Prevalence, cessation, and geographical variation of smoking among middle-aged and elderly adults in China: A population-based study

Qingjia Zeng; Chongyang Zhang; Feiyu Su; Yanli Wan; Wen-Jun Tu; Hongpu Hu

doi:10.18332/tid/190247

Prevalence, cessation, and geographical variation of smoking among middle-aged and elderly adults in China: A population-based study

Tob Induc Dis. 2024 Jul 19:22. doi: 10.18332/tid/190247. eCollection 2024.

Authors

Qingjia Zeng¹, Chongyang Zhang¹, Feiyu Su¹, Yanli Wan¹, Wen-Jun Tu², Hongpu Hu¹

Affiliations

¹ Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

Introduction: Smoking significantly burdens human health, contributing to an increasing incidence of mortality and morbidity. This study aims to explore the prevalence of smoking, cessation, and the association between various risk factors and smoking intensity measured in pack-years among Chinese adults.

Methods: During 2020-2021, the China Stroke High-risk Population Screening and Intervention Program (CSHPSIP) invited participants aged ≥40 years from 31 provinces in mainland China. This cross-sectional study presents the standardized prevalence of smoking and cessation across various demographics, including age, sex, residence, income, education level, BMI, and geographical region of residence. Multivariable logistic regression was used to examine the associations between smoking pack-years and related factors.

Results: Among 524741 participants (mean age: 61.9 ± 10.9 years; 41.1% male; 58.9% female), standardized smoking prevalence was 19.3% (95% CI: 19.2-19.4), with men (37.2%; 95% CI: 37.0-37.4) displaying significantly higher rates than women (1.3%; 95% CI: 1.2-1.3). Smoking cessation rate stood at 11.2% (95% CI: 11.0-11.4), with 11.3% (95% CI: 11.1-11.5) for men and 8.4% (95% CI: 7.5-9.2) for women. Urban residents and those with advanced education had lower smoking rates and higher cessation rates. Additionally, the dose-response relationship indicated a more pronounced association between higher smoking pack-years and elevated health risks, including hypertension (AOR=1.30; 95% CI: 1.24-1.36), diabetes (AOR=1.26; 95% CI: 1.20-1.33), hyperlipidemia (AOR=1.22; 95% CI: 1.16-1.28), heart disease (AOR=1.40; 95% CI: 1.26-1.54), and stroke (AOR=1.23; 95% CI: 1.10-1.36).

Conclusions: This comprehensive study emphasizes the profound impact of smoking on health in Chinese adults, indicating the critical need for tailored cessation programs, particularly for middle-aged individuals, men, rural residents, and those with lower level of education.

Keywords: associated factors; population-based; prevalence; smoking; smoking cessation.

Grants and funding

FUNDING This research was funded by CAMS Innovation Fund for Medical Sciences (CIFMS) [2022-I2M-1-019] and the National Natural Science Foundation of China (61971446). The funding bodies were not involved in any aspect of the study, from its conception and design to the collection, handling, analysis, or interpretation of the data, nor in the drafting, reviewing, or approving of the manuscript.