title: Multilevel analysis of the determinants of smoking and second-hand smoke exposure in a tobacco-cultivating rural area of southwest China.
abstract: OBJECTIVE
  To examine contextual and individual demographical predictors of smoking and exposure to second-hand smoke (SHS) in a tobacco-cultivating rural area of southwest China.
  
  
  METHODS
  A cross-sectional survey of 4070 consenting individuals aged 18 years or more was conducted in 2010. Information on demographical characteristics, tobacco smoking status and SHS exposure were obtained by a standard questionnaire. Multilevel logistic regression was used to model the variation in prevalence of smoking and SHS exposure.
  
  
  RESULTS
  In the study population, the prevalence rates of smoking and exposure to SHS were 63.5% and 74.7% for men, and 0.6% and 71.2% for women, respectively. Men were more likely to use tobacco than women: OR 8.27, 95% CI (4.83 to 10.97). Age was inversely associated with the probability of tobacco use (OR 0.98, 95% CI 0.97 to 0.99), and exposure to SHS (OR 0.97, 95% CI 0.96 to 0.99). Individual educational level was inversely associated with smoking, but showed no association with exposure to SHS. Adults who did not grow tobacco were less likely to consume tobacco (OR 0.75, 95% CI 0.57 to 0.99) and to be exposed to SHS (OR 0.76, 95% CI 0.58 to 0.99). Living in a high-income community was associated with a low rate of current smoking (OR 0.66, 95% CI 0.57 to 0.77) and SHS exposure (OR 0.58, 95% CI 0.52 to 0.65).
  
  
  CONCLUSIONS
  Future interventions to reduce smoking and exposure to SHS in China should focus more on tobacco farmers, less-educated individuals and on poor rural communities.
authors.affiliation: School of Public Health, Kunming Medical University, Kunming, China. caile002@hotmail.com
authors.forename: Le
authors.initials: L
authors.lastname: Cai
authors.forename: Xinan
authors.initials: X
authors.lastname: Wu
authors.forename: Abhinav
authors.initials: A
authors.lastname: Goyal
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Han
authors.forename: Wenlong
authors.initials: W
authors.lastname: Cui
authors.forename: Jianhui
authors.initials: J
authors.lastname: He
authors.forename: Xia
authors.initials: X
authors.lastname: Xiao
authors.forename: Keying
authors.initials: K
authors.lastname: Zhao
authors.forename: Feng
authors.initials: F
authors.lastname: Jiao
authors.forename: Ying
authors.initials: Y
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000383:Agriculture / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D055815:Young Adult; D014026:Nicotiana
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Low/Middle income country; Secondhand smoke; Socioeconomic status