Exploring the association of time-inconsistent preferences with smoking behavior: A cross-sectional survey study from Sichuan, China.

Abstract

Introduction: The high prevalence of tobacco use in China has led to a heavy social burden. There have been many studies on smoking behavior in China, but few have explored it from the perspective of behavioral economics. This study investigated the association between time-inconsistent preferences and smoking behavior.

Methods: We conducted a household-based cross-sectional survey in Sichuan Province, southwestern China, in 2022. Participants were selected using multistage stratified sampling. Data were collected through face-to-face, questionnaire-based household surveys, yielding 5446 valid responses. The smoking status of all participants was confirmed by cotinine test. Descriptive statistical analysis was performed on variables such as sociodemographic variables and time-inconsistent preference, and a binary logistic regression model was used to explore the relationship between time-inconsistent preference and smoking behavior.

Results: The smoking rate of the survey participants was 23.87%, among which that of drinkers was 45.90%, which was significantly higher than that of non-drinkers (15.10%); 712 participants (13.07%) both smoked and drank, and the average time-inconsistent preference (time-inconsistent preferences measured over 1-month and 12-month delay periods) of smokers (mean ± standard deviation: 0.91 ± 0.14) was significantly lower than that of non-smokers (0.95 ± 0.11, p<0.001). Thus, those with weaker time-inconsistent preferences were less likely to smoke (p<0.001, adjusted odds ratio, AOR=0.276; 95% CI: 0.140-0.544). This trend was significant in both drinkers and non-drinkers, with AOR of 0.253 (95% CI: 0.093-0.693) and 0.26 (95% CI: 0.102-0.661), respectively.

Conclusions: Weaker time-inconsistent preferences show a significant negative association with smoking behavior in this Chinese sample, independent of alcohol consumption. Commitment mechanisms targeting time-inconsistent preferences may hold promise for smoking cessation interventions, although efficacy requires validation through randomized trials.