Investigating the Trends in Socioeconomic Gaps in Smoking Behavior in Contemporary China

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 3. Inequality and Health Behaviors

Abstract

This paper seeks to integrate the life course approach with the theory of fundamental causes of health to investigate the trends in socioeconomic gaps in smoking, against the backdrop of drastic social changes that took place in China during the recent decades. We used the data from a national longitudinal survey that spanned 21 years from 1991 to 2011; we applied logistic and negative binomial growth curve models to examine the trends in the socioeconomic gaps in current smoking and number of cigarettes smoked per day over the life course for different cohorts. The prevalence rate of smoking was high among men during the study period, but declined markedly in the most recent cohorts. Education is inversely correlated with smoking. The educational gap narrowed across early cohorts and widened rapidly in more recent cohorts. Rural residents in general smoked more but the rural/urban gaps disappear in more recent cohorts. Socioeconomic gaps in smoking changed little over the life course within each cohort, suggesting that inter-cohort changes in socioeconomic gaps can mainly be attributed to changes in the gaps in the rates of smoking initiation, rather than cessation, among groups of different socioeconomic status. Among women, smoking rate was low and consistently declined across cohorts. The small number of female smokers makes it infeasible to assess changes in socioeconomics gaps in smoking among women. We argue that large-scale social changes in recent Chinese history combined with mechanisms of health disparities to shape the relationships between socioeconomic conditions and smoking across cohorts. These forces converged to widen socioeconomic gaps in tobacco consumption in recent cohorts. Policies for smoking cessation may need to target vulnerable groups. Moreover, our analysis suggests that prevent smoking initiation among vulnerable groups would be a more effective way to reduce social inequality in smoking rather than encouraging cessation.

Author

• Lei Jin, Chinese University of Hong Kong