Loneliness is associated with smoking and alcohol consumption in older adults: Findings from the Chinese Longitudinal Healthy Longevity Survey

Introduction Despite the well-known health risks associated with tobacco smoking and alcohol consumption, this study explores the association between loneliness and these behaviors specifically among the elderly in the Chinese context. It examines the relationship between loneliness and the tendency to smoke and drink among this demographic. Additionally, the research investigates how these associations vary between genders among the elderly, identifying distinct patterns in the relationship between loneliness and smoking and alcohol consumption among elderly men and women. Method This secondary cross-sectional analysis used data from the 2017–2018 Chinese Longitudinal Healthy Longevity Survey. We employed multivariate multinomial logistic regression to analyze these relationships, including sex-specific associations, and reported adjusted odds ratios (AOR), confidence intervals (CI), and p-values. The analysis was conducted using STATA version 18, with significant p-values set at 0.05. Result Our analysis included 15,874 participants, of which 6.4% (95% CI: 6.0 – 6.8; N=1015) were categorized as Always Lonely, indicating frequent loneliness, and 17.0% (95% CI: 16.4 – 17.6; N=2702) as Sometimes Lonely, indicating occasional loneliness, with 76.6% (95% CI: 75.9 – 77.2; N=12,157) not experiencing loneliness. The mean age was 85.5 years with a standard deviation of 11.7. Gender distribution showed that 43.6% (n=6925) were male and 56.4% (n=8949) were female. Frequently lonely participants had increased odds of current smoking (AOR = 1.26; 95% CI: 1.01–1.57; p = 0.040), while those occasionally lonely were less inclined towards current drinking (AOR = 0.81; 95% CI: 0.70–0.94; p = 0.005). Gender-specific outcomes indicated that often lonely men were more likely to smoke (AOR = 1.43; 95% CI: 1.10–1.87; p = 0.008) and were also less likely to be current drinkers (AOR = 0.74; 95% CI: 0.55–0.98; p = 0.038). No significant associations were found for women in smoking or drinking behaviors relative to loneliness levels. Conclusion Our study identified a significant relationship between loneliness and a higher likelihood of smoking in elderly Chinese men, not women, and observed gender-specific differences in alcohol use, with men showing a lower likelihood of drinking when occasionally lonely, a pattern absent in women. Future prospective studies are required to confirm these findings.