Objective  To investigate the status of tobacco use and tobacco control knowledge among middle school students in Guiyang city and to provide evidences for future interventions.

  Methods  With stratified cluster sampling, 3 994 students in 14 middle schools in Guiyang city were selected and surveyed with ‘China Youth Tobacco Epidemic Survey Questionnaire –2013' between May and June 2015.

  Results  The prevalence rate of smoking attempt, current smoking, and regular cigarette smoking were 40.4%, 17.1%, and 5.7%, respectively, among the students. Compared to the girl students, the boy students reported significantly higher prevalence rates of smoking attempt (54.5% vs. 27.3% ), current smoking (28.5% vs. 6.5%), and regular cigarette smoking (10.9% vs. 0.9%) (all P < 0.05). Gender, residential region, alcohol consumption, and type of school were the main influencing factors for smoking attempt, current smoking, and regular cigarette smoking among the students. High exposure to tobacco advertisement and cigarette sale promotion and low coverage of tobacco control information were reported by the students.

  Conclusion  Tobacco use is very prevalent among middle school students in Guiyang city, suggesting that education on tobacco control should be strengthened by health and education agencies and specific interventions should be carried out among the students.