Determinants of tobacco smoking among rural-to-urban migrant workers: a cross-sectional survey in Shanghai

BACKGROUND Although there are several studies to investigate the smoking behaviors among rural-to-urban Chinese migrants, no study has focused individually on this population in Shanghai. This study was performed to estimate the prevalence and identify the determinants of tobacco smoking among rural-to-urban migrants in Shanghai. METHODS In this cross-sectional study, multi-stage quota sampling was used to select 5,856 rural-to-urban migrants aged 18 years or older from seven districts in Shanghai between July and October 2012. A structured questionnaire was administered to assess smoking knowledge, attitude, behavior and demographic characteristics. Mental health was assessed by the self-reported SCL-90. Multiple logistic regression analysis was used to determine the risk factors of smoking behavior. RESULTS A total of 5,380 of the 5,856 migrants enrolled completed the questionnaire, among whom 45.0% of male and 2.0% of female participants reported current smoking. Multivariate analysis revealed current smoking in female migrants to be significantly associated with working at construction (OR, 8.08; 95% CI, 1.80-36.28), hotels/restaurants (OR, 5.06; 95% CI, 1.68-15.27), entertainment sector (OR, 6.79; 95% CI, 2.51-18.42), with monthly income > 3500 yuan (OR, 2.69; 95% CI, 1.21-5.98), number of migratory cities of 2 (OR, 2.39; 95% CI, 1.23-4.65), and SCL-90 total score > 160 (OR, 2.03; 95% CI, 1.03-3.98), while the male migrants working at construction (OR, 1.30; 95% CI, 1.04-1.62), entertainment sector (OR, 1.86; 95% CI, 1.36-2.56), being divorced/widowed (OR, 2.20; 95% CI, 1.02-4.74), with duration of migration of 4 or more than 4 years (OR, 1.42; 95% CI, 1.06-1.91), number of migratory cities of 3 or more than 3 (OR, 1.42; 95% CI, 1.13-1.80), and SCL-90 total score > 160 (OR,1.39; 95% CI, 1.07-1.79) showed an excess smoking prevalence. CONCLUSION Migration lifestyle and mental status were associated with current smoking behaviors. The identifications of risk factors for current smoking may help to target health promotion interventions.