Work stress, life stress, and smoking among rural-urban migrant workers in China

Background: Stimulated by rapid modernization and industrialization, there is massive rural-urban migration in China. The migrants are highly susceptible to smoking and mental health problems. This study examined the association between both perceived work stress and perceived life stress with smoking behavior among this group during the period of migration. Methods: Participants (n = 1,595) were identified through stratified, multi-stage, systematic sampling. Smoking status separated non-smokers from daily and occasional smokers, and migration history, work stress, and life stress were also measured. Analyses were conducted using the Chi-square test and multiple logistic regression. Two models were utilized. The first was the full model that comprised sociodemographic and migration-related characteristics, as well as the two stress variables. In addressing potential overlap between life and work stress, the second model eliminated one of the two stress variables as appropriate. Results: Overall smoking prevalence was 64.9% (95% CI: 62.4-67.2%). In the regression analysis, under the full model, migrants with high perceived life stress showed a 45% excess likelihood to be current smokers relative to low-stress counterparts (OR: 1.45; 95% CI: 1.05-2.06). Applying the second model, which excluded the life stress variable, migrants with high perceived work stress had a 75% excess likelihood to be current smokers relative to opposites (OR: 1.75; 95% CI: 1.26-2.45). Conclusions: Rural-urban migrant workers manifested a high prevalence of both life stress and work stress. While both forms of stress showed associations with current smoking, life stress appeared to outweigh the impact of work stress. Our findings could inform the design of tobacco control programs that would target Chinese rural-urban migrant workers as a special population.