The impact of chronic disease diagnoses on smoking behavior change and maintenance: Evidence from China
Introduction Managing chronic diseases and tobacco use is a formidable challenge in low- and middle-income countries (LMICs) with limited health literacy and access to quality healthcare. This study examines the empirical evidence from China, utilizing quasi-experimental approaches to assess the cau...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2024-01-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | https://www.tobaccoinduceddiseases.org/The-impact-of-chronic-disease-diagnoses-on-smoking-behavior-nchange-and-maintenance,176947,0,2.html |
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| Summary: | Introduction
Managing chronic diseases and tobacco use is a formidable challenge
in low- and middle-income countries (LMICs) with limited health literacy and
access to quality healthcare. This study examines the empirical evidence from
China, utilizing quasi-experimental approaches to assess the causal effect of
chronic disease diagnoses on smoking behavior.
Methods
Employing the diagnosis of chronic disease in the older cohorts of the
population as a natural experiment, this study utilizes recent advancements in
difference-in-difference estimation methods (CS-DID) to investigate the effect
of a diagnosis on smoking behavior. Self-reported new diagnoses of conditions
ascertained chronic disease diagnoses. CS-DID was run using the study sample
from the 2011 to 2018 waves of the China Health and Retirement Longitudinal
Study, comparing results with traditional two-way fixed effects and event-study
models.
Results
The average treatment effect (ATT) of CS-DID is slightly greater than the
effects reported using conventional difference-in-difference methods. We found
that diagnoses of cancer, heart disease, and stroke reduced smoking rates by 16%
(95% CI: -24 – -8), smoking intensity by 0.31 (95% CI: -0.46 – -0.15), and had
lasting impacts on smoking cessation behavior (one wave after diagnosis ATT=
-0.17; 95% CI: -0.34 – -0.00, two waves after diagnosis ATT= -0.17; 95% CI:
-0.37–0.03). A diagnosis of a mild chronic disease, such as hypertension, diabetes,
asthma, chronic lung disease, liver disease, or gastric disease, had more negligible
and transient effects on smoking behavior.
Conclusions
Efforts to enhance smoking cessation in middle-aged and elderly
patients with chronic diseases are crucial to improving health outcomes. The
‘teachable moment’ of chronic disease diagnosis should be seized to provide
smoking cessation assistance to achieve the goal of healthy ageing. |
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| ISSN: | 1617-9625 |