Background: This study reports the prevalence of adolescent smoking in the
urban and rural areas of Wuhan, China, the capital of Hubei Province, on th
e Yangtze River in central China.
Methods: Smoking behavior was examined by age, gender, and urbanicity as pa
rt of the Wuhan Smoking Prevention Trial. Subjects included 6994 seventh- t
o ninth-grade students attending 22 randomly selected schools in urban and
rural districts. Outcome measures included lifetime smoking, past-30-day sm
oking, established smoking (> 100 cigarettes in lifetime), and susceptibili
ty to smoking (absence of a firm commitment not to smoke).
Results: Lifetime smoking prevalence was 47% among boys and 18% among girls
. Past-30-day smoking prevalence was 16% among boys and 4% among girls. Est
ablished smoking prevalence was 2% among boys and 0% among girls. The preva
lence of susceptibility to smoking was 31% among boys and 10% among girls.
Smoking increased significantly with age (p < .0005). Susceptibility was mo
re prevalent in rural areas than in urban areas (p < .05), but there were n
o urban-rural differences in lifetime, past 30-day smoking, or established
smoking. Trend analyses revealed that smoking increased with age more rapid
ly among boys than among girls (p <0.5). Smoking was more prevalent among r
ural boys than among urban boys, but it was more prevalent among urban girl
s than among rural girls (p <0.5).
Conclusions: Adolescent smoking is a significant public health problem in C
hina. Boys are at particularly high risk, as are girls living in urban area
s. Effective smoking prevention programs for adolescents, as well as restri
ctions on tobacco industry marketing and youth access to tobacco, are neede
d to prevent tobacco-related morbidity and mortality in China.