Smoking and its risk factors in Chinese elementary and middle school students: A nationally representative sample study

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ObjectiveThe purpose of this study was to examine the prevalence of smoking in a nationally representative sample of Chinese elementary and middle school students and to investigate its risk factors from families and schools. MethodThe data were from the National Children's Study of China (NCSC), in which 24,013 fourth- to ninth-grade students were recruited from 100 counties in 31 provinces in China. Chi-square tests and one-way ANOVAs were used to analyze the relationships between smoking and the risk factors. Logistic regressions were used to calculate odds ratios. ResultsThe prevalence of ever smokers and current smokers were 19.0% and 5.4%. Focusing on current smokers, boys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels reported smoking significantly more than girls, elementary school students, urban students, non-boarding students, only children and those owning parents with high educational levels. Lower trust and support from teachers and higher parent–child conflict positively predicted both smoking and smoking frequency. Lower trust and support from classmates was associated with higher possibility of smoking. However, higher trust and support from classmates was associated with higher smoking frequency. Teacher smoking and friend smoking were only predictive of smoking, but not of smoking frequency. ConclusionsBoys, middle school students, rural students, boarding students, non-only children and those owning parents with low educational levels need special attention. The most risk factors for smoking and smoking frequency were lower trust and support from teachers and higher parent–child conflict.