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Social, Psychological, and Environmental-Structural Factors Associated with Tobacco Experimentation among Adolescents in Shanghai, China
School of Public Health affiliated with School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
Global Health Institute, Emory University, Atlanta, GA 30322, USA
Pudong Institute for Health Development, Shanghai 200129, China
* Author to whom correspondence should be addressed.
Received: 10 July 2012; in revised form: 13 August 2012 / Accepted: 17 September 2012 / Published: 26 September 2012
Abstract: Objective: To estimate the prevalence and social, psychological and environmental-structural determinants of tobacco experimentation among adolescents in Shanghai, China. Methods: We conducted a cross-sectional study based on a two-stage cluster sample design by using the Chinese version of the Global Youth Tobacco Survey (GYTS) to investigate smoking behavior among 19,117 students from 41 junior and senior high schools in Shanghai, China. The association between potential factors and tobacco experimentation were assessed using complex samples procedure logistic regression. Results: Of the 19,117 respondents, 10.5% (15.3% boys and 6.2% girls) reported the tobacco experimentation. The main social, psychological, and environmental-structural factors associated with tobacco experimentation were having close friends who smoke (AOR = 8.21; 95% CI: 6.49–10.39); one or both parents smoking (AOR 1.57; CI: 1.39–1.77); a poor school tobacco control environment (AOR 1.53; CI: 1.37–1.83); a high acceptance level of tobacco use (AOR 1.44; CI: 1.28–1.82); and a high level of media tobacco exposure (AOR 1.23; CI: 1.10–1.37). Peer smoking might contribute to smoking experimentation among girls (AOR 8.93; CI: 5.84–13.66) more so than among boys (AOR 7.79; CI: 5.97–9.94) and media tobacco exposure had no association with tobacco experimentation among female students. Conclusions: Social, psychological, and environmental factors are closely associated with tobacco experimentation among adolescents. Prevention programs aimed at reducing teen tobacco experimentation should be conducted at home and school with support by parents, peers and teachers. Our findings should prove useful for future development of intervention strategies among adolescents in Shanghai, China.
Keywords: tobacco experimentation; adolescent; environmental-structural factors; associations
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Cai, Y.; Lu, L.; Li, N.; Zhu, J.; He, Y.; Redmon, P.; Goyal, A.; Huang, C.; Qiao, Y.; Ma, J. Social, Psychological, and Environmental-Structural Factors Associated with Tobacco Experimentation among Adolescents in Shanghai, China. Int. J. Environ. Res. Public Health 2012, 9, 3421-3436.
Cai Y, Lu L, Li N, Zhu J, He Y, Redmon P, Goyal A, Huang C, Qiao Y, Ma J. Social, Psychological, and Environmental-Structural Factors Associated with Tobacco Experimentation among Adolescents in Shanghai, China. International Journal of Environmental Research and Public Health. 2012; 9(10):3421-3436.
Cai, Yong; Lu, Lin; Li, Na; Zhu, Jingfen; He, Yaping; Redmon, Pamela; Goyal, Abhinav; Huang, Cheng; Qiao, Yun; Ma, Jin. 2012. "Social, Psychological, and Environmental-Structural Factors Associated with Tobacco Experimentation among Adolescents in Shanghai, China." Int. J. Environ. Res. Public Health 9, no. 10: 3421-3436.