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Trends of smoking prevalence and implications for chronic diseases in China: an analysis of data from serial national cross-sectional surveys
Poster Abstracts
Trends of smoking prevalence and implications for chronic diseases in China: an analysis of data from serial national cross-sectional surveys Minghuan Wang, Shabei Xu, Chenchen Liu, Wenhua Liu, Xiang Luo, Xiaoxiang Zhang, Liang Wang, Jian Liu, Fengcai Zhu,Wei Wang
Abstract
Background Tobacco control in China is far from satisfactory and the demographic trends ofsmokers in China are poorly described. This study aimed to investigate the latest trends in smoking and its implication for chronic diseases. Methods We analysed data from serial cross-sectional national health service surveys from 2003 to 2013 in mainland China. Risk factors of ever-smoking were identified by multiple logistic regression. We compared the differences between ever-smokers and non-smokers in the prevalence of chronic diseases. Findings The overall prevalence of smoking remained high from 2003 (27·7%, 95% CI 27·5–27·9) to 2013 (27·9%, 27·7–28·1). Strikingly, the smoking prevalence in adolescents aged 15–24 years increased from 8·3% (8·0–8·7) in 2003 to 12·5% (12·1–13·0) in 2013. Among male smokers, the biggest difference between age groups was in 2013, when smoking prevalence in individuals aged 20–24 years (36·2%) was 3·9 times that in individuals aged 15–19 years (9·2%). 78% of male smokers reported starting smoking before age 25 years, whereas only 36·72% of female smokers reported smoking before this age. The prevalence of smoking in young people was positively related with the number of older smokers in their families, especially older female family members (p<0·0001; correlation coefficient 0·1). Young people aged 15–24 years with low education levels (junior high school or less) had an increased risk of tobacco use (OR 1·3, 95% CI 1·2–1·4) compared with those with senior high school or above. Smokers were more likely than non-smokers to have chronic diseases (OR 1·06, 95% CI 1·03–1·08), and even higher risks were related to early smoking initiation (smoking in adolescence) and long-term smoking (OR 1·2 every 10 years, 95% CI 1·2–1·3).
Published Online October 26, 2018 Department of Neurology (M Wang MD, C Liu MD, S Xu MD, X Luo MD, Prof W Wang MD), Department of Scientific Research Management (W Liu DPH), Department of Computer Centre (X Zhang DPH, L Wang DPH), and Department of Translational Medicine Center (J Liu DPH), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Correspondence to: Prof Wei Wang, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430030, China [email protected]
Interpretation The high plateau of tobacco use has not been curbed in China, particularly in young people and women. Programmes should target crucial years for smoking adoption (age 15–24 years), and thorough implementation of the 9-year compulsory education in China might help to reduce the initiation of smoking in young people. Involving older family members in tobacco control programme and addressing family influences on young people’s tobacco use might also contribute to this goal. Funding None Contributors WW conceived the idea for the study and managed the project. WHL, CCL, SBX, FCZ, and WW designed the study. MHW, CCL, WHL, XL, XXZ, LW, and JL collected the data, performed the statistical analyses, and wrote the statistical analysis plan. MHW and SBX wrote the manuscript. WW had full access to all of data in the study and took full responsibility for the integrity of data and the accuracy of the analyses. All authors read and approved the final manuscript. Declaration of interests We declare no competing interests. Acknowledgments The authors thank Jingxin Li and Jianping Hu for their valuable advice regarding the study design and data analysis.
www.thelancet.com
75
Trends of smoking prevalence and implications for chronic diseases in China: an analysis of data from serial national cross-sectional surveys Minghuan Wang, Shabei Xu, Chenchen Liu, Wenhua Liu, Xiang Luo, Xiaoxiang Zhang, Liang Wang, Jian Liu, Fengcai Zhu,Wei Wang
Abstract
Background Tobacco control in China is far from satisfactory and the demographic trends ofsmokers in China are poorly described. This study aimed to investigate the latest trends in smoking and its implication for chronic diseases. Methods We analysed data from serial cross-sectional national health service surveys from 2003 to 2013 in mainland China. Risk factors of ever-smoking were identified by multiple logistic regression. We compared the differences between ever-smokers and non-smokers in the prevalence of chronic diseases. Findings The overall prevalence of smoking remained high from 2003 (27·7%, 95% CI 27·5–27·9) to 2013 (27·9%, 27·7–28·1). Strikingly, the smoking prevalence in adolescents aged 15–24 years increased from 8·3% (8·0–8·7) in 2003 to 12·5% (12·1–13·0) in 2013. Among male smokers, the biggest difference between age groups was in 2013, when smoking prevalence in individuals aged 20–24 years (36·2%) was 3·9 times that in individuals aged 15–19 years (9·2%). 78% of male smokers reported starting smoking before age 25 years, whereas only 36·72% of female smokers reported smoking before this age. The prevalence of smoking in young people was positively related with the number of older smokers in their families, especially older female family members (p<0·0001; correlation coefficient 0·1). Young people aged 15–24 years with low education levels (junior high school or less) had an increased risk of tobacco use (OR 1·3, 95% CI 1·2–1·4) compared with those with senior high school or above. Smokers were more likely than non-smokers to have chronic diseases (OR 1·06, 95% CI 1·03–1·08), and even higher risks were related to early smoking initiation (smoking in adolescence) and long-term smoking (OR 1·2 every 10 years, 95% CI 1·2–1·3).
Published Online October 26, 2018 Department of Neurology (M Wang MD, C Liu MD, S Xu MD, X Luo MD, Prof W Wang MD), Department of Scientific Research Management (W Liu DPH), Department of Computer Centre (X Zhang DPH, L Wang DPH), and Department of Translational Medicine Center (J Liu DPH), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Correspondence to: Prof Wei Wang, Tongji Hospital, Tongji Medical College Huazhong University of Science and Technology, Wuhan, 430030, China [email protected]
Interpretation The high plateau of tobacco use has not been curbed in China, particularly in young people and women. Programmes should target crucial years for smoking adoption (age 15–24 years), and thorough implementation of the 9-year compulsory education in China might help to reduce the initiation of smoking in young people. Involving older family members in tobacco control programme and addressing family influences on young people’s tobacco use might also contribute to this goal. Funding None Contributors WW conceived the idea for the study and managed the project. WHL, CCL, SBX, FCZ, and WW designed the study. MHW, CCL, WHL, XL, XXZ, LW, and JL collected the data, performed the statistical analyses, and wrote the statistical analysis plan. MHW and SBX wrote the manuscript. WW had full access to all of data in the study and took full responsibility for the integrity of data and the accuracy of the analyses. All authors read and approved the final manuscript. Declaration of interests We declare no competing interests. Acknowledgments The authors thank Jingxin Li and Jianping Hu for their valuable advice regarding the study design and data analysis.
www.thelancet.com
75