Patterns and socioeconomic influences of tobacco exposure in tobacco cultivating rural areas of Yunnan Province, China

Abstract

BackgroundThis study describes the patterns and socioeconomic influences of tobacco use among adults in tobacco-cultivating regions of rural southwest China.MethodsA cross-sectional survey was conducted in 8681 adults aged ≥18 years in rural areas of Yunnan Province, China from 2010 to 2011. A standardized questionnaire was administered to obtain data about participants’ demographic characteristics, individual socioeconomic status, ethnicity, self-reported smoking habits, and exposure to secondhand smoke (SHS). The socioeconomic predictors of current smoking, nicotine addiction, and SHS exposure were analyzed using multivariate logistic regression.ResultsThe prevalence rates of tobacco use were much higher in men compared with women (current smoking 68.5% vs. 1.3%; and nicotine dependence 85.2% vs. 72.7%). However, the rate of SHS exposure was higher in women compared with men (76.6% vs. 70.5%). Tobacco farmers had higher prevalence rates of current smoking, nicotine dependence, and SHS exposure compared with participants not engaged in tobacco farming (P<0.01). Most tobacco users (84.5%) reported initiating smoking during adolescence. A total of 81.1% of smokers smoked in public places, and 77.6% smoked in workplaces. Individuals belonging to an ethnic minority had a lower probability of SHS exposure and nicotine dependence. Individual educational level was found to be inversely associated with the prevalence of current smoking, exposure to SHS, and nicotine dependence. Higher annual household income was associated with a greater risk of nicotine dependence.ConclusionsThis study suggests that tobacco control efforts in rural southwest China must be tailored to address tobacco-cultivating status and socioeconomic factors.

The impact of regional economic reliance on the tobacco industry on current smoking in China

“…This stands in contrast to the findings of some other studies. In a study of adults living in rural areas in Yunnan Province Cai et al (2012Cai et al ( , 2013 found that individuals who cultivated tobacco smoked more than those that did not. Similarly, Hoffer and Pellilo (2012), while they did not directly examine the direct effects of tobacco cultivation on smoking, nevertheless found the former to be important factor influencing tobacco control expenditures.…”

The economic burden of smoking and secondhand smoke exposure in rural South-West China

“…However, China has very few estimates of tobacco's costs, and past studies have been to focus on the estimation of economic burden associated with smoking-related diseases [5,9], while overlooking the economic costs of SHS exposure, especially in rural areas. Seventy percent of China's population lives in the countryside, and rural residents have higher prevalence rate of smoking and SHS exposure than urban inhabitants [3,10]. Based on past research conducted both inside and outside China, smoking has been demonstrated to be important contributors to COPD, asthma, coronary heart disease (CHD), stroke, hypertension and peptic ulcer [1,2,5,[11][12][13][14], which indicated that smoking increased the risk of overall mortality, accounting for more deaths than any other single cause.…”

The relationship between socioeconomic status and ‘hardcore’ smoking over time – greater accumulation of hardened smokers in low-SES than high-SES smokers

“…A link has also been observed between smoking and socioeconomic status (SES), with persons from low socioeconomic backgrounds more likely to be smokers in Western countries, including Australia,17–21 the UK18 20 22 and the USA,18 20 22 23 although this relationship may not generalise to less developed countries 24 25. The exact mechanisms behind socioeconomic difference in smoking are unknown, but have been linked to impoverished environments and lack of access to positive activities and alternatives to drugs 26.…”