Abstract: Objective To explore the status of cigarette smoking and its influencing factors among adolescent students in Guangdong Province, so as to provide a scientific basis for promoting tobacco control among adolescents. Methods Using a multi-stage stratified cluster random sampling method, selected students from 58 middle schools (including junior high schools, ordinary high schools, and vocational high schools) in 10 counties or districts of Guangdong Province for self-administered questionnaires. Univariate and multivariate analyses with complex survey module of SPSS 23.0 were used to explore the influencing factors. Results A total of 8 860 students were investigated, including 4 689 boys and 4 171 girls, mainly aged 13 to 18 years, accounting for 89.9%. The rate of cigarette smoking among adolescent students was 4.9% in Guangdong Province, with boys (7.4%) significantly higher than girls (2.0%), and the rates of junior high school, ordinary high school, and vocational high school students were 2.3%, 4.1%, and 17.7%, respectively (P<0.05). The rate of cigarette smoking attempt among adolescent students was 17.8%, with boys (24.8%) significantly higher than girls (9.7%), and the rates of junior high school, ordinary high school, and vocational high school students were 11.3%, 21.8%, and 37.4%, respectively (P<0.05). There were 68.2% of students were exposed to secondhand smoke in four types of public places: at home, indoors, outdoors, or public transport. In addition, 46.9% of students were exposed to secondhand smoke at school. Logistic regression analysis showed that boys (OR=2.434, 2.137), high school period (OR=1.873, 1.793), peer smoking (OR=31.681, 4.566), teachers smoking (OR=1.777, 1.614), and secondhand smoke exposure in the home (OR=1.706, 1.410) were the common risk factors of cigarette smoking and smoking attempt behaviors among adolescent students. Exposure to tobacco control information within 30 days (OR=0.616, 0.758) was the factor that impede cigarette smoking and smoking attempt behaviors. Conclusions The rate of cigarette smoking attempt is higher among adolescent students in Guangdong, and boys and high school students are the key groups of smoking cigarettes. Smoking behavior is affected by gender, school level, smoking of important relationships, and second-hand smoke exposure. Comprehensive intervention measures should be taken to reduce smoking among students.

Key words: Adolescents, Students, Cigarette smoking, Secondhand smoke, Influencing factor