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IJE Advance Access originally published online on June 24, 2004
International Journal of Epidemiology 2004 33(5):1103-1110; doi:10.1093/ije/dyh225
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IJE vol.33 no.5 © International Epidemiological Association 2004; all rights reserved.

Smoking among adolescents in China: 1998 survey findings

Gonghuan Yang1, Jiemin Ma1, Ai Ping Chen1, Shannon Brown2, Carl E Taylor3 and Jonathan M Samet3

1 Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences
2 Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health
3 Johns Hopkins Bloomberg School of Public Health

Correspondence: Prof. J Samet, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, 615N Wolfe St, Baltimore, MD21205, USA. E-mail: jsamet{at}jhsph.edu

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.


Keywords Tobacco, smoking, prevalence, China, adolescents, youth

Accepted 7 April 2004


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