Trends and Socioeconomic Factors in Smoking and Alcohol Consumption Among Chinese Adults: Evidence From National Health Service Surveys

Abstract Background: Smoking and excessive drinking are risk factors for many diseases. With the rapid economic development in China, it is important to identify trends in smoking and alcohol consumption and factors that contribute to these behaviors to ensure the health of the population.Methods: we analyzed pooled cross-sectional data from the fourth, fifth, and sixth National Health Service Surveys conducted in Jiangsu Province in 2008, 2013, and 2018, respectively. Trends in smoking and alcohol use were analyzed with descriptive statistics, and bivariate and multivariate logistic regression was used to identify contributing factors.Results: Among total sample, smoking rate was 23.95%, in which the incidence of mild, moderate and severe smoking was 5.75%, 4.63% and 13.56%, respectively; drinking rate was 23.29%, in which non-excessive drinking and excessive drinking were 19.80% and 3.49%, respectively. From 2008–2018, overall and light-to-moderate smoking rates first increased and then decreased while heavy smoking rate declined; and alcohol consumption increased while excessive drinking increased before decreasing. The varying tendency of smoking and drinking rates in urban area was similar to rural area, however there was a significant gap in incidence between urban and rural area. Socioeconomic factors, demographic, health-related and year variables were significant associated with smoking and drinking. Conclusion: Preventive measures such as education and support services along with stricter regulations for tobacco and alcohol use are needed to improve public health in China.