Elsevier

Preventive Medicine

Volume 39, Issue 4, October 2004, Pages 666-673
Preventive Medicine

Cigarette smoking among rural-to-urban migrants in Beijing, China

https://doi.org/10.1016/j.ypmed.2004.02.033Get rights and content

Abstract

Background. Tobacco use remains a substantial public health challenge in China. The rapidly growing rural-to-urban migrant population currently numbering approximately 121 million individuals may be especially vulnerable to tobacco use.

Methods. Cigarette smoking levels and associated factors were examined among 2,201 subjects using cross-sectional data from the Migrant Health Behavior Survey (MHBS), conducted in 2002, Beijing, China.

Results. Respondents (39.3% females) were 18–30 years old with a mean age of 22.7 years; 77.3% were single and 35.6% had at least attended high school for education. Migrants reported an average of 4 years of migratory experience; 28.8% had worked in at least three cities and 36.8 had held at least four jobs. Males (51.7%) and females (10.9%) reported 30-day cigarette use. Smoking levels were positively associated with age, education, income, migration years, number of cities in which the migrants had worked, living in rental properties, and number of jobs held. Smoking levels were negatively associated with job and life satisfaction and living with relatives in Beijing. Smoking levels were not associated with marital status.

Conclusions. Female migrants had disproportionately high rate of cigarette smoking. Several conditions and experiences common to the migratory lifestyle were associated with increased levels of smoking. Tobacco control measures are needed to protect migrant populations in China.

Introduction

Tobacco use is an important public health issue in China where approximately 70% of males and 5% of females smoke cigarettes [1], [2], [3]. Numerous studies have investigated cigarette use among various populations in China [4], [5], [6], [7], [8]. To date, however, no studies published in English literature have examined cigarette smoking among rural-to-urban migrants, a new and rapidly expanding subgroup of the Chinese population. According to the China 2000 Census, among its 1.3 billion total population, there are approximately 121 million rural-to-urban migrants [9]. It is estimated that the migrant population in China will grow at the rate of 5 million per year over the next 5–10 years [10].

For several reasons, the migrant population may be highly susceptible to tobacco use. Although migrants are needed to maintain the rapid economic growth in urban China, the Chinese Household Registration System prevents migrants from becoming urban residents [11]. Furthermore, in many cities, urban residents discriminate against migrants [11]. The rapid mobility and the relative instability of living and employment conditions have contributed to the labeling of the migrant population as “vulnerable” in China [12]. Taken together, these factors may lead to high levels of stress among migrants at both the worksites and the urban residence [12], [13]. These high levels of stress may increase the likelihood of use of tobacco products.

Stress has been recognized as a risk factor for smoking in populations in general and nonmigrant Chinese in China [14], [15], [16], [17]. Both observational and laboratory studies suggest that stress may trigger behavioral responses of cigarette smoking and increase the intensity of urges to smoke [18], [19], [20]. Smoking appears to temporally enables smokers to feel more relaxed, happier, and achieve a higher sense of control over the stressors [18], [21], [22], [23], [24], [25]. Finally, migrants may also be at increased risk for tobacco use as a result of more disposable income and increased influence of urban lifestyle, including exposure to cigarette smoking [15], [26], [27], [28], [29]. Information on cigarette use among migrants would be useful for effective planning of tobacco control in China.

Beijing, the Capital of China, has a population of approximately 13.8 million with per capital annual income of approximately $1,500. In 2002, Beijing housed an estimate of 3 million rural-to-urban migrants [9]. Approximate 2.1 million of the migrants were settled in the eight urban districts, with the remainder in the suburban (29%) and the rural area (1.5%) of Beijing [30]. Available data from the China National Bureau of Statistics indicate that migrants in Beijing come from many rural villages or small towns and only 12% of them have a high school education. A majority of the migrants (90%) have a job, and those who are employed tend to work in two broad areas: the service sector (about 60% worked in hotels, restaurants, barbershops/beauty salons, street vendors, and domestic services) and construction (40%) [31].

The purpose of this study was to examine levels of and factors associated with cigarette smoking among rural-to-urban migrants in China. After describing the general demographic characteristics and the migratory lifestyle of the study subjects, we sought to address the following questions: (1) what are the smoking levels among the migrants? and (2) are migratory lifestyle factors such as migratory history, employment, residential conditions, and levels of job and life satisfaction associated with smoking behavior?

Section snippets

Data source and study sample

Data used for this study were derived from a large feasibility study on HIV/STD prevention among rural-to-urban migrants in China [32]. The study sample in Beijing was drawn from six (Chaoyang, Haidian, Shijingshan, Fengtai, Xuanwu, and Xicheng) of the eight urban districts in Beijing. It has been estimated that these six districts account for approximately 90% of the total migrant population in urban Beijing [30]. A quota-sampling procedure was used to recruit participants to yield a composite

Sample statistics and migratory experience

Information on sample characteristics and migratory history is presented in Table 1. Among the 2,201 respondents, 866 (39.3%) were females with half being 22 years old or younger (range: 18–30 years, mean = 22.97 years, SD = 3.50 years). Slightly less than two-third (63.1%) of the respondents had three or more years of migratory experiences (range = 1 month to 15 years, mean = 3.91 years, and SD = 2.72 years), 42.8% of respondents reported having migrated to only one city throughout their

Migration from rural to urban and cigarette smoking

Findings from this study indicated that approximately half of male migrants and 10% of female migrants reported smoking cigarettes during the 30 days preceding the survey. The self-reported smoking prevalence among males appeared to be comparable to, or even slightly lower than, the national current smoking rate for people in the 20–29 year age group (54–65%) in 1996. Smoking among female migrants, however, was approximately 10-fold higher than the national prevalence rate at the same age range

Acknowledgements

This study is supported by NIMH (grant #R01MH064878), West Virginia University, and Wayne State University Department of Pediatrics. The authors are grateful to those graduate students and colleagues from Beijing Normal University Institute of Developmental Psychology and China CDC Resources Center for STD and Leprosy Control who kindly contributed their effort in field data collection.

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