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: Shuang Yu, Yu Liu, Manyi Wang, Yinhe Liang
Format: Article
Language:English
Published: European Publishing 2025-05-01
Series:Tobacco Induced Diseases
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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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author Shuang Yu
Yu Liu
Manyi Wang
Yinhe Liang
author_facet Shuang Yu
Yu Liu
Manyi Wang
Yinhe Liang
author_sort Shuang Yu
collection DOAJ
description 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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spelling doaj-art-67096dd344cf4689bcafbc38cd0a8c142025-08-20T03:15:31ZengEuropean PublishingTobacco Induced Diseases1617-96252025-05-0123May11310.18332/tid/204512204512The effects of community education on tobacco use among older adults in ChinaShuang Yu0Yu Liu1Manyi Wang2Yinhe Liang3https://orcid.org/0000-0002-9481-1300Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, ChinaInstitute of Chinese Financial Studies, Southwestern University of Finance and Economics, Chengdu City, ChinaInstitute of Chinese Financial Studies, Tsinghua University, Beijing, ChinaSchool of Economics and Management, Central University of Finance and Economics, Beijing, ChinaIntroduction 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.https://www.tobaccoinduceddiseases.org/The-effects-of-community-education-on-tobacco-use-among-older-adults-in-China,204512,0,2.htmltobacco useolder adultscommunity educationinstrumental-variable
spellingShingle Shuang Yu
Yu Liu
Manyi Wang
Yinhe Liang
The effects of community education on tobacco use among older adults in China
Tobacco Induced Diseases
tobacco use
older adults
community education
instrumental-variable
title The effects of community education on tobacco use among older adults in China
title_full The effects of community education on tobacco use among older adults in China
title_fullStr The effects of community education on tobacco use among older adults in China
title_full_unstemmed The effects of community education on tobacco use among older adults in China
title_short The effects of community education on tobacco use among older adults in China
title_sort effects of community education on tobacco use among older adults in china
topic tobacco use
older adults
community education
instrumental-variable
url 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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