Abstract: ObjectiveTo examine health risk behaviors among middle school students and the difference in the behaviors between Tujia and Miao students in Xiangxi Autonomous Prefecture to provide reference for effective health education in minority area.MethodsWith stratified cluster random sampling,a questionnaire survey on smoking,alcohol drinking,unintentional and intentional injury,diet,physical exercise,and psychological dependence was conducted among 2 094 middle school students of Tujia and Miao selected from eight middle schools in Fenghuang,Luxi,Yongshun,and Longshan county of Xiangxi Autonomous Prefecture.ResultsThe report rate of smoking attempt was from 25.35% to 70.14%;the rate of first smoking before 13 years old was from 12.56% to 48.73%;the rate of alcohol drinking attempt was from 48.60% to 77.74%;the rate of high study pressure was from 17.09% to 38.59%,the rate of not drinking milk was from 28.95% to 54.01%;and the rate of lack of physical exercise was from 58.03% to 72.35%.The rate of drinking attempt(70.05%),high study pressure(31.09%),and having homework time more than three hours per day(21.47%)of Tujia students were higher than those of Miao.The rate of current smoking(22.42%),heavy smoking(3.06%),current alcohol drinking(32.36%),drunken(14.78%),swimming in unsafewaters(38.09%),drinking soda water once or more a day(18.22%),eating sweet food once or more a day(36.69%),eating snack three days or more a week(5.10%),not drinking milk(46.11%),not having breakfast(10.57%),and watching TV two hours or more a day(51.08%)of Miao students were higher than those of Tujia,with significant differences(P<0.01 for all).ConclusionHealth interventions should be conducted according to the different health risk behaviors among specific groups to prevent and control the health risk behaviors among Tujia and Miao students.