A Meta-Analysis of Cigarette Smoking Prevalence among Adolescents in China: 1981–2010

BACKGROUND Systematic data regarding adolescent smoking are needed at the national level to support evidence-based tobacco control in China. The goal of this study was to estimate smoking prevalence among Chinese adolescents using published data. METHODS Published studies were located electronically from the commonly used databases in Chinese and English, complemented by manual searching. Forty-five studies were selected of the 9771 retrieved from the databases. These studies targeted adolescents aged 12-17 or middle/high school students, were conducted during the 1981-2010, and had adequate data for meta-analysis. The 45 selected studies covered 52 sites in different parts of China. Smoking rates were estimated using the sample-weighted and random effect method. RESULTS The estimated prevalence rate of lifetime smoking (ever smoked) varied within a narrow range (39.04%-46.03%) for males and progressively increased from 2.47% in 1981-1985 to 19.72% in 2001-2005 for females. The prevalence rate of current (30-day) smoking for males declined from 26.62% in 1981-1985 to 10.86% in 1996-2000 before increasing again. The prevalence of current smoking for females increased from 0.29% in 1981-1985 to 3.26% in 2006-2010. CONCLUSIONS The high levels of male smoking and the rapid increase in female smoking indicate growing burdens from tobacco-related diseases, underscoring the urgent need to strengthen adolescent tobacco control in China.