)
No198(72%)163(78.7%)
Length of the job（unanswered＝8）>3years
95(34.1%)
54(26.0%)<3years184(65.9%)154(74.0%)
Item

2. Anti-smoking Measures Classification
As for classification of anti-smoking measures in 6 universities, three of them were on-the-premise smoking prohibition
implementing schools, and remaining three of them were onthe-premise smoking prohibition non-implementing schools.
The numbers of faculty members of the former schools were
285 and those of the latter were 210.
3. Anti-smoking Classification Recognized by Faculty Members
Anti-smoking classifications recognized by faculty members
are shown in Table 2 by each anti-smoking measure which has
been actually introduced by each university. Of all faculty
members of three on-the-premise smoking prohibition implementing schools, 205 of them (73.0%) had recognized the onthe-premise smoking prohibition correctly and 62 of them(22.1%) had mistakenly recognized it, revealing that 76 (27.1%)
of faculty members including 14 (5.0%) of those who responded
they didn’t know had not recognized the on-the-premisesmoking prohibition. On the other hand, of all faculty members of three on-the-premise smoking prohibition nonimplementing schools, 124 of them (59.6%) had correctly rec-

Table2.Smoking regulation recognized by teachers
smoking regulation status
The number of the respondents.smoking regulation recognizwd by teachers
total smoking ban
smoking ban in buildings
smoking is allowed in smoking rooms
smoking place is not directed
unclearpearson`s χ 2 analysis

1)2）

except unanswered

total smoking ban
3

Not total smoking ban
3n2812）（％）2082）（％）

205（73.0）23（8.2）25（8.9）14（5.0)14（5.0)6（2.9）
124（59.6）20（9.6）55（26.4）
3（1.4）

p

p<0.0011)

禁煙科学 6巻(2012)-04-P4

ognized anti-smoking classification introduced by the universities they belonged to, while 6 of them (2.9%) had recognized
as on-the-premise smoking prohibition and 3 of them (1.4%)
responded they didn’t know.
Then, difference in ratios of correct recognition of antismoking classification by faculty members for each antismoking measure introduced by each university was compared
between those who had medical/welfare related qualifications
and those who didn’t (Table 3). As a result, among faculty
members of on-the-premise smoking prohibition implementing
schools who had recognized the anti-smoking classification
correctly, 50 of them (66.7%) had medical/welfare related
professional qualifications while 150 of them (76.1%) didn’t,
showing significant difference recognized depending on with orwithout such qualifications (p < 0.001). On the other hand,among faculty members of on-the-premise smoking prohibition non-implementing schools who had recognized the antismoking classification correctly, 31 of them (70.5%) had medical/welfare related professional qualifications and 92 of them
(56.8%) didn’t, and it has been confirmed that ratio of those
who had correctly recognized the indoor no-smoking intro-

duced by on-the-premise smoking prohibition nonimplementing schools was significantly higher in those who had
medical/ welfare related professional qualifications (p <0.05).
Further, as a result of comparison on difference in ratios ofrecognition of anti-smoking classification between sexes(Table 4), among faculty members of on-the-premise smoking
prohibition implementing schools who had recognized the anti
-smoking classification, 68 of men (68.7%) and 136 of women(75.1%), i.e. about 70% of both men and women had correctly
recognized the on-the-premise smoking prohibition, showing
no significant difference between sexes. Among faculty members of on-the-premise smoking prohibition non-implementing
schools who had recognized the anti-smoking classification,
however, 47 of men (48.0%) and 77 of women (71.0%) had recognized the anti-smoking classification correctly, showing
significantly high ratio of correct recognition of the classification in women (p < 0.001).
4. Experience of Second-hand Smoke on the Campuses
Table 5 shows the status of experience of second-handsmoke on the campuses for each anti-smoking measure prac-

Table3. Teachers who have medical welfare system professional qualifications and those
who do not were compared. Anti-smoking divisions that those teachers are aware of are as follows:
smoking regulation status
Medical welfare employment qualification

total smoking ban
3
Yes

No

75 （％）

197 （％）

50(66.7)1(1.3)
10(13.3)6(8.0)
8(10.7)150(76.1)21(10.7)14(7.1)6(3.0)
6(3.0)

2）

Anti-smoking divisions that teachers are aware of
total smoking ban
smoking ban in buildings
smoking is allowed in smoking rooms
smoking place is not directed
unclearNot total smoking ban
3
Yes

p

2）

p<0.001Nop

44 （％） 1622）（％）2）

1)

3(6.8)
31(70.5)1(2.3)
7(15.9)2(4.5)

3(1.9)
92(56.8)
18(11.1)
48(29.6)
1(0.6)

p<0.051)

pearson`s χ 2 analysis
except unanswered

1)

2）

Table4.Smoking regulation recognized by teachers when sex compares.
smoking regulation status

The number of the respondents2）
Smoking regulation recognizwd by teachers
total smoking ban
smoking ban in buildings
smoking is allowed in smoking rooms
smoking place is not directed
unclearpearson`s χ 2 analysis
except unanswered1)

total smoking ban
3
Male
Femalen99（％）
181（％）
68（68.7）8（8.1）
15（15.2）
5（5.1）
3（3.0）

p136（75.1）15（8.3）10（5.5）9（5.0）
11（6.1）n.s1)

Not total smoking ban
3
Male
Femalen98（％）
109（％）
1（1.0）
47（48.0）16（16.3）
34（34.7）
05（4.6）
77（71.0）3（2.8）
21（19.3）3（2.8）

p

p<0.0011)

n.s=not significant

2）

Table5．Passive smoking in the university
smoking regulation status
The number of the respondents
passive smoking
daily
sometimes
never
pearson`s χ 2 analysis
except unanswered1)

2）

total smoking ban
3

Not total smoking ban
3n2842）（％）2092）（％）

8(2.8）
53（18.7）
223（78.5）14（6.7）88(41.2）
107（51.2）

p

p<0.0011)

禁煙科学 6巻(2012)-04-P5

Table6.Feelings when received passive smoking when compared between respondents who have medical welfare systemprofessional qualifications and those who do not.
Yes

No

Medical welfare employment qualification
Feelings when received passive smoking
Do not feel anything in particular
It is disturbing, but it does not affect or damage my health
It affects or damages my health, so I feel bad
pearson`s χ 2 analysis
except unanswered

1)

p

ｎ
462）（％）

1182）（％）

4（8.7）
32（69.6）
10（21.7）25（21.2）
75（63.6）
18（15.3）

n.s1)

n.s=not significant

2）

Table7.Feelings when received passive smoking when sex compares.
Male
The number of the respondents
Feelings when received passive smoking
Do not feel anything in particular
It is disturbing, but it does not affect or damage my health
It affects or damages my health, so I feel bad

Femalepｎ782）（％）

892）（％）

20（25.6）48（61.5）
10（12.8）8（9.0）
61（68.5）20（22.5）

p<0.011)

pearson`s χ 2 analysis
except unanswered

1)2）

ticed during the past 6 months. Those who responded they
had experienced second-hand smoke routinely and occasionally were 8 persons (2.8%) and 53 persons (18.7%) in on-thepremise smoking prohibition implementing schools and 14
persons (6.7% ) and 88 persons (41.2% ) in the nonimplementing schools respectively, showing significantly lower
ratio of experience of second-hand smoke in on-the-premisesmoking prohibition implementing schools (p < 0.001). However, those who had experienced second-hand smoke on theuniversities they belonged to during the past 6 months were
163 persons in the 6 universities, making up 33.1% of thewhole respondents. Moreover, those who had experienced
second-hand smoke while smoking prohibition on the premise
was practiced were 61 persons, making up 21.5% of faculty
members who belonged to on-the-premise smoking prohibition implementing schools. In other words, it has been proved
the reality that second-hand smoke was observed even at
higher education institutions such as medical/welfare related
universities which educate specialists to work at medical/
welfare related site in the future in spite of implementing
smoking prohibition on the premise.
5. Sensation When Exposed to Second-hand Smoke
We asked 163 of those who responded they had experienced
second-hand smoke routinely and occasionally in the universities they belonged to during the past 6 months about thesensation when they were exposed to second-hand smoke. As
shown in Fig.1, the result shows that 66.3% of them responded
they had felt it annoying but it had no harmful effect (damage)on health and 16.6% of them had complained its harmful effect(damage) on health with arduous feeling, revealing that morethan 80% of them in total had felt adverse effect on health andarduous feeling as well. Further, as nearly 20% of them responded they had already been affected (damaged) by secondhand smoke with arduous feeling, it has been confirmed that
there were faculty members whose health conditions wereaffected by second-hand smoke on the campuses.
Then, difference in ratios with regard to sensation when they
were exposed to second-hand smoke was compared between

Figure1．Feelings when received passive smoking
respondents with and without medical/welfare related professional qualifications (Table 6). As the result, those who responded it had not affected (damaged) their health but annoyed them with and without medical/welfare related professional qualifications were 32 persons (69.6%) and 75 persons(63.6%) respectively, and similarly those who responded it had
affected (damaged) their health and distressed as well, andthose with and without the qualifications who did it had madethem feel nothing special were 10 persons (21.7%) and 18
persons (15.3%) in the former case, and 4 persons (8.7%) and25 persons (21.2%) in the latter case respectively, with nosignificant difference confirmed depending on medical/welfare
related professional qualifications.
Further, differences of ratios in each item by sex were compared (Table 7). As the result, of all those who responded it
had not affected (damaged) their health but annoyed them, 48
were men (61.5%) and 61 were women (68.5%), and similarly of
all those who responded it had affected (damaged) their healthand distressed them as well and those who did it had madethem feel nothing special, 10 were men (12.8%) and 20 were
women (22.5%) in the former case , and 20 were men (25.6%)
and 8 were women (9.0%) in the latter case respectively, withsignificant difference confirmed between men and women (p <0.01).
6. Awareness of Faculty Members on Second-hand Smoke ofStudents on the Campus
The faculty members were asked how they considered sec-

禁煙科学 6巻(2012)-04-P6

Figure2． Teachers' awareness concerning thefact that students receive passive smoking in
the university
ond-hand smoke of students on the campuses of universities
they belonged to. As shown in Fig. 2, the result indicates
89.3% of faculty members took it undesirable for students tobe exposed to second-hand smoke on the campuses. In otherwords, it has been revealed that nearly 90% of faculty members think it unfavorable for students to be exposed to second-hand smoke on the campuses. On the other hand, it has

been also revealed that there still exist some faculty members
who don’t mind if students are exposed to second-handsmoke on the campuses of universities they belonged to, even
if the ratio was as low as 2.8%.
As a result of comparison of awareness on second-handsmoke of students on the campuses between faculty memberswith and without medical/welfare related professional qualifications (Table 8), of all those who considered it undesirable,
113 persons (93.4%) had professional qualifications and 316
persons (87.8%) didn’t, and similarly of all those who responded yes or no and those who tolerated it, 6 persons(5.0%) had the qualifications and 32 persons (8.9%) didn’t in
the former case and 2 persons (1.7%) had the qualifications
and 12 persons (3.3%) didn’t respectively, with no significant
difference recognized depending on the medical/welfare related professional qualifications.
Further, as a result of comparison by sex of awareness on
second-hand smoke of students on the campuses between
faculty members (Table 9), of all those who considered it undesirable, 173 were men (88.3%) and 266 were women (90.5%),and similarly of those who responded yes or no and those who

Table8. Teachers' awareness concerning the fact that students receive passive smoking in the university
when compared between respondents who have medical welfare system professional qualifications and those who do not.
Yes

No

Medical welfare employment qualification
1212）（％）
Awareness of Faculty Members on Second-hand Smoke of Students on the Campus
good2（1.7）
not good
113（93.4）
Cannot say if it is6（5.0）
good or not good
pearson`s χ 2 analysis
except unanswered

1)

p

ｎ
3602）（％）
12（3.3）316（87.8）

n.s1)

32（8.9）n.s=not significant

2）

Table9.Awareness of Faculty Members on Second-hand Smoke of Students on the Campus when sex compares.
Male
The number of the respondents2）

Female196（％）
Awareness of Faculty Members on Second-hand Smoke of Students on the Campus
good
3（1.5）
not good
173（88.3）
Cannot say if it is20（10.2）
good or not good
pearson`s χ analysis

1)

2）

2

p

ｎ
294（％）
11（3.7）266（90.5）17（5.8）n.s=not significant

except unanswered

Table10. Students' smoking conditions that teachers feel and the influences of passive smoking prevention
measures at each university.
smoking regulation status
student's smoking
Increased comparing with the past
Decreased comparing with the past
unclear
The influences of passive smoking prevention
measures
Greatly affected
Affected to some extent
Not significantly affected
unclearpearson`s χ 2 analysis
except unanswered

1)2）

n.s=not significant

total smoking ban
32852）（％）
18（6.3)120（42.1）
147（51.6）

Not total smoking ban
32092）（％）
22（10.5）
87（41.6）
100（47.8）2812）（％）2062）（％）

36（12.8）
88（31.3）
51（18.1)
106（37.7）9（4.4）
66（32.0）69（33.5）62（30.1）pn.s1)

p<0.0011)

n.s1)

禁煙科学 6巻(2012)-04-P7

tolerated it, 20 were men (10.2%) and 17 were women (5.8%) in
the former case and 3 were men (1.5%) and 11 were women(3.7%) in the latter case respectively, with no significant difference confirmed between men and women.

on-the-premise smoking prohibition implementing schools,
the highest ratio of 75.7% of them responded on-the-premisesmoking prohibition should be continued, followed by 13.7% ofthem preferring completely separate smoking and 9.9% of them
preferring indoor no-smoking. In case of those who belonged
to on-the-premise smoking prohibition non-implementing
schools, the highest ratio of 45.9% of them responded on-thepremise smoking prohibition should be continued, followed by
28.2% of them preferring indoor no-smoking and 21.5% of them
preferring completely separate smoking, revealing that faculty
members of on-the-premise smoking prohibition implementing
schools more likely recognized a need to continue the on-the-premise smoking prohibition as a trend for second-handsmoke prevention measures in the future (p < 0.001).
Then, as a result of comparison (Table 12) between faculty
members with and without medical/welfare related professional
qualifications about how they considered the second-handsmoke prevention measures to be implemented or continued
ultimately in the universities they belonged to, it has been
revealed that those who had medical/welfare related professional qualifications more likely recognized a need to continue
the on-the-premise smoking prohibition (p < 0.001).

7. Trend of Smoking among Students Perceived by Faculty
Members and Effects of Second-hand Smoke Prevention
Measures Implemented by Each University
Trend of smoking among students perceived by faculty members is shown in Table 10 by each anti-smoking measure. In
terms of trend of smoking among students of universities they
belonged to, ratios of the faculty members in on-the-premisesmoking prohibition implementing schools and nonimplementing schools who perceived the trend had shrunk
than before were 42.1% and 41.6% respectively, and ratios of
those who perceived the trend had strengthened than before
were 6.3 % and 10.5% respectively, showing almost the sameratios with no significant difference observed depending on theanti-smoking measures. By a question whether they thought
the second-hand smoking prohibition measures implemented
by the universities they belonged to had influence on thetrend of smoking among students, such a tendency has beenrecognized that faculty members of on-the-premise smoking
prohibition implementing schools more likely perceived significant impact and those who belonged to the non-implementing
schools more likely perceived less impact (p < 0.001).

9. Reason for Selection Relating to Direction for Secondhand Smoke Prevention Measures in the Future
As 182 out of 493 respondents relating to direction for second-hand smoke prevention measures in the future described also
about reasons of selection, a result of analysis of their descriptions is shown. Of 182 respondents, 104 selected to implement or continue on-the-premise smoking prohibition as adirection for second-hand smoke prevention measures in the
future, followed by 39, 36 and 3 respondents who selectedindoor no-smoking, completely separate smoking, and sepa-

8. Second-hand Smoke Prevention Measures to be Implemented or Continued Ultimately
The results shown in Table 11 are responses to a question
about second-hand smoke prevention measures which shouldbe implemented or continued ultimately in the future in theuniversities they belonged to. In case of faculty members ofTable11. Passive smoking prevention measures that should be implemented finally or continued to implement.
smoking regulation status

total smoking ban
3

Not total smoking ban
3n2842）（％）2092）（％）
The direction of the anti-smoking that should be implemented finally or continued to implement
total smoking ban
215(75.7）
96（45.9）
smoking ban in buildings
28（9.9）59（28.2）
smoking is allowed in smoking rooms
39（13.7）45（21.5）
smoking place is not directed2（0.7）
8（3.8）
free smoking
01（0.5）The number of the respondentspp<0.0011)

pearson`s χ 2 analysis
except unanswered

1)

2）

Table12.
Passive smoking prevention measures that should be implemented finally or continued to implement
when compared between respondents who have medical welfare system professional qualifications and those who
do not.
Medical welfare employment qualification

Yes

No

n
1212）（％）3592）（％）
Passive smoking prevention measures that should be implemented finally or continued to implement
total smoking ban
96（79.3）
204（56.8）
smoking ban in buildings
13（10.7）
74（20.6）
smoking is allowed in smoking rooms
11（9.1）71（19.8）
smoking place is not directed1（0.8）
9（2.5）
free smoking
01（0.3）The number of the respondents

pearson`s χ 2 analysis
except unanswered

1)

2）

p

p<0.0011)

禁煙科学 6巻(2012)-04-P8

Table13. The reasons of the selection regarding the orientation of passive smoking prevention measures in the future.
Categories that have been extracted from the contents of free description
1)total smoking ban
Necessary for passive smoking prevention measures
Necessary for health
Smoking itself is annoying or unpleasantReasonable as a university of Medical Welfare system
Necessary for education2)smoking ban in buildings
Possible occurrence of harmful effects caused by banning smoking in the site
Smoking is a personal freedom and rights
Difficult to ban smoking completely
No problem with the present situation
Banning smoking in the site is too compulsory
Health hazards are reduced by banning smoking in the building3)smoking is allowed in smoking rooms
Possible occurrence of harmful effects caused by banning smoking in the site
Smoking is a personal freedom and rights
Difficult to ban smoking completely
Acceptable to separate smoking and non-smoking areas completely4)smoking place is not directed
Other measures are unrealistic
Smoking is a personal freedom and rights

rate smoking respectively. In relation to the reason for selecting implementation or continuation of on-the-premise smoking prohibition as a direction for second-hand smoke prevention measures in the future, the highest ratio of 45.2% of respondents selected reasons belonged to a category of“necessity of second-hand smoke prevention measures”, followed by 19.2%, 13.5%, 11.5% and 10.6% of those who selectedcategories of “necessity for health”, “unpleasant and disturbing properties of smoking”, “as a matter of course for medial/
welfare related universities” and “necessity for education”
respectively. Further, among reasons of those who selected
implementation or continuation of indoor no-smoking, orcompletely separate smoking, and separate smoking, thosereasons categorized into “possibility of adverse effect causedby on-the-premise smoking prohibition”, “smoking as anindividual liberty and right” and “difficulty in complete smoking prohibition” ranked high, and such reasons categorized
into “necessity for second-hand smoke prevention measures”,“necessity for health” and “necessity for education” weren’t
observed at all compared with descriptive contents of those
who selected implementation or continuation of on-thepremise smoking prohibition.
*Words quoted by ” “ indicate category names.

Number of Descriptions
104
47
20
14
12
11
39
13
11
8
4
2
1
36
13
11
7
5
3
2
1

%
(100.0)
45.2
19.2
13.5
11.5
10.6
(100.0)
33.3
28.2
20.5
10.3
5.1
2.6
(100.0)
36.1
30.6
19.4
13.9
(100.0)66.7
33.3

10. Obstructive Factors for On-the-premise Smoking Prohibition
As for 96 of faculty members who desired on-the-premisesmoking prohibition ultimately in the universities they belonged to where the on-the-premise smoking prohibition hasn’t been introduced yet, factors shown in Fig. 3 are those
responded by them as the hindrance to implementation of onthe-premise smoking prohibition by the universities they currently belong to. As the result, the most dominant reason
accounting for 29.6% was that cooperation of faculty memberswith smoking habit wasn’t obtained, followed by those accounting for 26.9% and 13.0% that increased smoking outside
the premise could cause troubles for neighbors and that it wasdifficult to obtain assistance from top management with smoking habit, respectively. In Health Promotion Law, schools aredesignated as an institution with an obligation to take any
measure as required to prevent second-hand smoke and sofacility managers are imposed with a duty to make efforts totake second-hand smoke prevention measures. However, as afactor to prevent on-the-premise smoking prohibition frombeing introduced, such responses that it was difficult to obtainassistance from top management with smoking habit made up
for more than 10% of the whole responses.

Figure3．Factors that prevent people from banning smoking in the site

禁煙科学 6巻(2012)-04-P9

Discussion
With faculty members who didn’t correctly understand second-hand smoke prevention measures of each university accounting for approximately 30% and 40% of those who belonged to on-the-premise smoking prohibition implementing
schools and non-implementing schools respectively, it has
been revealed that there exist certain faculty members who
didn’t understood actual state of second-hand smoke prevention measures. In addition, as for experience of second-handsmoke during the past 6 months, from 20% to more than 40%of people were exposed to second-hand smoke on the campuses in both on-the-premise smoking prohibition implementing schools and non-implementing schools, revealing existence of second-hand smoke regardless the state of implementation of second-hand smoke prevention measures byuniversities. In other words, the result has suggested a realitythat second-hand smoke still exists even under implementation of on-the-premise smoking prohibition. According to asurvey conducted at public elementary, junior and seniorhigh schools by Kiyohara et al. (2008), the number of those
who were exposed to second-hand smoke in schools of on-the-premise smoking prohibition implementing group was lessthan one-tenth of that in schools of on-the-premise smoking
prohibition non-implementing group, suggesting that theregulation of on-the-premise smoking prohibition had a great
impact on reducing second-hand smoke 13). With second-handsmoke observed in on-the-premise smoking prohibition implementing schools by around half of that in non-implementing
schools, however, such great impact on second-hand smoke
reduction by implementation of on-the-premise smoking prohibition wasn’t recognized as did in public elementary, juniorand senior high schools. It is believed that it was affected bydifferences between universities and public elementary, juniorand senior high schools. Therefore, a lot of factors were
thought to be associated with. For example, unlike public
elementary, junior and senior high schools, universities don’t
have such institutions like the board of education to integrally
decide and perform regulations, and unlike such institutions inwhich majority of educational object students are minors, they
have not only students who haven’t reached the age eligible
to smoke but also those who have arrived in adulthood including more than half of them at eligible age for smoking, and so
there are generous opinions on smoking by faculty members
and students on the campuses 9, 12, 14). As may be apparent
from the result this survey, the fact that 30% of faculty members hadn’t recognized the anti-smoking classification in onthe-premise smoking prohibition implementing schools was
believed to be a factor to hamper publicizing on-the-premisesmoking inhibition implementation. As there has been a report11)that around 10% of students and faculty members hadn’t
acknowledged the on-the-premise smoking prohibition at thetime two years after introducing on-the-premise smoking
prohibition, this aspect was taken as a problem also in a survey conducted in universities implementing on-the-premisesmoking prohibition, and therefore the result of the survey
isn’t an exception. It is believed such environmental characteristics of universities might have become factors to makefaculty members difficult to acknowledge the anti-smoking
classification correctly that faculty members work on in theirindividual rooms such as laboratories because universities
don’t have faculty rooms unlike elementary, junior and seniorhigh schools and that school buildings are scattered in the
broad premises, resulting in generating a circumstance prone
to smoke even on the premises where smoking is prohibited.
Further, judging from the fact that faculty members hadn’t
acknowledged the anti-smoking classification in spite of implementation of on-the-premise smoking prohibition, it wasconcerned that similar phenomenon had occurred in recognition among students. Therefore, it may be an urgent need toconsider how to widely supply and notify information of second-hand smoke prevention measures in order to make students and faculty members correctly recognize anti-smoking
classifications.
In terms of direction for second-hand smoke prevention
measures in the future in the universities faculty members
belonged to, it has been revealed that many of them had recognized it undesirable to expose students to second-handsmoke regardless the on-going anti-smoking classifications
and considered it necessary to introduce on-the-premisesmoking prohibition for second-hand smoke prevention measures to be aimed at in the future. The tendency was observed
more significantly in those who have medical/welfare related
professional qualifications. As many researchers of antismoking measures in school have mentioned, universities are
positioned as a final stage for anti-smoking education and thefaculty members are required to play a role to prevent students from starting to smoke 13, 15, 16). Based on these aspects,
this survey is believed to have provided a result to support a
correct way for promotion of second-hand smoke prevention
measures. On the other hand, however, some faculty members
have selected an anti-smoking classification other than on-the-premise smoking prohibition as a direction for second-handsmoke prevention measures in the future. Moreover, responses which were belonged to such categories as to “assert
liberty and rights to smoke” or “fear adverse effects by introduction of on-the-premise smoking prohibition” made up
more than half of the reasons they selected anti-smoking
classifications other than on-the-premise smoking prohibition.
It was believed form these results that such a persistent socially-accepted idea that smoking was a personal liberty still
remained actually even in medical/welfare related universities,
making it difficult to introduce on-the-premise smoking prohibition. Nakai et al. (2008) has described difficulty for students after enrollment in universities to prohibit smoking on
their own and importance of smoking prohibition support byuniversities, taking into consideration that smoking habit instudents becomes addictive during a period before or after
enrollment in universities 17). It may be important for universities to make efforts to eliminate circumstances in which smoking is tolerated as many as possible as well as to prevent
smokers from increasing by providing correct information to
students and faculty members as well. Since students tograduate medical/welfare related universities will be involvedin professions relating to people’s health, it is a mission for
universities to produce specialist personnel capable of not
only keeping their own health but also taking actions in consideration of effects to surroundings and faculty members are
expected to be the closest to students and to show a betterrole model as well. It is required for universities in the future
to improve environments to take advantage of anti-smoking
education which has been addressed through elementary andjunior high schools to senior high schools and to make every

禁煙科学 6巻(2012)-04-P10

single faculty member practice educational involvement for
anti-smoking activities with correct knowledge.
In addition, although the survey is a crossover one and theanalyses were conducted on actual situation of second-handsmoke prevention measures and awareness and knowledge of
faculty members, it can’t be denied that various factors which
weren’t involved in this survey items may have some impacts
on such awareness and knowledge. Therefore, the analyses
were conducted only within a range of simple comparison
based on respective perspectives of anti-smoking classification, sex and possession of medical/welfare related professional qualifications.

9)

10)

11)

Conclusion
Even in medical/welfare related universities for which many
faculty members with a lot of medical knowledge are supposed
to work, events of second-smoke have been confirmed underon-the-premise smoking prohibition. In addition, 30% of faculty members of on-the-premise smoking prohibition implementing schools haven’t correctly recognized the antismoking classification of the universities they belonged to.

12)

13)

Acknowledgment
We’d like to offer our heartfelt thanks to all of cooperative
respondents to the survey and those who have taken responsibility to play a communication and coordinating role for our
researchers as contacts of universities to pursue this study.
For your information, the study has been conducted with afinancial assistance of 2010 cooperative research grant (study
representative: Tomomi Katayama) provided by Institute ofRegional Social Welfare Policy of Kansai University of Social
Welfare.

Literatures
1)
2)

3)
4)

5)

6)

7)

8)

Hyogo prefecture : Hyogo Prefecture Second-handSmoke Prevention Measures Guidelines. 2004
Hyogo prefecture: Survey Results of Implementation
Status of Hyogo Prefecture Second-hand Smoke Prevention Measures. 2008.
Ministry of Health, Labor and Welfare : Health Japan 21“Tobacco” . 2000.
Ministry of Education, Culture, Sports, and Science &Technology : Primary School Curriculum Guidelines(Announced on December in 1998, partially revised on
December in 2003).
Yoneatsu Ozaki, Takashi Ohida, Yoshitaka Kaneita, etal. : Smoking and Drinking by Juveniles. Central Reseach Service, 2009: 623.
Satomura Kazunari, Suketaka Iwanaga, Megumi Noami,
et al. : Science for Society and Health Based on Public
Health (5) Transition of Anti-tobacco Measures in Japanand its Effect. Japanese Journal of Public Health 58 (4),2011: 311-315.
Akiko Higashiyama, Tadao Tsuda, Yuko Takahashi:
Smoking Consciousness in University Students – Current Status of Smoking and Marginal Cost Consciousness in University Student Smokers. Kinen Kagaku 3(3), 2010: 35-40.
Miyuki Takeuchi, Akie Kobayashi, Namiko Yurie et al.:
Smoking Consciousness Survey for Anti-smoking Meas-

14)

15)

16)

ures for Female University Students, Kagawa Prefectural
College of Health Sciences Bulletine 3, 2006: 117-125.
Kaori Fujii, Ayako Higo, Yasuko Kunegi et al.: Antismoking Activities and Transition of Smoking Rates byCampus in Our University. Keio Health Research 23 (1),2005: 73-77.
Hiroko Iwaoka: Behavioral Science Research for Smoking
in Female University Students –Young Lady-oriented
Quitting and Preventing Smoking Program Development
Based on University’s Community-. Research Report 36
of Life Environmental Science Institute of Miyagi Gakuin
Women’s University, 2004: 45-46.
Ministry of Education, Culture, Sports, and Science &Technology : International Comparison of Educational
Guidelines. 2011.
Mayumi Yamamoto, Mika Tanaka, Jun Takeda: Anonymous Self-administered Questionnaire about On-thepremise Total Smoking Prohibition Conducted for All ofStudents and Faculty Members of Universities. Kinen
Kagaku 1 (2), 2007: 10-15.
Kousuke Kiyohara, Yuri Itani, Yoshitaka Matsumoto etal. : Introduction of On-the-campus Smoking Prohibition and Awareness and Attitude of Faculty Members
against Tobacco – Comparative Study between On-thepremise Smoking Prohibition Implementing Schools and
Non-Implementing Schools, Kinen Kagaku 2 (3) , 2008:
11-16.
Akira Ishii : Development of Quit Smoking Program on
College Campus as Sanctuary. COPD FRONTIER 6 (4),2007: 63-67.
Hiromi Muratani, Hiromasa Okumura, Haruhiko Yasugouchi et al. : Factors Relating to Smoking by Students of
Kyushu Sangyo University – The First Report: Lifestyle
Habit and Health Consciousness-. Health & Sports Science Research 5, 2003: 51-56.
Kumiko Nakai, Yuko Takahashi, Kousuke Kiyohara et al.
: Achievement in Quit Smoking Support for Smoking
Students on a Project of Smoking Prohibition Introduction to Universities. Kinen Kagaku 2 (4) , 2008: 33-27.