Differences of cigarette smoking and alcohol consumption by sex and region in China: a population-based, multi-stage, cluster sampling survey

Abstract

BackgroundIn China, the prevalence of cigarette smoking and alcohol consumption is generally higher in men than in women. However, little is known about the regional differences in prevalence of cigarette smoking and alcohol consumption among Chinese. We aimed to measure the gender and regional differences in cigarette smoking and alcohol consumption in the general Chinese population. MethodsThis population-based, multistage, cluster sampling survey was done in the Hunan province of China. Participants from the general population were interviewed to assess cigarette smoking and alcohol consumption. A cigarette smoker was defined as a person who had smoked more than 100 cigarettes in the life time, and we defined alcohol drinkers as people who consume at least 30g alcohol or three standard drinks per week. The protocol was approved by the Second Xiangya Hospital of Central South University Review Board (No. S101, 2011). Eligible subjects were at least aged 12 years and fully understood the context of the survey. Descriptive statistics were used to examine demographic characteristics and pooled responses, including the mean, standard deviation for continuous variables, and percentage for categorical variables. Between-group comparisons were performed using χ2 test for categorical variables and two sample t-test for continuous measures. An alpha level of 0·05 was set to determine statistical significance. Statistical analyses were performed using SPSS 22.0. FindingsWe interviewed 26 851 participants. 47% of respondents were women, and 31% of respondents were from rural area. 26 282 participants (98%) completed the smoking-related questions, and 26 168 participants (98%) completed the questions relating to alcohol drinking. Overall, 25% of participants (45% men and 3% female) were cigarette smokers, and 20·0% (34% men and 4% women) were alcohol drinkers. The duration of smoking was longer in men than in women (mean 16·9 years [SD 12·05] vs 13·5 years [13·68]; p<0·0001). We found no difference in the amount of cigarettes smoked per day between men and women (18·3 cigarettes [14·80] for men vs 18·7 cigarettes [15·46] for women; p=0·658). Men had been drinking for longer than women (16·0 years [12·60] for men vs 10·3 years [11·09] for women; p<0·0001). Men tended to drink more often than women (4·5 drinks per week [4·39] by men vs 3·2 drinks per week [3·27] by women (p<0·0001). 27% of participants from rural areas were smokers, and 25% of participants from urban areas were cigarette smokers. In both rural and urban areas, 20% of participants were alcohol drinkers. Participants from rural areas had smoked for longer than participants from urban areas (20·5 years [13·42] in rural area vs 14·9 years [11·04] in urban areas; p<0·0001). We found no difference in the number of cigarettes smoked per day among participants from urban and rural areas (18·5 cigarettes per day [14·29] in rural areas vs 18·3 cigarettes per day [15·17] in urban areas; p=0·697). People in rural areas had been drinking alcohol for longer than people in urban areas (19·4 years [14·05] in rural area vs 13·7 years [11·40] in urban areas; p<0·0001). Participants from rural areas drink alcohol more often than participants from urban areas (5·6 drinks per week [5·45] in rural areas vs 3·8 drinks per week [3·46] in urban areas; p<0·0001). InterpretationThese findings suggested an overwhelmingly higher prevalence of cigarette smokers and alcohol drinkers among men than among women in China and a higher prevalence of cigarette smokers in rural areas than in urban areas. Compared with women, men started smoking and drinking in an earlier age and consumed more alcohol per week. Similarly, compared with people living in urban areas, people from rural areas started to smoke and drink at an earlier age and consumed more alcohol per week. We found no sex-specific or regional differences in terms of number of smoked cigarettes per day. FundingNatural Science Foundation of China (81100996, 81371480).