ArticleA comparative survey on alcohol and tobacco use in urban and rural populations in the Huaihua District of Hunan Province, China
Introduction
Alcohol and tobacco, which are highly social addictive substances, have been practiced worldwide by hundreds of millions of people and exerted an enormous toll on the lives and communities of many nations (Brown, 2005, Chou et al., 2006, Lee et al., 2006, Ogden, 2005). According to the Global Status Report on Alcohol provided by WHO in 2004, the level of consumption of alcohol has declined in the past 20 years in developed countries but is increasing in developing countries, especially in Asian countries (WHO, 2004). As one of the oldest brewing countries in the world, China has also been faced with the challenge. With the rapid development of economy and the living standard of people, national and regional epidemiological surveys in China since the 1980s have shown that adult per capita alcohol, tobacco consumption, and the prevalence rates of alcohol- and tobacco-related problems have increased steadily, with the potential for a major impact on health (Hao et al., 1998, Hao et al., 1999, Hao et al., 2004, Yan et al., 2004, Zheng et al., 2004).
However, in a country as large and as diverse as China it is difficult to estimate actual alcohol and tobacco consumption. Modern Chinese society is comprised primarily of two subgroups—urban and rural subpopulations—with disparate custom and cultural attitudes toward alcohol drinking and tobacco smoking. The status of drinking and smoking may vary in different subpopulations by geographic location, generating different behaviors, and problems. For instance, WHO estimates that the per capita alcohol consumption in pure alcohol for adults in China in 2001 was 4.45 l (WHO, 2002). Making meaningful explanation from the figure is difficult. Some 80% of China's population lives in rural areas and an even larger percent could be considered poor. Their ability to purchase alcohol is limited. They are much more likely to produce their own alcohol in quantities that are unrecorded in government statistics. This means that the estimated consumption of 4.45 l per capita actually applies only to the more affluent Chinese, who tend to live in the urban and economic development regions of the country (Newman, 2002).
Moreover, tobacco abuse has also been identified as a particular concern for rural China, those long-neglected areas, where tobacco abuse problems are likely to increase at an alarming rate in the future (Cheng et al., 2003, Wang et al., 2006). Unfortunately, studies examining difference in urban and rural subgroups with regard to patterns of drinking and smoking are lacking. Therefore, we conducted an epidemiological survey in the Huaihua District of Hunan Province of China, presented an overview and comparative analyses of the alcohol and tobacco use status among urban and rural populations, and discussed potential explanations for the high variability of prevalence between urban and rural. The results would provide further evidences for further research and the development of public health policy on alcohol and tobacco, and reduce the negative consequences associated with alcohol and tobacco consumption in China.
Section snippets
Samples
All sampling took place in the Huaihua District of Hunan Province, which lies in the central south of China (see Fig. 1). To begin with, we divided all the studied populations into two levels: urban and rural subpopulations. Secondly, Hecheng block in Huaihua City and Dizhuang Village in Xupu country were selected probability proportionately and randomly to size from the primary units. Finally, within those areas households were selected in clusters.
Study populations
All respondents from these two areas were
Results
There were 8,263 selected participants (3,743 urban and 4,520 rural dwellers) and 7,853 were interviewed (3,551 urban and 4,302 rural respondents); of whom, 7,837 (99.8%) provided valid data. The completion rates were 95.0%. Nonresponse was due to the following reasons: refused (1.8%), contact not being made (2.9%), and others (0.3%).
Discussion
We analyzed data from a regional survey to examine differences in urban and rural subgroups with regard to drinking and smoking patterns. Our findings presented that there were clear urban and rural differences regarding alcohol and tobacco use.
Acknowledgments
We would like to acknowledge the supports from grants of National Basic Programs of China (2003CB515400) and National Natural Science Foundation (30370522) to Dr. Wei Hao.
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