Parental, Behavioral, and Psychological Factors Associated with Cigarette Smoking among Secondary School Students in Nanjing, China

We designed this study to assess parental, behavioral, and psychological factors associated with tobacco use among Chinese adolescents. The data were collected from 995 middle school students in Nanjing, China. Both smoking experimentation and current smoking (smoking in the past 30 days) were assessed among the study sample. Psychosocial measures include family structure, problem behaviors, social influence of smoking (both parental and friends' approval of smoking), depressive symptoms, social alienation, self-esteem, parental monitoring (social monitoring and academic monitoring) and parenting style (responsiveness and demandingness). Among the study sample (mean age 15.16 years and 50% females), 24% ever smoked and 15% smoked in the past 30 days. Advanced age, male gender, low family SES, low school performance and low educational aspiration were associated with both smoking experimentation and current smoking. Depressive symptoms, social alienation, low self-esteem, low social and academic monitoring, problem behaviors, low maternal and paternal responsiveness, peer smoking, parent smoking, and parental and friends' approval of smoking were positively associated with current smoking among Chinese adolescents. Future tobacco use prevention efforts among Chinese adolescents need to consider the parental, behavioral, and psychological correlates identified in the current study.