LAUSR

BACKGROUND Previous literature supports that tobacco smoking and second-hand smoking (SHS) exposure were strongly associated with poor mental health in the general population. However, there is a lack of empirical data on the relationship between tobacco smoking, SHS exposure and psychotic-like experiences (PLEs). This study conducted a cross-sectional survey to explore PLEs and the associations of PLEs with tobacco smoking and SHS exposure among adolescents in China. METHODS A total sample of 67 182 Chinese adolescents were recruited from Guangdong province in China (53.7% boys, mean age = 12.79 years) from December 17 to 26, 2021. All adolescents have completed self-reported questionnaires on demographic characteristics, smoking status, SHS exposure and PLEs. RESULTS Within the sample, only 1.2% of participants had an experience of tobacco smoking while approximately three-fifths reported being exposed to SHS. 10.7% of adolescents reported frequent PLEs over the past month. Adolescents who smoked showed a higher prevalence of PLEs than in non-smoking samples. After controlling for confounders, SHS exposure was a robust risk factor for PLEs with or without the effect of tobacco smoking. DISCUSSION These findings support the importance of smoke-free legislation, and anti-smoking measures in educational settings directed at both adolescents and their caregiver, which may decrease occurring rates of PLEs among adolescents.