Changes in smoking behaviors following exposure to health shocks in China

Background: Evidence suggests that following major individual health shocks, smokers change their smoking behaviors. However, little is known about the association between spousal health shocks and smoking. This study examined the contemporaneous and long-term effects of individual and spousal health shocks on males’ smoking behaviors in China. Methods: This study employed a nation-wide data base from the 1991–2011 China Health and Nutrition Study. Random effects models were estimated to ascertain the impacts of health shocks on males’ smoking behavior. Smoking behaviors were measured by smoking status, smoking consumption and smoking cessation. Results: In the short term, respondents who incurred health shocks decreased their likelihood of smoking by 10%. In addition, health shocks decreased the likelihood of heavy smoking versus the combined moderate and light categories by 41.6%, and increased their likelihood of quitting by 85.3% for ever smokers. Spousal health shocks had no significant effects on individual smoking behaviors. The long-term effects were similar to the short term impacts. Conclusions: People changed their smoking behaviors in response to their own health experiences but not those of their spouses. Antismoking messages about the health effects on others are unlikely to influence individual smoking behaviors, unless individuals believed that they are personally vulnerable to smoking-related diseases.