Objective To understand the current status and influencing factors of tobacco use among adolescents in Nanning, and to provide a scientific basis for formulating targeted tobacco control policies.

Methods From April to June 2024, a multi-stage stratified cluster sampling method was used to conduct a questionnaire survey among 9, 817 students from 84 junior high schools, general senior high schools, and vocational high schools in Nanning. SPSS 26.0 was used for the chi-square test and binary logistic regression analysis.

Results The attempted smoking rate of adolescents in Nanning was 11.04%, including 14.42% boys and 7.19% girls. The current smoking rate was 3.45%, including 5.13% boys and 1.55% girls. The current smoking rate and attempted smoking rates were higher among students aged ≥18 years, those from rural areas, and those in vocational high schools. 67.11% of smokers who tried smoking for the first time were 13 years old or younger. Multivariate analysis showed that having smoking friends (current smoking: OR=13.481; trial smoking: OR=5.150), believing that smoking at social gatherings was more comfortable (current smoking: OR=12.226; trial smoking: OR=3.904), perceiving smoking as more attractive (current smoking: OR=2.104, trial smoking: OR=1.709), having cigarette retail outlets within 500 meters of the school gate (current smoking: OR=1.793; trial smoking: OR=1.527), considering it not difficult to quit smoking (current smoking: OR=1.503, trial smoking: OR=1.777), having smoking parents (current smoking: OR=1.336, trial smoking: OR=1.509), and being from rural areas (current smoking: OR= 1.646, trial smoking: OR=1.234) were the main risk factors. For adolescents, being female was a protective factor (current smoking: OR=0.603; trial smoking: OR=0.686).

Conclusion Tobacco use among adolescents in Nanning shows significant differences in gender, age, urban-rural areas, and school types. The influence of social circles, incorrect perceptions of smoking, and easy access to tobacco are the core risk factors.