Association between psychological factors and adolescent smoking in seven cities in China

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Cigarette smoking is a culturally accepted behavior among adult males in China. However, there is limited information on smoking among Chinese adolescents, particularly the information on the relationship between psychological well-being and smoking behavior among this population.


This study explored associations between three psychological factors—anxiety, hostility, and depressive symptoms—and smoking behavior among Chinese adolescents. Methods: The data presented in this study are a cross-sectional slice from a longitudinal investigation of tobacco use and lifestyle carried out in China. The study population consisted of 4,724 7th and 11th grade students from seven large cities in China.


Odds ratios showed that anxiety, hostility, and depressive symptoms were significantly associated with a higher risk of lifetime smoking for both boys and girls.


Much like their Western counterparts, Chinese adolescents face developmental stress. The resulting distress may increase their risk for substance use and other health-risk behaviors.

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