Short communicationRisk factors for adolescent smoking in urban and rural China: Findings from the China seven cities study
Introduction
Cigarette smoking is rising among urban Chinese adolescents and poses a significant public health concern. While the majority of Chinese youth live in rural areas, there have been no studies that address whether risk and protective factors for smoking are similar or different between urban and rural adolescents in China. Clarification of this question is crucial to inform the development of smoking prevention programs appropriate for both groups. Therefore, the primary focus of this study is to assess whether risk factors for smoking that have been identified in Western studies (Hoffman, Sussman, Unger, & Valente, 2006) are also risk factors for smoking in urban and rural areas of China. Such factors include parental smoking, peer smoking, and low refusal self-efficacy. This study also compares and contrasts the strength of these risk factors in urban and rural areas.
Section snippets
Data sources and sample selection
Cross-sectional data for the current study were obtained during the third-year survey (in 2004) of the China Seven Cities Study (CSCS). The CSCS is a longitudinal, school-based cohort study of health-related behaviors conducted by a consortium of researchers and public health officials in each of the seven cities and at the University of Southern California (USC). The seven participating cities are located in four regions across China: Northeast (Harbin, Shenyang), Center (Wuhan), Southwest
Comparison of demographics and predictors between urban and rural areas
Parental smoking rates were similar in urban (63.01%) and rural (63.43%) areas (Table 2). Compared to urban boys, rural boys were more likely to report that their friend(s) smoked at least one cigarette per month (P < 0.0001), perceived a higher percentage of smoking prevalence among their same gendered best friends (P = 0.03), and were more likely to have low smoking refusal self-efficacy (P < 0.0001). In comparison to urban girls, rural girls perceived a lower percentage of smoking among their same
Discussion
Overall, the influence of parental smoking on the smoking behavior of ninth grade students was relatively weak in both urban and rural areas of China. Parental influences on adolescent smoking were similarly weak in studies in urban Guangzhou, China (Wen et al., 2007), and in Western countries (Hoffman et al., 2006).
Friends' smoking and perceived smoking prevalence were risk factors for adolescent smoking in both urban and rural areas of China. These effects are similar in direction and
Acknowledgment
This research was supported by the USC Pacific Rim Transdisciplinary Tobacco and Alcohol Use Research Center (NIH grant 1 P50 CA84735-01) and the Sidney R. Garfield Endowment. The authors are deeply grateful to the CSCS steering committee and team members.
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