Peer influences and access to cigarettes as correlates of adolescent smoking: a cross-cultural comparison of Wuhan, China, and California.
BACKGROUND
Few studies have assessed the effects of access to cigarettes and peer influences on adolescent smoking in non-Western countries. Using samples characterized by two distinct cultural, social, and economic systems, this study evaluated the associations of friends' smoking and perceived access to cigarettes with adolescent smoking behavior in California and Wuhan, China.


METHODS
Survey data were obtained from 5870 eighth-grade students in the Independent Evaluation of the California Tobacco Control Program and 6992 seventh- to ninth-grade students in the Wuhan Smoking Prevention Trial. Odds ratios for lifetime and 30-day smoking, according to friends' smoking and perceived access to cigarettes, were calculated for boys and girls in both samples and compared.


RESULTS
California students were more likely than Wuhan students to have friends who smoked and to perceive easy access to cigarettes. The smoking prevalence was lower in Wuhan than in California, mainly due to the low smoking prevalence among Wuhan girls. Friends' smoking was strongly associated with smoking in both samples, and the strength of this association did not differ between the two cultures. Access to cigarettes was associated with a higher risk of lifetime smoking in both cultures and a higher risk of past 30-day smoking in California only.


CONCLUSIONS
Despite divergent tobacco control policy enforcement, social structures, and cultural contexts, similarities exist between Wuhan and California. The findings suggest support for adapting a social-influences-based smoking prevention program developed in the United States to the culturally specific needs of youth in Wuhan, China.
Unger
Jennifer B
JB
University of Southern California, Los Angeles, California 90089, USA. unger@hsc.usc.edu
Yan
Li
L
Shakib
Sohaila
S
Rohrbach
Louise Ann
LA
Chen
Xinguang
X
Qian
Guo
G
Chou
Chih-Ping
CP
Jianguo
Shan
S
Azen
Stanley
S
Zheng
Hong
H
Johnson
C Anderson
CA
D000293:Adolescent; D000367:Age Factors; D002140:California / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003132:Commerce / Q000331:legislation & jurisprudence; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010379:Peer Group; D015995:Prevalence; D012306:Risk; D017678:Sex Distribution; D012907:Smoking / Q000208:ethnology* / Q000331:legislation & jurisprudence / Q000523:psychology; D000074606:Smoking Prevention