Abstract: ObjectiveTo investigate the relationship between cigarette smoking and health risk behavior and psychological-emotional disorder among urban and rural middle school students in Liuzhou city of Guangxi Zhuang Autonomous Region.MethodsTotally 1 528 urban and 1 213 rural students from general middle schools in Liuzhou city were selected with stratified cluster sampling and surveyed with a questionnaire.ResultsThe prevalence of cigarette smoking among the students was 8.90%,and the prevalence was significantly different between urban(7.91%)and rural(10.14%)students (χ²=3.84,P<0.05).There was a significant difference in the prevalence of cigarette smoking among the students with different age in the rural(χ²=43.40,P<0.01).The prevalence of cigarette smoking in male students was higher than that in female among urban and rural students(P<0.01).The prevalence of swimming in unsafe water area and the prevalence of gambling were lower in urban students compared with rural students(P<0.01).The results of logistic regression analysis showed that health risk behavior and psychological-emotional disorder were correlated with smoking in urban students.In the rural students,the factors related to smoking were alcohol use,physical fight,being teased,internet addiction,swimming in unsafe water,and anxiety.ConclusionHealth risk behavior and psychological-emotional disorder are risk factors of cigarette smoking.The prevalence of factors related to smoking is different between urban and rural students.