The effect of self-perceived stress, the history of smoking and drinking on weight status in Chinese adults - evidence from the 2015 China Health and Nutrition Survey: A cross-sectional study in Chongqing, China

Being overweight and obese is a serious public health issues in China. However, the effects of substance use and mental factors on weight changes remain unclear. In this study, we aimed to investigate the association among self-perceived stress, history of smoking and drinking, and weight status by using data from the China Health and Nutrition Survey in 2015. A total of 8028 adults were selected from China Health and Nutrition Survey in 2015. The self-reported data primarily included sociodemographic data, self-perceived stress scores, and history of smoking and drinking. Physical measurements including height and weight were logged to calculate body mass index. Multivariate and multinomial regression models were used to estimate effects of substance and perceived stress on weight status. The prevalence of underweight and overweight/obese people were 4.52% and 51.51% in Chinese adults, respectively. Adults with high perceived stress were negatively associated with being overweight and obese (OR = 0.80, 95% CI = 0.66–0.97 in the middle level and OR = 0.69, 95%CI = 0.55–0.88 in the high level). Adults with history of smoking had low risk of being overweight/obese (OR = 0.71, 95% CI = 0.62–0.82). Adults with history of drinking had high risk of overweight/obese (OR = 1.22, 95% CI = 1.06–1.40). In addition, the association between drinking and overweight/obese was affected by different levels of perceived stress (OR = 1.15, 95%CI = 0.83–1.59 in low-stress group and OR = 1.42, 95%CI = 1.04–1.94 in high-stress group). The effects of self-perceived stress and history of smoking as well as drinking on weight status were significant in this study. The government and healthcare policymakers should strengthen early psychological factor and behavioral intervention to decrease the prevalence of abnormal-weight status.