Cigarette and E-Cigarette Use Among Adolescents Based on a Nationwide Survey - China, 2021.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Adolescent cigarette and e-cigarette use remains common in China. Previous studies identified multiple individual-, family-, and school-related risk factors. However, national-level evidence distinguishing dual use from exclusive cigarette or e-cigarette use is limited.

WHAT IS ADDED BY THIS REPORT?: A nationally representative survey of high-school students in 31 provincial-level administrative divisions in China produced updated estimates of tobacco use in 2021: dual (6.9%), cigarette (24.6%), e-cigarette (9.5%). Socio-ecological factors differed across statuses, and some preventive measures, including school-based tobacco education, had no associated use reduction.

WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Adolescent tobacco control should adopt differentiated strategies for dual/exclusive tobacco use, strengthen family/peer involvement, and improve school-based education program effectiveness.