Can Chronic Disease Diagnosis Urge the Patients to Quit Smoking? — Evidence from the China Health and Nutrition Survey

Yue Hu,1 Qihui Chen,2 Bo Zhang3 1College of Economics and Management, China Agricultural University, Beijing, People’s Republic of China; 2Beijing Food Safety Policy & Strategy Research Base, China Agricultural University, Beijing, People’s Republic of China; 3Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USACorrespondence: Qihui Chen Email chen1006@umn.eduBackground: Tobacco consumption is one of the world’s largest public health threats. Yet little is known about how chronic disease diagnoses affect individuals’ smoking behavior in China, where the world’s largest smoking population resides.Methods: This study analyzes an unbalanced panel dataset on 2986 Chinese males aged 50 or above from the China Health and Nutrition Survey, a household survey covering nine Chinese provinces. We adopt a zero-inflated negative binomial (ZINB) regression framework to account for the count-data nature of the outcome variable of interest, the number of cigarettes one smokes per day. Logit regressions are also adopted to predict one’s likelihood of smoking cessation.Results: First, the estimated ZINB model suggests that the number of chronic disease diagnoses only affects whether one smokes, but conditional on one being a smoker, it does not affect the number of cigarettes one smokes per day. Logit estimates suggest that an additional diagnosed chronic disease is associated with a 4.8 percentage-point increase in the likelihood of smoking cessation. Second, while the diagnoses of all four chronic conditions examined are found to increase the likelihood of smoking cessation, the diagnosis of myocardial infarction has the largest impact, followed by diabetes diagnosis.Conclusion: While chronic disease diagnoses reduce smoking in China, their effects are small. Healthcare policies and relevant measures (such as helping smoking patients switch to a diet with more foods enriched with antioxidants) are thus needed to reduce the adverse effects that continued smoking might impose on their health.Keywords: chronic disease, diagnosis, smoking, count-data models, Chin