The Influence of Alcohol Consumption on Tobacco Use among Urban Older Adults: Evidence from Western China in 2017

Background: Tobacco use is a global public health concern due to its association with a myriad of health hazards and costs. Previous studies have found that the disinhibiting influence of alcohol consumption may lead to an increase in tobacco use. In this study, we investigated why alcohol consumption is associated with tobacco use among older adults in Western China, and we attempted to explain the mechanisms that underlie the link between alcohol consumption and tobacco use. Methods: In this cross-sectional study, we employed a representative sample of 812 urban individuals aged 60 and older in 2017 in Western China. Results: We found that alcohol consumption (OR = 2.816, 95%CI: 1.770-4.479) was positively associated with tobacco use. Additionally, other factors, including gender (OR = 0.023, 95%CI: 0.009-0.060), age (OR = 0.758, 95%CI: 0.634-0.906), health literacy (OR = 0.977, 95%CI: 0.959-0.995) and functional impairment (OR = 0.871, 95%CI: 0.767-0.988) were also strongly related to tobacco use. Conclusions: Consistent with the results of existing studies, our findings demonstrated the disinhibiting influence of alcohol consumption on tobacco use, which confirmed the theoretical mechanisms that underlie the alcohol-tobacco link and implied the co-occurrence and co-use of alcohol and tobacco, which are used as "social lubricants" in the Chinese context. The importance of other factors related to tobacco use were also discussed. As the tobacco epidemic is combatted, joint interventions tailored to concurrent control over alcohol and tobacco need to be performed, and corresponding male-specific and age-specific health education and the reinforcement of health literacy must be considered as important priorities.