Class status and social mobility on tobacco smoking in post-reform China between 1991 and 2011

XY Yang - Nicotine and Tobacco Research, 2020 - academic.oup.com
Nicotine and Tobacco Research, 2020academic.oup.com
Introduction There is growing attention to social mobility's impact on tobacco use, but few
studies have differentiated the two conceptually distinct mechanisms through which changes
in social class can affect tobacco smoking: the class status effect and the mobility effect.
Aims and Methods I applied Diagonal Reference Modeling to smoking and heavy smoking
among respondents of the 1991 China Health and Nutrition Survey who were revisited two
decades later in 2011 (n= 3841, 49% male, baseline mean age was 38 years). I divided the …
Introduction
There is growing attention to social mobility’s impact on tobacco use, but few studies have differentiated the two conceptually distinct mechanisms through which changes in social class can affect tobacco smoking: the class status effect and the mobility effect.
Aims and Methods
I applied Diagonal Reference Modeling to smoking and heavy smoking among respondents of the 1991 China Health and Nutrition Survey who were revisited two decades later in 2011 (n = 3841, 49% male, baseline mean age was 38 years). I divided the sample into six social classes (non-employment, self-employed, owners, workers, farmers, and retirees) and measured social mobility by changes in income and occupational prestige.
Results
About 61.7% of men were smokers and those from the classes of workers, owners, and self-employees consumed more cigarettes compared to the unemployed, but women smokers (3.7%) tend to be from the lower classes (unemployed and farmers). Controlling for social class, each 1000 Yuan increase in annual income led to smoking 0.03 more cigarettes (p < .05) and 1% increase (p < .05) in the likelihood of heavy smoking among men, but the income effect is null for women. Upwardly mobile men (a 10-points surge in occupational prestige) smoked like their destination class (weight = 78%), whereas men with downward mobility were more similar to peers in the original class (weight = 60%).
Conclusions
Contrary to the social gradient in smoking in other industrial countries, higher class status and upward mobility are each associated with more smoking among Chinese men, but not among women.
Implications
Tobacco control policies should prioritize male smoking at workplaces and the instrumental purposes of using tobacco as gifts and social lubricant. Taxation may counter the surge in smoking brought by individuals’ income increase after upward mobility. Caution should be paid to women joining the similar social gradient in smoking as they gain foothold in the labor market.
Oxford University Press
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