The Moderating Effect of Community-Level Deprivation on the Association between Individual Characteristics and Smoking Behavior among Chinese Adults: A Cross-Level Study

Int J Environ Res Public Health. 2021 May 27;18(11):5785. doi: 10.3390/ijerph18115785.

Abstract

China joined the World Health Organization (WHO) Framework Convention on Tobacco Control in 2006; however, the overall Chinese smoking rate is still high. The aim of this study is to provide new evidence for the direct effects of community-level deprivation, and the effects of interactions between community-level deprivation and individual characteristics, on smoking intensity, by using cross-sectional data from the 2015 China Health and Nutrition Survey (CHNS). The results show that there is a strong association between community-level deprivation and individual smoking intensity, and that community deprivation moderates the relationship between individual perceived stress and smoking intensity. The findings imply that adequate interventions should be conducted in the context of deprived neighborhoods, and should consider differences between levels of individual perceived stress and between sexes, especially focusing on highly stressed women who live in deprived communities.

Keywords: China; China Health and Nutrition Survey (CHNS); community deprivation; multilevel analysis; perceived stress; smoking intensity; socioeconomic status.

MeSH terms

  • Adult
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Residence Characteristics*
  • Smoking*
  • Socioeconomic Factors