Smoking among adolescents in China: 1998 survey findings

BACKGROUND: In China, tobacco smoking accounts for approximately 800 000 deaths annually and evidence suggests that tobacco use is rising. To improve tobacco control initiatives directed at youth, we conducted a population-based survey of children ages 11-20 years, both in and out of school. While there have been previous school-based studies on smoking prevalence and smoking-related knowledge, attitudes, and behaviours among adolescents in China, including the Global Youth Tobacco Survey, this survey also describes smoking behaviour among non-student youth. This population is important as approximately 40% of Chinese youths aged 15-19 years have already discontinued their studies. METHODS: A survey of smoking behaviour and smoking-related knowledge and attitudes was administered to 24 000 youths (students and non-students of middle school age) in 24 disease surveillance points in China, selected to include equal numbers of urban and rural children. RESULTS: The prevalence rates of experimenting were 47.8% for boys and 12.8% for girls. The prevalence of regular smoking among non-students was higher (8.3%) compared with students (5.2%). The strongest predictor of regular smoking was peer influence with 44% reporting that they obtained their first cigarette from peers. The majority of youths were aware that smoking was a cause of several diseases and addictive; however, non-students were less aware than students. CONCLUSIONS: The evidence highlights the need for tobacco control interventions aimed at youths in China including non-student youths. For males, prevention programmes should extend into young adulthood.