Abstract
Purpose: We provided smoking prevention and cessation education to university students and evaluated how their subjective harm awareness to cigarettes and new types of tobacco (heat-not-burn tobacco, electronic cigarettes) changed after the lecture.
Method: In the common education course, we provided three 90-minute lectures about smoking-related diseases, such as cancer and chronic obstructive pulmonary disease, smoking cessation aids, and the harmful effects of cigarettes and new types of tobacco. After the lecture, a questionnaire was distributed to students query their age and gender and describe changes (1– 5 points) in the students’ awareness of three types of tobacco.
Results and Discussion: After smoking cessation and prevention education for university students, awareness about the impact of smoking significantly increased. Of the three types of tobacco, cigarettes were the most recognized as harmful, followed by heat-not-burn tobacco and electronic cigarettes. Although the harmfulness of cigarettes has been communicated in elementary schools, new types of tobacco have emerged in recent years and are advertised as having low toxicity. Women tended to be more aware of the harmful effects of all types of tobacco than men. This may be because women tend to be more conscious about their health conditions, such as pregnancy and childbirth. Conversely, the recognition of heat-not-burn tobacco and electronic cigarettes before the lecture was lower than that of cigarettes. Many students may be willing to smoke electronic cigarettes because awareness of their harmfulness was lowest before the lecture. The students likely believed that electronic cigarettes are less harmful because they do not contain nicotine or tar.
Conclusion: It is necessary to educate university students about the harmfulness of new types of tobacco based on our survey of their subjective degree of hazard awareness of cigarettes and new types of tobacco.

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