Prevalence and correlates of co-use of alcohol and cigarettes among Chinese adolescents: a cross-sectional national survey in 2021.

OBJECTIVE

Alcohol and cigarette use are prevalent among Chinese adolescents. This study examines the prevalence and correlates of co-use.

METHODS

Data were drawn from the 2021 China Adolescent Alcohol Use Survey targeting middle and high school students, conducted in seven provinces from China's seven geographic regions. We examined the past-month prevalence of alcohol and cigarettes co-use across sociodemographic and behavioral subgroups. Multivariable logistic regression was used to identify factors associated with co-use.

RESULTS

Past-month co-use prevalence was 1.7% (95% CI: 1.4%, 2.1%), and varied by peer substance use, with higher rates among those whose close friends smoked or drank. Co-use rates were higher among adolescents whose parents held favourable attitudes toward drinking (either parent: 4.0%, 95% CI: 3.1%, 4.9%; both parents: 3.7%, 95% CI: 2.9%, 4.5%) than among those whose parents did not (0.9%, 95% CI: 0.7%, 1.1%). Past-month e-cigarette users had a significantly higher co-use rate than non-users. Peer substance use, e-cigarette use, and parental attitudes were significantly associated with co-use.

CONCLUSIONS

Although the prevalence of co-use among Chinese adolescents is low, the absolute number of affected youth is substantial given China's population size. Prevention should target peer influence and e-cigarette use.