{"title":"社区教育对中国老年人烟草使用的影响。","authors":"Shuang Yu, Yu Liu, Manyi Wang, Yinhe Liang","doi":"10.18332/tid/204512","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23202,"journal":{"name":"Tobacco Induced Diseases","volume":"23 ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118464/pdf/","citationCount":"0","resultStr":"{\"title\":\"The effects of community education on tobacco use among older adults in China.\",\"authors\":\"Shuang Yu, Yu Liu, Manyi Wang, Yinhe Liang\",\"doi\":\"10.18332/tid/204512\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":23202,\"journal\":{\"name\":\"Tobacco Induced Diseases\",\"volume\":\"23 \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12118464/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tobacco Induced Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.18332/tid/204512\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tobacco Induced Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.18332/tid/204512","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
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 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.
期刊介绍：
Tobacco Induced Diseases encompasses all aspects of research related to the prevention and control of tobacco use at a global level. Preventing diseases attributable to tobacco is only one aspect of the journal, whose overall scope is to provide a forum for the publication of research articles that can contribute to reducing the burden of tobacco induced diseases globally. To address this epidemic we believe that there must be an avenue for the publication of research/policy activities on tobacco control initiatives that may be very important at a regional and national level. This approach provides a very important "hands on" service to the tobacco control community at a global scale - as common problems have common solutions. Hence, we see ourselves as "connectors" within this global community.
The journal hence encourages the submission of articles from all medical, biological and psychosocial disciplines, ranging from medical and dental clinicians, through health professionals to basic biomedical and clinical scientists.
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