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Cigarette Smoking and Alcohol Consumption among Chinese Older Adults: Do Living Arrangements Matter?

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      This study used five waves of the Chinese Longitudinal Healthy Longevity Survey to examine the relationship between living arrangements, smoking, and drinking among older adults in China from 1998–2008. We found that living arrangements had strong implications for cigarette smoking and alcohol consumption among the elderly. First, the likelihood of smoking was lower among older men living with children, and older women living either with a spouse, or with both a spouse and children; and the likelihood of drinking was lower among both older men, and women living with both a spouse and children, compared with those living alone. Second, among dual consumers ( i.e., being a drinker and a smoker), the amount of alcohol consumption was lower among male dual consumers living with children, while the number of cigarettes smoked was higher among female dual consumers living with others, compared with those living alone. Third, among non-smoking drinkers, the alcohol consumption was lower among non-smoking male drinkers in all types of co-residential arrangements ( i.e., living with a spouse, living with children, living with both a spouse and children, or living with others), and non-smoking female drinkers living with others, compared with those living alone. Results highlighted the importance of living arrangements to cigarette smoking and alcohol consumption among Chinese elderly. Co-residential arrangements provided constraints on Chinese older adults’ health-risk behaviors, and had differential effects for men and women.

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      Most cited references 80

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      Gender, marital status and the social control of health behavior.

       D Umberson (1992)
      Mortality rates are lower for married individuals than they are for unmarried individuals, and marriage seems to be even more beneficial to men than women in this regard. A theoretical model of social integration and social control is developed to explain why this may occur. Drawing from this model, I hypothesize that marriage may be beneficial to health because many spouses monitor and attempt to control their spouse's health behaviors. Furthermore, the provision, receipt, and consequences of these social control efforts may vary for men and women. These hypotheses are considered with analysis of a national panel survey conducted in 1986 (N = 3617) and 1989 (N = 2867). Results show that: (1) marriage is associated with receipt of substantially more efforts to control health for men than women, (2) those who attempt to control the health of others are more likely to be female than male, (3) there is some support for the social control and health behavior hypothesis among the married, and (4) the transition from married to unmarried status is associated with an increase in negative health behavior while the transition from unmarried to married status seems to have little effect on health behavior. A theoretical explanation is developed to explain these marital status differences.
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          Gender differences in alcohol consumption and adverse drinking consequences: cross-cultural patterns.

          To examine the consistency and/or variability of gender differences in drinking behavior cross-culturally. Women's and men's responses in 16 general population surveys from 10 countries, analyzed by members of the International Research Group on Gender and Alcohol. Comparable measures of drinking, versus abstention, typical drinking frequencies and quantities, heavy episodic drinking, intoxication, morning drinking, and alcohol-related family and occupational problems. Women and men differed little in the probability of currently drinking versus abstaining, but men consistently exceeded women in typical drinking frequencies and quantities and in rates of heavy drinking episodes and adverse drinking consequences, while women were consistently more likely than men to be life-time abstainers. In older age groups, both men and women drank smaller quantities of alcohol and were more likely to stop drinking altogether, but drinking frequencies did not change consistently with age. A theoretical synthesis proposes that gender roles may amplify biological differences in reactions to alcohol, and that gender differences in drinking behavior may be modified by macrosocial factors that modify gender role contrasts.

            Author and article information

            [1 ]Department of Social Work, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
            [2 ]The Ethelyn R. Strong School of Social Work, Norfolk State University, 700 Park Avenue, Norfolk, VA 23504, USA; E-Mail: lwu@
            Author notes
            [* ]Author to whom correspondence should be addressed; E-Mail: jazhang@ ; Tel.: +852-3943-7557.
            Role: Academic Editor
            Int J Environ Res Public Health
            Int J Environ Res Public Health
            International Journal of Environmental Research and Public Health
            23 February 2015
            March 2015
            : 12
            : 3
            : 2411-2436
            25711361 4377909 10.3390/ijerph120302411 ijerph-12-02411
            © 2015 by the authors; licensee MDPI, Basel, Switzerland.

            This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (


            Public health

            smoking, china, old adults, living arrangements, drinking


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