Trends and socioeconomic factors in smoking and alcohol consumption among Chinese people: evidence from the 2008–2018 National Health Service Surveys in Jiangsu Province

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 socioeconomic 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. The study population was those over 15 years old in three surveys. Trends in smoking and alcohol use were analyzed with descriptive statistics, and bivariate and multinomial logistic regression was used to identify contributing factors. RESULTS: Among total sample, smoking rate was 23.95%, in which the incidence of light, moderate and heavy 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, “smoking and drinking” rate was 13.41%. From 2008 to 2018, overall and light-to-moderate smoking rates first increased and then decreased while heavy smoking rate declined; alcohol consumption increased while excessive drinking increased before decreasing; and the incidence of “smoking and drinking” has been rising continuously. The trend of smoking and drinking rates in urban area was similar to rural area, however there was significant difference between urban and rural area. Socioeconomic factors, demographic, health-related and year variables were significant influencing factors of smoking and drinking. CONCLUSION: Our research can provide important evidences for tobacco and alcohol control in China and other similar developing countries. 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.