Ethnic differences in prevalence and behaviors of smoking and its association with chronic obstructive pulmonary disease among the elderly in rural southwest China：a cross-sectional study

Abstract

Abstract Background This study examines how prevalence and behaviors of smoking differ by ethnicity and the association of smoking with chronic obstructive pulmonary disease (COPD) among the elderly Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. Methods A cross-sectional survey was conducted including 5,642 adults aged ≥ 60 years in rural regions of Yunnan Province, China. Information about participants’ demographic characteristics as well as smoking habits was obtained using a standard questionnaire. Anthropometric measurements, including height and weight, and post-bronchodilator spirometry tests were recorded for each participant. Results In all four studied ethnicities, males had significantly higher prevalence of both current smokers (48.8% vs. 0.8%) and COPD (12.7% vs. 4.5%) than females (P༜0.01). Filtered cigarettes were the most popular form of tobacco used, comprising 76.6% of tobacco consumed among all four studied ethnicities. Bai ethnic minority participants had the highest prevalence of current smoking and COPD as well as the highest number of cigarettes smoked per day compared to the other three studied ethnicities (P < 0.01). Ha Ni ethnic minority participants had the lowest rate of smoking cessation (8.7%) and the highest rate of smoking in public places (66.8%) (P < 0.01). The results of multivariate logistic regression analysis indicated that current smokers had a greater probability of suffering from COPD across all four studied ethnicities (P < 0.05), with the strongest association of current smoking with COPD observed in the Bai ethnic population (OR = 3.32, P < 0.01). Conclusions Prevalence and behaviors of smoking among the elderly in rural southwest China differ significantly by ethnicity. Future tobacco cessation interventions should be tailored to address ethnicity, and reducing prevalence of smoking may reduce prevalence of COPD.