Abstract：Objective To investigate the prevalence of intention to smoke and current smoking and identify its influencing factors among middle school students in Ningbo City, so as to provide insights into the development and implementation of tobacco control among adolescents. Methods The epidemiological data of tobacco use among adolescents in Ningbo City in 2021 were collected, including demographics, tobacco use, parents' and close friends' smoking status, secondhand smoke exposure and tobacco advertisement exposure. The intention to smoke, current smoking, secondhand smoke exposure and tobacco advertisement exposure were descriptively analyzed among middle school students, and the factors affecting intention to smoke, current smoking were identified using a multivariable logistic regression analysis. Results Totally 1 591 questionnaires were allocated to middle school students, and 1 574 valid questionnaires were recovered, with an effective recovery rate of 98.93%. The respondents included 787 junior high school students, 535 high school students and 252 vocational high school students, and the prevalence was intention to smoke and current smoking was 6.73% and 1.78% among the respondents, respectively. Multivariable logistic regression analysis identified boys (OR=2.398, 95%CI: 1.466-3.922), high school students (OR=2.051, 95%CI: 1.212-3.470), vocational high school students (OR=2.011, 95%CI: 1.108-3.650), more than 100 yuan disposable pocket money per week (OR=2.534, 95%CI: 1.301-4.935) and close friends' smoking (OR=4.310, 95% CI: 2.755-6.757) as risk factors of intention to smoke, and boys (OR=12.420, 95%CI: 1.645-93.753), close friends' smoking (OR=11.628, 95%CI: 4.348-31.250) and parents' smoking (OR=2.667, 95%CI: 1.029-6.897) as risk factors of current smoking among middle school students. The prevalence of secondhand smoke exposure and tobacco advertisement exposure was 76.43% and 51.65%, and television/video/cinema was the most likely route of tobacco advertisement exposure (42.06%). Conclusions The prevalence of intention to smoke and current smoking is low among middle school students in Ningbo City; however, the proportions of exposure to secondhand smoke and tobacco advertisement are relatively high. Tobacco control interventions are recommended to be intensified targeting high-risk populations, such as vocational high school students.
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