Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China.
Institute of Nutrition and Food Hygiene, Beijing Centers for Diseases Control and Prevention, Beijing, China.
BMJ Open. 2022 Nov 22;12(11):e058097. doi: 10.1136/bmjopen-2021-058097.
To identify clues for women's tobacco control, this study analyses the gender differences in social environmental changes associated with smoking and the interaction between the environment and individuals' social integration.
DESIGN, SETTING AND PARTICIPANTS: A cross-sectional design and secondary analysis were used among Chinese internal migrants. Data were from the 2012 Migrant Dynamics Monitoring Survey in China with participants aged 15-59 years old (75 416 women and 83 140 men) who resided in cities for more than 1 month.
Social environmental changes were measured by differences in smoking prevalence and women's empowerment between the migrant-receiving province (MRP) and migrant-sending province (MSP). Social participation and duration of stay (DOS) were adopted as indicators of social integration. Stratified analysis and binary logistic regression models were used to determine the dependent variable (smoking status) and environmental changes after controlling for age, education, income and happiness.
Differences in the smoking prevalence environment (lower in MRP, OR 0.70, 95% CI 0.60 to 0.83; higher rate in MRP, OR 1.79, 95% CI 1.35 to 2.37) and women's empowerment (lower rate in MRP, OR 0.80, 95% CI 0.68 to 0.97; higher rate in MRP, OR 1.15, 95% CI 1.00 to 1.33) between MRP and MSP were positively correlated with women's smoking. In men, however, migrating to an area with lower smoking prevalence could not reduce smoking risk, whereas moving to an area with higher women's empowerment could. A long DOS was an independent risk factor for smoking in women (ranged from 1.20 to 2.00 in various environmental changes scenarios) but a protective factor for men. An interaction between environmental changes and social integration could not be verified.
Tobacco control strategies should consider gender differences, especially women who are experiencing social environmental changes.
为了寻找女性控烟的线索，本研究分析了与吸烟相关的社会环境变化中的性别差异，以及环境与个体社会融合之间的相互作用。
设计、地点和参与者：本研究采用了中国流动人口的横断面设计和二次分析。数据来自于 2012 年中国流动人口动态监测调查，参与者年龄在 15-59 岁之间（女性 75416 人，男性 83140 人），他们在城市居住超过 1 个月。
社会环境变化通过移民接收省（MRP）和移民输出省（MSP）之间吸烟率和女性赋权的差异来衡量。社会参与和居留时间（DOS）被用作社会融合的指标。在控制年龄、教育、收入和幸福感后，采用分层分析和二元逻辑回归模型来确定因变量（吸烟状况）和环境变化。
MRP 和 MSP 之间吸烟率环境（MRP 较低，OR=0.70，95%CI=0.60-0.83；MRP 较高，OR=1.79，95%CI=1.35-2.37）和女性赋权环境（MRP 较低，OR=0.80，95%CI=0.68-0.97；MRP 较高，OR=1.15，95%CI=1.00-1.33）的差异与女性吸烟呈正相关。然而，在男性中，移民到吸烟率较低的地区并不能降低吸烟风险，而移民到女性赋权较高的地区则可以。较长的 DOS 是女性吸烟的独立危险因素（在不同的环境变化情景下，范围从 1.20 到 2.00），但对男性来说是保护因素。环境变化和社会融合之间的相互作用无法得到证实。
烟草控制策略应考虑性别差异，尤其是处于社会环境变化中的女性。
