Influence of major non-communicable chronic disease diagnoses on Chinese adult males' smoking behavior: is there a moderating role for the home environment?

Smoking is widely acknowledged as a major contributor to the high prevalence of chronic diseases. It is, therefore, important to explore measures that could help reduce cigarette consumption, especially from a policy perspective. This study investigates the effects of the diagnoses of four major non-communicable chronic diseases (NCDs), namely, diabetes, hypertension, myocardial infarction and stroke, on Chinese adult males’ daily cigarette consumption. It also examines how the home environment, including family members’ NCD diagnoses and smoking behavior, may moderate these effects and explores whether the impacts of one’s own NCD diagnosis and home environment vary with one’s smoking intensity. Using longitudinal data from 5388 Chinese males aged 45–85 residing in 9 provinces, our zero-inflated Negative Binomial regression models yielded four findings. First, one’s own NCD diagnosis is associated with a 27.3%increase in the odds of smoking cessation compared to continuing smoking among Chinese adult males, but for those who continue to smoke, their own NCD diagnosis does not affect the number of daily cigarettes smoked. Second, the presence of family members who smoke increases the likelihood of Chinese adult males continuing to smoke and their smoking intensity, while family members’ NCD diagnosis has a minimal impact on one’s cigarette consumption. Third, neither family members’ smoking behavior nor their NCD diagnoses moderate the relationship between an individual’s own NCD diagnosis and their smoking habits. Finally, the impacts of one’s own NCD diagnosis and the home environment vary significantly between heavy and non-heavy smokers. While one’s NCD diagnosis significantly reduces cigarette consumption among non-heavy smokers, it has the opposite effect among heavy smokers. The home environment shows a marginally significant impact only among non-heavy smokers.