Agreement among multiple measures of self-reported smoking status in Chinese urban residents.

OBJECTIVE: To compare five alternative self-report methods for assessing the smoking status of Chinese urban residents, and to estimate their reliability or agreement. STUDY DESIGN: Cross-sectional survey with multistage sampling. METHODS: Cross-sectional survey data were collected from residents in two Chinese cities, and the prevalence of smoking and smoking frequency were estimated by means of six methods of self-report labelled SMD, SM1, SM6, SMF, SMC and SM. SM, the method of smoking assessment endorsed by the World Health Organisation (WHO), served as a referent in estimating agreement among the domestic methods. Cohen's kappa measured overall intermethod agreement. RESULTS: Data on 1167 eligible respondents were analysed. kappa values ranged from 0.79 to 0.89 for current smoking, from 0.84 to 0.94 for daily smoking, and from 0.23 to 0.62 for occasional smoking. Compared with the referent (SM, 61%), SMD (53%), SM1 (57%), SM6 (54%) and SMC (55%) significantly understated the prevalence of current smoking among Chinese urban residents. SM1 (11%), SM6 (10%), SMD (6%) and SMC (6%) significantly understated the prevalence of occasional smoking compared with the refererent (SM, 14%). No variation emerged in prevalence estimates of daily smoking. CONCLUSIONS: Despite some variability, the five domestic methods used to assess smoking status in China generally produced similar results to those based on SM, the method advocated by WHO. Discrepancies between domestic assessment methods peaked in estimating the prevalence of occasional smoking.

Patterns and correlates of stress among rural Chinese males: a four-region study.

OBJECTIVES: Prior research has revealed a high prevalence of stress among general urban populations in China. However, little is known about stress in rural Chinese counterparts. This research estimates the prevalence of severe stress among rural Chinese males and identifies sociodemographic and psychological correlates. STUDY DESIGN: The study design was a cross-sectional survey with multistage sampling. METHODS: Subjects were male residents aged > or =15 years from four geographic regions of China (N=4414), namely Jinbei, Jinnan, Guidongbei and Subei. Information was collected on perceived stress and potential sociodemographic and behavioural correlates as well as on perceived health status. Data were assessed by means of chi(2) tests and unconditional logistic regression analysis. RESULTS: The mean score for the rural male resident sample on the Chinese Perceived Stress Scale (CPSS) was 24.8 (standard deviation=7.7), and 44% of subjects reported severe stress. With Subei residents as the referent, respondents from Guidongbei region [adjusted odds ratio (OR)=0.66; 95% confidence interval (CI)=0.52-0.84] had a lower likelihood of reporting severe stress and those from Jinbei region (OR=3.54; 95% CI=2.85-4.39) and Jinnan region (OR=2.73; 95% CI=2.21-2.39) had higher likelihoods. Respondents aged 35-44 years (OR=0.69; 95% CI=0.55-0.85) and > or =45 years (OR=0.67; 95% CI=0.54-0.83) had a lower likelihood of reporting severe stress than those aged <25 years, and respondents in non-farming jobs (OR=1.33; 95% CI=1.09-1.62) had an excess likelihood relative to those in farming. An excess likelihood of reporting severe stress was manifest among the divorced and widowed relative to the unmarried, and a lower likelihood was observed among respondents with a higher education relative to the least educated. Hedonism seeking was positively associated with severe stress among rural Chinese males (OR=2.43; 95% CI=2.09-2.84) and social participation was negatively associated (OR=0.62, 95% CI=0.54-0.73). CONCLUSIONS: This study found a high stress level among rural Chinese males. To ameliorate this problem, we recommend policy and prevention initiatives at national and local levels.

Smoking patterns among Chinese rural-urban migrant workers.

OBJECTIVES: To estimate smoking prevalence and identify correlates of smoking initiation among rural-urban migrant workers. STUDY DESIGN: Subjects were 4198 rural-urban migrant workers, aged 18 years and older, residing in three Chinese cities. METHODS: Participants were identified through multistage quota sampling. They were asked about their migration history, pre-migration and post-migration smoking status, employment and home life. Analyses were conducted using Chi-squared test and multiple logistic regression. RESULTS: Overall, smoking prevalence was higher subsequent to migration (28.4%) compared with before migration (20.8%) (P<0.01). Initiation of daily smoking was associated with gender [odds ratio (OR) 0.02]; high school or greater education (OR 0.48; vs elementary school or lower); having a monthly personal income of 1000-1999 Yuan (OR 2.60), 2000-2999 Yuan (OR 3.08) or > or =3000 Yuan (OR 4.04) (vs <500 Yuan US$ 1=7.5 Yuan); and history of migration to three cities (OR:1.65) or four or more cities (OR 2.80) (vs one city). Initiation of occasional smoking was only associated with gender (OR 0.11). Solitude was the primary situational trigger for smoking initiation. CONCLUSIONS: A migratory lifestyle is associated with smoking initiation. Findings could inform the design of tobacco control programmes that would target Chinese rural-urban migrant workers as a special population.