title: Risk factors for adolescent smoking in urban and rural China: findings from the China seven cities study.
abstract: Cigarette smoking is rising among urban Chinese adolescents and poses a significant public health concern. The majority of Chinese youth live in rural areas, but most research on the risk factors for smoking has been conducted in urban areas of China. This study examined the associations between parental smoking, peer smoking, and low refusal self-efficacy and smoking among urban and rural Chinese youth. This analysis used a cross-sectional sample of 3412 ninth grade students in urban and rural areas under the administrative jurisdiction of seven large cities in China. Multilevel logistic regression models were used to associate the risk factors with lifetime and current smoking, separately in boys and girls. Adolescent smoking was not strongly associated with parental smoking. However it was strongly associated with peer smoking and low refusal self-efficacy across both the urban and rural samples. Students with lower refusal self-efficacy were approximately 5-17 times more likely to be lifetime or current smokers than those with higher refusal self-efficacy. Smoking prevention interventions in China may need to focus on raising adolescents' refusal self-efficacy.
authors.affiliation: Keck School of Medicine, University of Southern California, Alhambra, CA91803, USA. huiyanma@usc.edu
authors.forename: Huiyan
authors.initials: H
authors.lastname: Ma
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Unger
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.forename: Paula H
authors.initials: PH
authors.lastname: Palmer
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jie
authors.initials: J
authors.lastname: Yao
authors.forename: Bin
authors.initials: B
authors.lastname: Xie
authors.forename: Peggy E
authors.initials: PE
authors.lastname: Gallaher
authors.forename: Qian
authors.initials: Q
authors.lastname: Guo
authors.forename: Yonglan
authors.initials: Y
authors.lastname: Wei
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.forename: Zhanju
authors.initials: Z
authors.lastname: Wang
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.forename: Haiping
authors.initials: H
authors.lastname: Duan
authors.forename: Yu
authors.initials: Y
authors.lastname: Song
authors.forename: Jie
authors.initials: J
authors.lastname: Gong
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Liming
authors.initials: L
authors.lastname: Lee
authors.forename: C Anderson
authors.initials: CA
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011634:Public Health; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D000074606:Smoking Prevention; D012931:Social Environment