BACKGROUND: This study aims to identify strategies to reduce cigarette and e-cigarette use among youth in Heilongjiang Province by analyzing usage trends from 2014 to 2023, providing evidence for school-based tobacco control strategies.
METHODS: Data were extracted from the 2014, 2019, 2021 and 2023 China National Youth Tobacco Survey in Heilongjiang Province, which were school-based cross-sectional survey with provincial representative. The survey employed a randomized multistage stratified cluster sampling design with probability proportional to size sampling method and used an anonymous self-administrated questionnaire to collect data. The cigarette and e-cigarette use were analyzed, and all parameter estimates were weighted to account for the complex sampling design.
RESULTS: The current cigarette use rate of middle school students in Heilongjiang Province from 2014 to 2023 is 4.22%, 3.38%, 2.05%, and 1.6%, respectively; the current e-cigarette use rate is 1.32%, 2.65%, 2.67%, and 1.6%, respectively; and the cigarette or e-cigarette use rate is 5.25%, 5.12%, 3.74%, and 2.73%, respectively. Factors influencing cigarette or e-cigarette use included: gender, parents, teachers, and friends smoking status, pocket money, exposure to tobacco advertisements, and awareness of secondhand smoke risks.
CONCLUSIONS: Cigarette use rates among middle school students in Heilongjiang Province has declined, while e-cigarette use showed a peak in 2021 before decreasing. Policies such as "smoke-free schools" and e-cigarette regulation are beginning to show results. Joint efforts between families and schools, as well as collaboration among multiple departments, from family supervision to campus intervention and health education, and then to comprehensive social supervision and management, are essential to ensure the effective implementation of tobacco control measures and will be the focus of future tobacco control work.