Multilevel influencing factors of adolescent smoking in Fujian, China: a social ecological model-based study

LIN Benxiang; ZHENG Yunting; BIAN Jianqiang; CHEN Meilan; WU Ying; MAO Yimeng; CHEN Jinhui

doi:10.16462/j.cnki.zhjbkz.2025.07.008

Volume 29 Issue 7

Jul. 2025

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LIN Benxiang, ZHENG Yunting, BIAN Jianqiang, CHEN Meilan, WU Ying, MAO Yimeng, CHEN Jinhui. Multilevel influencing factors of adolescent smoking in Fujian, China: a social ecological model-based study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 798-803. doi: 10.16462/j.cnki.zhjbkz.2025.07.008

Citation:

LIN Benxiang, ZHENG Yunting, BIAN Jianqiang, CHEN Meilan, WU Ying, MAO Yimeng, CHEN Jinhui. Multilevel influencing factors of adolescent smoking in Fujian, China: a social ecological model-based study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 798-803. doi: 10.16462/j.cnki.zhjbkz.2025.07.008

Citation:

LIN Benxiang, ZHENG Yunting, BIAN Jianqiang, CHEN Meilan, WU Ying, MAO Yimeng, CHEN Jinhui. Multilevel influencing factors of adolescent smoking in Fujian, China: a social ecological model-based study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 798-803. doi: 10.16462/j.cnki.zhjbkz.2025.07.008

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Multilevel influencing factors of adolescent smoking in Fujian, China: a social ecological model-based study

doi: 10.16462/j.cnki.zhjbkz.2025.07.008

1.
Department of Health Education and Promotion, Fujian Center for Disease Control and Prevention, Fuzhou 350012, China
2.
School of Health Management, Fujian Medical University, Fuzhou 350122, China

Funds:

Scientific Research Startup Fund Project for High-level Talents of Fujian Medical University XRCZX2022002

More Information

Corresponding author: CHEN Jinhui, E-mail: 524840467@qq.com
Received Date: 2025-03-31
Rev Recd Date: 2025-05-18

Available Online: 2025-08-11

Publish Date: 2025-07-10

Abstract

Abstract

Objective Using the social ecological model, this study aims to systematically investigate multi-level determinants of adolescent smoking behavior in Fujian, China, encompassing individual, familial, peer, and school dimensions, and to establish an evidence base for multidimensional intervention strategies. Methods In 2021, a multi-stage stratified cluster sampling approach was employed to recruit 7 652 students from junior, general senior, and vocational high schools in Fujian Province, with a response rate of 94.4%. Weighted complex sampling and multivariate logistic regression analyses were conducted to examine associated risk factors. Results The weighted prevalence of smoking experimentation among adolescents was 15.24% (95% CI: 14.12-16.36), with 2.92% (95% CI: 2.45-3.40) classified as current smokers. Multivariate analysis identified significant risk factors across three domains: At the family level, parental smoking was associated with a 153% increased risk of current smoking (OR=2.53, 95% CI: 1.76-3.55, P < 0.001), while adolescents receiving ≥30 CNY weekly allowance showed a 260% elevated risk (OR=3.60, 95% CI: 2.08-6.23, P < 0.001). At the peer level, those who accepted offered cigarettes had 67.63 times higher current smoking risk than those who refused (OR=67.63, 95% CI: 29.57-154.68, P < 0.001). The high-frequency teacher smoking exposure group showed 8.52 times higher risk (OR=9.52, 95% CI: 4.39-20.65, P < 0.001), and the campus smoking phenomenon group demonstrated 3.00 times elevated risk (OR=4.00, 95% CI: 2.78-5.75, P < 0.001). Conclusions Adolescent smoking behavior demonstrates significant clustering among rural populations, males, and vocational high school students. To address this, we propose a multi-level intervention framework. At the individual level, allowance restrictions combined with cognitive behavioral interventions should be implemented; at the family level, parental smoking cessation contracts with monitoring mechanisms should be established; and at the school level, teacher smoking bans alongside mandatory tobacco control curricula should be enforced. Simultaneously, the construction of healthy school should be promoted.
- Adolescents,
- Smoking behavior,
- Tiered interventions

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References(22)

References

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