Changes in smoking prevalence after the enforcement of smoking control regulations in urban Shanghai, China: Findings from two cross-sectional surveys

INTRODUCTION: The Smoking Control Regulation in Public Places (hereafter, the 'regulations') has been implemented in Shanghai since 2010. This study explores the changes in smoking prevalence and its influencing factors among urban Shanghai residents. METHODS: Two rounds of household investigations (the Health Status and Health Service Utilization Survey) were carried out using a multistage probability proportionate-to-size sampling method in an urbanized district in 2010 and 2015. Descriptive and logistic regression analyses were applied to the statistics. RESULTS: From 2010 to 2015, the standardized current smoking rate fell from 24.8% to 19.1% (38.3% to 32.0% among men, and 1.9% to 1.4% among women). Meanwhile, the standardized smoking cessation rate increased from 18.1% to 23.3%. Smoking prevalence in respondents aged 45 to 59 years was still higher than that of other age groups. Changes in smoking prevalence and cessation rates were more obvious in respondents aged 30-44 and over 75 years. Sex, age, education, marital status, and alcohol use were influencing factors of current smoking, while sex, age and alcohol use were influencing factors of smoking cessation. CONCLUSIONS: The implementation of smoking control regulations may be beneficial for reducing smoking and increasing smoking cessation, especially among middle-aged and older men. Nevertheless, tobacco control in urban Shanghai still faces huge challenges. Therefore, more targeted and comprehensive measures should be taken.