OBJECTIVETo explore the relationship between psychological stress, fatigue and different smoking behaviors among undergraduate students.

METHODS8138 undergraduate students in grade 1 to 3 were sampled with cluster sampling method from a comprehensive university in Guangzhou, and were studied on their psychological stress, peer and self smoking behaviors, as well as socio-demographic factors with a self-administered questionnaire. Physical and mental fatigue was measured by Chalder fatigue scale. A multinomial logistic regression analysis was performed to explore the association between psychological stress, fatigue and different smoking behaviors with 'non-smokers' defined as control group while 'triers' and 'current smokers' as case group, respectively.

RESULTSThere were students trying to smoke or becoming current smokers on university campus. After adjusting the effect of relevant socio-demographic factors and peer smoking behavior, physical fatigue (OR = 1.044, 95% CI: 1.013-1.075) and 'worry about current academic and future work' (OR = 1.020, 95% CI: 1.001-1.040) were the risk factors of trying to smoke among male students, while 'study stress (OR = 1.063,95% CI: 1.012-1.117) was the risk factor for female students when start smoking. 'Personnel relationship and environment stress' (OR = 1.152, 95% CI: 1.012-1.312) were the risk factors for female students' current smoking behavior.

CONCLUSIONPsychological stress and fatigue were moderately associated with smoking behavior among undergraduate students and the impact was different on different gender and smoking behaviors that suggesting that some specific psychological measures should be taken so as to control different smoking behaviors among undergraduate students.