Cigarette smoking and its risk factors among elementary school students in Beijing

Objectives. This study investigated patterns of and risk factors for smoking among elementary school children in Beijing, China. Methods. In 1988, anonymous questionnaires were administered to a multistage stratified cluster sample of 16 996 students, aged mostly 10 to 12, in 479 fourth- to sixth- grade classes from 122 Beijing elementary schools. Results. Approximately 28% of boys and 3% of girls had smoked cigarettes. The most frequently cited reasons for smoking initiation were 'to imitate others' behavior' and 'to see what it was like.' Girls were more likely to get cigarettes from home than to purchase their own. Having close friends who smoked and being encouraged by close friends to smoke were strong risk factors for smoking. Smoking was also associated with lower parental socioeconomic status; having parents, siblings, or teachers who smoked; buying cigarettes for parents; performing poorly in school; and not believing that smoking is harmful to health. Conclusions. Gender differences in smoking prevalence among adolescents in China are larger than those among US teenagers, whereas the proximal risk factors for smoking are similar. Major efforts are needed to monitor and prevent smoking initiation among Chinese adolescents, particularly girls.