# Ethnic differences in prevalence and behaviors of smoking and their association with chronic obstructive pulmonary disease among the elderly in rural southwest China: A cross-sectional study

## TL;DR

This study finds that smoking and COPD rates vary by ethnicity among elderly people in rural southwest China, with Bai and Ha Ni minorities showing notable differences.

## Contribution

The study reveals ethnic disparities in smoking behaviors and COPD risk in rural southwest China's elderly population.

## Key findings

- Current smoking and COPD prevalence were significantly higher in males than females.
- Bai ethnic minority had the highest smoking and COPD rates, while Ha Ni had the lowest smoking cessation and highest public smoking.
- Current smoking was strongly associated with COPD, especially among the Bai ethnic group.

## Abstract

This study examines how prevalence and behaviors of smoking differ by ethnicity and their associations with chronic obstructive pulmonary disease (COPD) among elderly people of four ethnicities in rural southwest China.

A cross-sectional survey of 5642 adults aged ≥60 years was conducted in rural southwest China. Data on the demographics, smoking habits, and post-bronchodilator spirometry were collected.

Among the participants, the prevalence of current smoking (48.8% vs 0.8%) and COPD (12.7% vs 4.5%) was significantly higher in males compared to females (p<0.01). Filtered cigarettes were the most popular form of tobacco used, comprising 76.6% of tobacco consumed. Bai ethnic minority participants had the highest prevalence of current smoking and COPD, and the highest number of cigarettes smoked per day compared to the other three studied ethnicities (p<0.01). Ha Ni ethnic minority participants had the lowest rate of smoking cessation (8.7%) and the highest rate of smoking in public places (66.8%) (p<0.01). The results of multivariable logistic regression indicated that current smokers were more likely to suffer from COPD across all four studied ethnicities (p<0.05). Further, the association of current smoking with COPD in Bai ethnicity elderly participants was stronger compared to other ethnic groups (p<0.01).

The present study shows that ethnicity plays a significant role in influencing both the prevalence and behaviors related to smoking among elderly people in rural southwest China. Future efforts to prevent and reduce tobacco use in rural China should consider ethnicity, as culturally tailored tobacco control strategies could help prevent and manage the COPD epidemic.