Results of this study indicate that in China, with almost two out of three adult males smoking, it is difficult for young men to grow up and not smoke. The college students in this study were among the most highly educated young adults in the country, yet their smoking prevalence increased with age and with years in college. Even the group seemingly best equipped to resist that trend, young adults being educated in modern medicine, fared no better. They managed only to restrict their cigarette consumption to a lower level. These findings illustrate the challenges of tobacco control in China, but also accentuate the urgent need for action.
To help prevent medical students from initiating smoking and to better prepare them to become early adopters of a non-smoking culture, tobacco education programs can be introduced into medical school curricula, as some schools in China have already done (Richmond, 1996). In addition, and probably more importantly, there must be strong policies that will affect the acceptability of smoking. Thus, college campuses, especially medical school campuses, should be smoke-free. On a broader societal level, tobacco control measures such as those outlined in the World Health Organization Framework Convention on Tobacco Control should be implemented. While there are many challenges ahead, past successes in world tobacco control (Glantz, 2003) offer hope for China's future if appropriate and timely action is taken.