Yang, X. Y., Kelly, B. C., Pawson, M., & Vuolo, M. (2022). Vaping in a Time of Pandemics: Risk Perception and Motivations for Electronic Cigarette Use. Nicotine & Tobacco Research. doi:10.1093/ntr/ntac050
Prior studies on the association between the intensity of and motives for vaping e-cigarettes have highlighted the psychological dynamics of motivational changes, but less about how vaping motives may shift as a function of risk perceptions exacerbated by unanticipated events. This study frames the COVID-19 pandemic as an exacerbating threat to pulmonary health, and tests how e-cigarette users’ risk perceptions of COVID-19 are related to different motives for vaping and ultimately the intensity of e-cigarette use.an online survey of e-cigarette users in the U.S. (n=562) was conducted during April 2020 when much of the U.S. was under “lockdown” conditions. We distinguished three types of vaping motives (health, socialization, and dependence) and established the classification with confirmatory factor analysis. Structural equation modeling was conducted for path analyses and mediation tests.all three vaping motives were significantly associated with greater use intensity. A heightened risk perception of e-cigarette users’ vulnerability to COVID-19 was inversely associated with use intensity (-.18, p<.01) and health motives for vaping (-.27, p<.001), but not associated with socialization and dependence motivations. Health motives for vaping mediated 35% of the association between COVID-19 risk perceptions and use intensity. Our findings indicate that risk perceptions of exacerbated threats may reduce e-cigarette use directly, and also indirectly through shifting certain types of motivations for vaping. Beyond elucidating the relational dynamics between vaping psychology and health risks, these results also indicate health professionals may leverage the pandemic to promote nicotine cessation or reduced use.
Xiaozhao Yousef Yang (2020) Class Status and Social Mobility on Tobacco Smoking in Post-Reform China Between 1991 and 2011, Nicotine & Tobacco Research, https://doi.org/10.1093/ntr/ntaa103
Introduction
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.
Aims and Methods
I 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 years). I divided the sample into six social classes (non-employment, self-employed, owners, workers, farmers, and retirees) and measured social mobility by changes in income and occupational prestige.
Results
About 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 0.03 more cigarettes (p < .05) and 1% 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%).
Conclusions
Contrary to the social gradient in smoking in other industrial countries, higher class status and upward mobility are each associated with more smoking among Chinese men, but not among women.
Implications
Tobacco control policies should prioritize male smoking at workplaces and the instrumental purposes of using tobacco as gifts and social lubricant. Taxation may counter the surge in smoking brought by individuals’ income increase after upward mobility. Caution should be paid to women joining the similar social gradient in smoking as they gain foothold in the labor market.
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.
Aims and Methods
I 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 years). I divided the sample into six social classes (non-employment, self-employed, owners, workers, farmers, and retirees) and measured social mobility by changes in income and occupational prestige.
Results
About 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 0.03 more cigarettes (p < .05) and 1% 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%).
Conclusions
Contrary to the social gradient in smoking in other industrial countries, higher class status and upward mobility are each associated with more smoking among Chinese men, but not among women.
Implications
Tobacco control policies should prioritize male smoking at workplaces and the instrumental purposes of using tobacco as gifts and social lubricant. Taxation may counter the surge in smoking brought by individuals’ income increase after upward mobility. Caution should be paid to women joining the similar social gradient in smoking as they gain foothold in the labor market.
| class_status_and_social_mobility_on_tobacco_smoking_in_post.pdf |
Nie, F., & Yang, X. Y. (2019). Smoking in the temple of the holy spirit? Geographic location matters. Health & Place, 58, 102139.
Smoking at a young age poses significant risks to one's health and is linked with a wide range of deviant conducts. While prior research has looked into the ways in which individual religious characteristics may influence smoking, much less is known about how the overall religious context in which individuals are embedded may affect smoking during adolescence and early adulthood. In this study, multilevel regression analyses were used on nationally representative panel data to explore this understudied area. The results suggest that when a county has higher population share of conservative Protestants, youth living there are more likely to smoke. A similar robust relationship is also found for county-level mainline Protestant population share and smoking. By simultaneously examining both the individual and contextual religious effects on smoking, this study contributes to a renewed, more comprehensive understanding of an important public health and youth deviance issue.
Yang, X. Y., & Hendley, A. (2018). The gendered effects of substance use on employment stability in transitional China. Health Sociology Review, 1-18. doi:10.1080/14461242.2018.1495572
Substance use is often thought to harm employment prospects, an assumption challenged by the anomaly that people who use licit substances such as alcohol and tobacco are sometimes at a lower risk of unemployment. We argue that employment stability may benefit from the socialisation afforded through using licit substances, particularly in a context where licit substance use is encouraged. Furthermore, because the norms associated with substance use often reflect the gender hierarchy in a society, the impact of substance use on employment stability may be contingent on an individual's gender. Applying Cox proportional hazard modelling to a panel dataset during the critical two decades of China's market-based transition (1991?2011), we found that the impact of substance use on unemployment hazards varies depending on the dosage of the use and the gender of the users. Compared to abstinence, moderate alcohol-drinking reduces the risk of unemployment, and the reduction benefits especially men. The standalone effect of tobacco-smoking is to elevate unemployment hazards; however, this effect is heavily moderated by gender so that female smokers were penalised while male smokers were rewarded in the labour market. Such patterns cannot be explained by community-level modernisation progress and individual-level covariates.
| the_gendered_effects_of_substance_use_on_employment.pdf |
Nie, F., Yang, X. Y., & Olson, D. V. (2018). Religious Context Matters: Exploring the Relationship Between Religious Context and Underage Alcohol Consumption. Review of Religious Research. https://doi.org/10.1007/s13644-017-0320-7
Previous research has demonstrated that individual religious beliefs and practices may reduce the likelihood of underage alcohol consumption, but less is known about how the overall religious cultural influence of a religion may influence individual alcohol consumption behaviors. Using multilevel analyses on two waves of the National Study of Youth and Religion merged with county-level variables from the U.S. Census and the Religious Congregations and Membership Study, we find that a county’s higher Catholic population share leads to more frequent underage drunkenness even after controlling for a wide range of individual and county-level variables. Contrary to other studies’ findings discovered at individual level, a greater population share of conservative Protestants is also linked with higher level of underage drunkenness. This study highlights the importance of viewing religious influence on health behaviors as a contextual, cultural force.
religious_context_matters.pdf
religious_context_matters.pdf
Yang, X. Y., & Yang, T. (2017). Nonmedical Prescription Drug Use Among Adults in Their Late Twenties: The Importance of Social Bonding Trajectories. Journal of Drug Issues, 47(4), 665-678.
Although weak social bonds are found to be associated with addictive behaviors in cross-sectional studies, few studies have explored the longitudinal impacts of social bonds on nonmedical prescription drug use (NPDU). This study adopted a developmental perspective on social bonds and tested how their different trajectories are associated with NPDU among adults. With panel surveys from the National Longitudinal Study of Adolescent to Adult Health from 1994 to 2008, this study employed group-based latent trajectory modeling to obtain the different trajectories of social bonds including religious, civic, familial, educational, and marital, and then used them as predictors of NPDU while controlling for potential confounders and the baseline NPDU. The findings show that constant and high-level social bonds significantly reduce the risk of NPDU, except for educational bond. However, for religious, civic, and educational bonds, the “low initial” trajectories are not significantly different from the “high-decrease” trajectories, implying that strong early-life social bonds do not prevent NPDU if such bonds register a recent decline. Weak social bonds constitute significant risk of NPDU for adults in their late twenties, and recent social bonds override the contribution of early-life bonds in most cases. Policy makers may consider strategies to sustain the active and meaningful participation in conventional institutions, and not solely rely on programs that facilitate early-life social integration.
| nonmedical_prescription_drug.pdf |
Yang, X. Y. (2017). Marijuana Use at Early Midlife and the Trajectories of Social Bonds. Journal of Developmental and Life-Course Criminology, 3(3), 284-303.
Purpose: Marijuana is popular among younger people, but who smoke it into their early midlife? Do these smokers have a different trajectory of social bonds? Current studies on social control and substance use measure social bonds either retrospectively or concurrently with marijuana use, but I argue that marijuana use is determined not only by social bonds at specific time points, but by a lifelong trajectory of them.
Methods: With panel data from the National Longitudinal Study of Adolescent to Adult Health, I constructed the trajectories of different social bonds, then conducted zero-inflated negative binomial regressions to predict marijuana use in early midlife by these trajectories. Baseline marijuana use as well as individual and family backgrounds were controlled for.
Results: People with constant and high-level attachment to religious, educational, marital, familial, and civic institutions smoke less marijuana and are more likely to quit smoking at early midlife. Furthermore, except for religious bond, people with weaker initial bonds are more likely to smoke than those with stronger initial bonds, even if their proximal bonds are at the same level. This reinforces the argument that early-life social bonds have a lasting and cascading effect.
Conclusion: As a popular substance among the youth, marijuana use at early midlife is a continuing legacy of the trajectories, rather than the cumulative or concurrent impact, of social bonds. Given the significance of early bonds, policy makers should consider building integrative educational, familial, and social services for adolescents.
Methods: With panel data from the National Longitudinal Study of Adolescent to Adult Health, I constructed the trajectories of different social bonds, then conducted zero-inflated negative binomial regressions to predict marijuana use in early midlife by these trajectories. Baseline marijuana use as well as individual and family backgrounds were controlled for.
Results: People with constant and high-level attachment to religious, educational, marital, familial, and civic institutions smoke less marijuana and are more likely to quit smoking at early midlife. Furthermore, except for religious bond, people with weaker initial bonds are more likely to smoke than those with stronger initial bonds, even if their proximal bonds are at the same level. This reinforces the argument that early-life social bonds have a lasting and cascading effect.
Conclusion: As a popular substance among the youth, marijuana use at early midlife is a continuing legacy of the trajectories, rather than the cumulative or concurrent impact, of social bonds. Given the significance of early bonds, policy makers should consider building integrative educational, familial, and social services for adolescents.
| marijuana_use_at_early_midlife.pdf |
X.Y. Yang, F Yang (2018): Acculturation versus cultural retention: the interactive impact of acculturation and co-ethnic ties on substance use among Chinese students in the U.S. Journal of Immigrant and Minority Health 20(3), 546-560
Acculturation is often found to increase substance use among immigrants in the U.S., but such effect may depend on how immigrants are attached to their co-ethnic community. Meanwhile, the high socioeconomic status of some new immigrant groups also challenges the classical assumption that ties to co-ethnic community are associated with deviance. With a sample (n = 960) collected from a population of Chinese students in a large public university in the U.S., we tested how do the interplays between acculturation and co-ethnic ties affect substance use. This study establishes that: (1) different dimensions of acculturation have opposite effects on substance use; (2) acculturative stress does not explain the association between acculturation and substance use; (3) acculturation increases the likelihood of substance use only when one has weak attachment to their co-ethnic community. The findings are consistent for three dependent variables: smoking, drinking, and drunkenness, and for the different constructs of acculturation and co-ethnic ties. Ties to co-ethnic community may provide important social support for immigrants, while acculturation may alleviate the insular subculture that promotes at-risk behaviors. We encourage policy makers to consider the cooperative nature of acculturation and cultural retention for the improvement of health among this growing population.
| acculturation_versus_cultural_retention.pdf |
X. Y. Yang (2017). How community-level social and economic developments have changed the patterns of substance use in a transition economy? Health & Place, 46, 91-100.
Most social changes take place at the community level before indirectly affecting individuals. Although the contextual effect is far-reaching, few studies have investigated the important questions of: how do community-level developments affect drinking and smoking, and how do they change the existing gender and income patterns of drinking and smoking, particularly in transition economies? In this study, I used a Chinese panel dataset between 1991 and 2011 to reveal the moderating effects of community developments. Through multilevel growth curve modeling that controls for age, period, and cohort effects, as well as individual- and community-level covariates, I found that community-level economic development and social development are negatively associated with drinking and smoking. Moreover, economic and social developments also moderate the important influences of income and gender: women start to drink more in communities with higher economic development; the traditionally positive association between income and smoking/drinking is also reversed, i.e. the rich start to smoke and drink less in communities with higher social development. This study concludes that the rapid changes in communal social and economic structures have created new health disparities based on the gender and socioeconomic hierarchy.
| how_community-leve.pdf |
Yang, X. Y., Kelly, B. C., & Yang, T. (2014). The influence of self-exempting beliefs and social networks on daily smoking: A mediation relationship explored. Psychology of Addictive Behaviors, 28(3), 921-927.
The decision to initiate, maintain, or quit cigarette smoking is structured by both social networks and health beliefs. Self-exempting beliefs affect people’s decisions in favor of a behavior even when they recognize the harm associated with it. This study incorporated the literatures on social networks and self-exempting beliefs to study the problem of daily smoking by exploring their mediatory relationships and the mechanisms of how smoking behavior is developed and maintained. Specifically, this article hypothesizes that social networks affect daily smoking directly as well as indirectly by facilitating the formation of self-exempting beliefs. The sample comes from urban male residents in Hangzhou, China randomly selected and interviewed through multistage sampling in 2011. Using binary mediation analysis with logistic regression to test the hypotheses, the authors found that (a) daily smoking is associated with having smokers in several social network arenas and (b) self-exempting beliefs about smoking mediate the association between coworker network and daily smoking, but not for family network and friend network. The role of social network at work place in the creation and maintenance of self-exempting beliefs should be considered by policymakers, prevention experts, and interventionists.
| the_influence_of_self-exempting_beliefs.pdf |
Kelly, B. C., Liu, T., Yang, X. Y., Zhang, G., Hao, W., & Wang, J. (2014). Perceived risk of methamphetamine among Chinese methamphetamine users. International Journal of Drug Policy, 25(6), 1076-1083.
Methamphetamine use has grown considerably in China in recent years. Information about perceptions of risk on methamphetamine is important to facilitate health promotion efforts. Using both survey data and qualitative interview data, the authors evaluate the perceived risk of methamphetamine use among Chinese users using a mixed-methods approach. Through Respondent Driven Sampling, the authors recruited a sample of 303 methamphetamine users in Changsha, China. A majority (59.1%) perceive that infrequent methamphetamine use poses no risk to the user, while 11.2% perceive at least moderate risk for light use. A majority (56.7%) perceived at least moderate risk associated with regular methamphetamine use. Most (82.2%) also perceive methamphetamine to be easily obtainable. A path model indicates that perceived risk shapes intentions to use and expectations of future use, as does perceived availability. Qualitatively, while addiction was the most common risk discussed by users, they differed on whether they perceived the drug addictive. Other concerns raised by interviewees included impaired cognition, mental health problems, physical harm, and social dysfunction. While some users identify significant risks with methamphetamine, others do not perceive its use to be problematic. Collectively, these findings indicate that intervening upon perceptions of risk among Chinese methamphetamine users may be a means to influence intentions to use.
| perceived_risk_of_methamphetamine.pdf |
Yang, T., Li, F., Yang, X., Wu, Z., Feng, X., Wang, Y., et al. (2008). Smoking patterns and sociodemographic factors associated with tobacco use among Chinese rural male residents: a descriptive analysis. BMC Public Health, 8(1), 248-255.
Background: Although evidence has shown high prevalence rates of tobacco use in the general urban populations in China, relatively little is known in its rural population. The purposes of this study were to examine smoking patterns and sociodemographic correlates of smoking in a sample of rural Chinese male residents.
Methods: The study employed a cross-sectional, multi-stage sampling design. Residents (N = 4,414; aged 15 years and older) were recruited from four geographic regions in China. Information on participants' tobacco use (of all forms), including their daily use, and sociodemographic characteristics were collected via survey questionnaires and the resultant data were analyzed using chi-square tests and logistic regression procedures.
Results: The overall smoking prevalence in the study sample was 66.8% (n = 2,950). Of these, the average use of tobacco products per day was 12.70 (SD = 7.99) and over 60% reported daily smoking of more than 10 cigarettes. Geographic regions of the study areas, age of the participants, marital status, ethnicity, education, occupation, and average personal annual income were found to be significantly associated with an increased likelihood of smoking among rural Chinese male residents.
Conclusion: There is a high smoking prevalence in the Chinese rural population and smoking behaviors are associated with important sociodemographic factors. Findings suggest the need for tobacco control and intervention policies aimed at reducing tobacco use in Chinese rural smoking populations.
Methods: The study employed a cross-sectional, multi-stage sampling design. Residents (N = 4,414; aged 15 years and older) were recruited from four geographic regions in China. Information on participants' tobacco use (of all forms), including their daily use, and sociodemographic characteristics were collected via survey questionnaires and the resultant data were analyzed using chi-square tests and logistic regression procedures.
Results: The overall smoking prevalence in the study sample was 66.8% (n = 2,950). Of these, the average use of tobacco products per day was 12.70 (SD = 7.99) and over 60% reported daily smoking of more than 10 cigarettes. Geographic regions of the study areas, age of the participants, marital status, ethnicity, education, occupation, and average personal annual income were found to be significantly associated with an increased likelihood of smoking among rural Chinese male residents.
Conclusion: There is a high smoking prevalence in the Chinese rural population and smoking behaviors are associated with important sociodemographic factors. Findings suggest the need for tobacco control and intervention policies aimed at reducing tobacco use in Chinese rural smoking populations.
| smoking_patterns.pdf |
