Background. Knowledge about age of smoking initiation among adolescents in
China is helpful for exploring cultural differences in adolescent smoking b
ehavior and informative for global tobacco control. However, little has bee
n documented on this issue.
Method. Adolescents (6,473) attending grades 7, 8, and 9 completed the base
line survey of a longitudinal, randomized smoking prevention trial, Data we
re collected in classrooms with a paper-and-pencil questionnaire. A surviva
l model was used in the statistical analysis.
Results. The hazard of smoking initiation for boys showed a pattern previou
sly observed in the United States: very low (<2%) before 7 years of age, in
creasing rapidly after age 10, and peaking at 14-15 years of age. The hazar
d for girls was below or around 1% until 12 years of age before it increase
d. The hazard levels were similar for adolescents both in urban and in rura
l areas, but higher for those in grade 7 than in grades 8 and 9.
Conclusions. Chinese boys in Wuhan, China, experienced a hazard pattern of
smoking initiation by age similar to those observed in the United States, w
hile Chinese girls there experienced a rather low risk of smoking initiatio
n. The hazard pattern suggests that the best time for smoking prevention is
between 10 and 15 years of age. Adolescents in lower grades are at higher
risk of early smoking initiation, suggesting a potential cohort effect in a
dolescent smoking initiation in Wuhan, China. (C) 2001 American Health Foun
dation and Academic Press.