Decreased smoking initiation among male youths in China: an urban–rural comparison

Kuiyun Zhi, Jin Huang, Suo Deng, Yongjin Chen, Michael G. Vaughn, Zhengmin Qian

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3 Citations (Scopus)


Objectives: This study compared urban/rural differences in smoking initiation during the transition from adolescence to young adulthood among Chinese males. Methods: Data were derived from the China Health and Nutrition Survey (N = 2395). Logistic and cox models were computed to assess smoking initiation between the ages of 15 and 20 across urban/rural administrative districts (i.e. urban neighborhood, suburban village, county town neighborhood, and rural village). Results: Findings revealed that rates of smoking initiation decreased from the 1970 to 1996 cohorts in all four administrative districts. After adjusting for household and community characteristics, the inverse association between smoking initiation and birth year remained statistically significant (p < 0.05) in all administrative districts with the exception of urban neighborhoods. County town neighborhoods and suburban villages witnessed accelerated reductions in smoking initiation. Conclusions: Decreased smoking initiation appears to be associated with birth year, which may be correlated with social and economic development of China in conjunction with an unprecedented rate of urbanization. Results suggest that the rate of smoking initiation for male youths may experience further decreases, particularly in areas with a heightened potential of urbanization.

Original languageEnglish
Pages (from-to)417-425
Number of pages9
JournalInternational Journal of Public Health
Issue number4
Publication statusPublished - 2016 May 1

Bibliographical note

Funding Information:
This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center (5 R24 HD050924), the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01-HD38700) and the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveys, and the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009. Ms. Zhi is grateful for the support provided by School of Social Work, Saint Louis University during her visit and the support from the National Social Science Foundation Research Program (12BRK001).

Publisher Copyright:
© 2016, Swiss School of Public Health (SSPH+).

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health


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