The Effects of Cigarette Smoking, Alcohol Consumption, and Use of Both Cigarettes and Alcohol on Chinese Older Adults’ Sleep: Results from a Longitudinal Study


We examined the effects of cigarette smoking, alcohol consumption, and use of both cigarettes and alcohol on changes in sleep quality and duration among Chinese older adults. Using four waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we employed Cox two-state regression models to examine the changes in sleep quality and duration. The results showed the following: (1) Former users (cigarettes and/or alcohol), current alcohol users, current smokers, or users who used both cigarettes and alcohol all reported lower odds of worsening sleep quality (all p < 0.01; except former users, which was p < 0.05), compared with those who did not smoke and use alcohol at all. (2) Among older adults who maintained poorer sleep quality (from not good to not good), only users of both cigarettes and alcohol were less likely to experience this outcome (p < 0.05). (3) Only former users and current smokers had higher odds of transitioning from recommended sleep duration of 7–8 h daily into the non-recommended range (all p < 0.05), compared with older adults who did not use cigarettes and alcohol. Chinese older adults may be more adaptive to the cultural norms and traditions of cigarette and alcohol uses. Further research efforts with experimental data are warranted to examine the impact of cigarettes and alcohol on Chinese older adults’ sleep.


Public Health and Sports Medicine

Document Type





Alcohol consumption, China, Cigarette smoking, Older adults, Sleep

Publication Date


Journal Title

International Journal of Mental Health and Addiction