The effects of community education on tobacco use among older adults in China
Introduction Smoking among older adults is increasingly linked to chronic diseases and higher mortality rates. However, the influence of community education on smoking behavior in older adults remains understudied. This research examines the causal effect of community education on smoking habits of...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2025-05-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | https://www.tobaccoinduceddiseases.org/The-effects-of-community-education-on-tobacco-use-among-older-adults-in-China,204512,0,2.html |
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| Summary: | Introduction
Smoking among older adults is increasingly linked to chronic diseases
and higher mortality rates. However, the influence of community education on
smoking behavior in older adults remains understudied. This research examines
the causal effect of community education on smoking habits of older adults in
China.
Methods
We use four waves of longitudinal secondary data (2011, 2013, 2015, and
2018) from the China Health and Retirement Longitudinal Study (CHARLS),
covering adult children aged 22–58 years and their parents aged ≥60 years. A
two-stage least squares (2SLS) model is applied to estimate the causal impact of
community education on smoking behaviors among older adults, using exposure to
the 1986 Compulsory Schooling Law as an instrumental variable. Mechanism and
subgroup analyses are further conducted to validate and interpret the estimated
effects.
Results
This study includes 26489 adults aged ≥60 years. Community education
significantly reduces the likelihood of ever smoking (β= -0.030; 95% CI: -0.048 –
-0.012), current smoking (β= -0.020; 95% CI: -0.038 – -0.003), and the number
of cigarettes (β= -0.038; 95% CI: -0.075 – -0.001). Mediation analysis indicates
that these effects are partially explained by intergenerational support, well-being,
and mental health. Among ever smokers, the Center for Epidemiologic Studies
Depression Scale (CES-D) score shows the largest indirect effect (β=0.0004; 95%
CI: 0.0000–0.0010), accounting for 3.5% of the total effect, followed by contact
with children (β= -0.0003; 95% CI: -0.0010 – -0.0000; 1.8%) and optimism (β=
-0.0001; 95% CI: -0.0002 – -0.0000; 0.7%). For smoking intensity, CES-D remains
the only significant mediator (β=0.0008; 95% CI: -0.0003–0.0010), explaining
4% of the total effect.
Conclusions
Community education plays a crucial role in lowering smoking rates
among older adults. Policymakers should prioritize educational programs and
enhance healthcare services to reduce smoking and improve public health
outcomes for aging populations. |
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| ISSN: | 1617-9625 |