There is growing attention to social mobility’s impact on tobacco use, but few studies have differentiated the two conceptually distinct mechanisms through which changes in social class can affect tobacco smoking: the class status effect and the mobility effect.
We applied Diagonal Reference Modeling to smoking and heavy smoking among respondents of the 1991 China Health and Nutrition Survey who were revisited two decades later in 2011 (n=3841, 49% male, baseline mean age was 38). We divided the sample into six social classes (non-employment, self-employed, owners, workers, farmers, retirees) and measured social mobility by changes in income and occupational prestige.
61.7% of men were smokers and those from the classes of workers, owners, and self-employees consumed more cigarettes compared to the unemployed, but women smokers (3.7%) tend to be from the lower classes (unemployed and farmers). Controlling for social class, each 1000 Yuan increase in annual income led to smoking .03 more cigarette (p<.05) and one percent increase (p<.05) in the likelihood of heavy smoking among men, but the income effect is null for women. Upwardly mobile men (a 10-points surge in occupational prestige) smoked like their destination class (weight=78%), whereas men with downward mobility were more similar to peers in the original class (weight=60%).
Contrary to the social gradient in smoking in other Industrial countries, higher class status and upward mobility is each associated with more smoking among Chinese men, but not among women.