The number of people who use synthetic drugs, such as amphetamine-type stimulants (ATS) and ecstasy, has increased in recent years across the globe (United Nations Office on Drugs and Crime, 2014). China is no exception. Official statistics show that the rate of synthetic drug use in China grew faster than the rate of natural drug use (China National Narcotics Control Commission Office, 2015), especially among the younger population. Nationally, approximately 75% of the 7 million synthetic drug users in mainland China are below the age of 35 years (China CCTV, 2015). Although what fueled the rapid increase in synthetic drug abuse in China is not completely known, there seems to be little doubt that the popularity of synthetic drugs among youth and adolescents has played an important role shaping the trend. Unlike American youth who are more likely to use marijuana than any other illicit drug (Johnston, O'Malley, Miech, Bachman, & Schulenberg, 2017), adolescents in Asia, especially those in the Greater China Region, typically choose synthetic drugs as their drugs of choice. Official statistics released by the Food and Drug Administration of China (2014) show that people below the age of 18 years are far more likely to use synthetic drugs than traditional drugs. This pattern holds true in Macao, a Special Administrative Region of China and the only place in the country where gambling is legal. According to the surveys conducted by Macao's Social Welfare Bureau in 2010 and 2014, methamphetamine and ketamine were the most frequently used drugs among young drug users in recent years (Macao Social Welfare Bureau, 2010, 2014). In consistency with the survey data, official statistics from the Central Registration System for Drug Abusers of Macao also show that young drug users registered in the system disproportionally used synthetic drugs such as methamphetamine and ketamine as opposed to traditional drugs (Macao Social Welfare Bureau, 2016). To reverse the trend of increase in synthetic drug use among adolescents in the Greater China Region, we need countermeasures that are scientifically based and effective. A starting point in developing such countermeasures is to identify culturally relevant factors contributing to the problem. However, there has been little scientific evidence that can serve as a basis for building systematic understanding of the key driving forces leading to the spread of adolescent synthetic drug abuse in this region. Our study aims to contribute to the knowledge base through a population-based survey. While large-scale representative studies are lacking, smaller studies using nonprobability samples have offered some suggestions of potential predictors of adolescent use of synthetical drugs in the Greater China Region.