Smoking among adolescents in China: 1998 survey findings

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.

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.

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.

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.