Risk factors for adolescent smoking in urban and rural China: findings from the China seven cities study.
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.
Ma
Huiyan
H
Keck School of Medicine, University of Southern California, Alhambra, CA91803, USA. huiyanma@usc.edu
Unger
Jennifer B
JB
Chou
Chih-Ping
CP
Sun
Ping
P
Palmer
Paula H
PH
Zhou
Yan
Y
Yao
Jie
J
Xie
Bin
B
Gallaher
Peggy E
PE
Guo
Qian
Q
Wei
Yonglan
Y
Chen
Bin
B
Wang
Zhanju
Z
Wang
Xu
X
Duan
Haiping
H
Song
Yu
Y
Gong
Jie
J
Azen
Stanley P
SP
Lee
Liming
L
Johnson
C Anderson
CA
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