Prevalence and Multiple-Level Determinants of Smoking Among Women in the Workforce in China

Introduction: To describe the prevalence of smoking among Chinese women in the workforce and to investigate its potential associated factors from a multilevel perspective. Aims and Methods: The study was based on data collected from the “Asia Best Workplace” program in 2021. We obtained a sample of 6260 women in the workforce and collected the data using a self-administered questionnaire, including occupational characteristics, utilization of workplace health services, and mental health status. We employed univariate and multivariate logistic regression analyses to examine the associations between interested variables and the smoking status of women in the workforce. Results: The prevalence of smoking among Chinese women in the workforce was 3.4%. After controlling for potential confounders, factors that were associated with smoking included field sales personnel (adjusted odds ratio, AOR = 3.45, 95% confidence interval, CI: 2.29–5.18, reference: white collar), mixed shift workers (AOR = 2.42, 95% CI: 1.66–3.53), working overtime every day (AOR = 2.27, 95% CI: 1.38–3.74, reference: no overtime work), having depressive (AOR = 1.10, 95% CI: 1.07–1.13) or anxiety symptoms (AOR = 1.25, 95% CI: 1.13–1.39), and daily exposure to secondhand smoke (AOR = 12.54, 95% CI: 8.70–18.05). Women with access to infirmaries (AOR = 0.38, 95% CI: 0.18–0.81) and fitness facilities (AOR = 0.60, 95% CI: 0.38–0.96) were less likely to smoke. Conclusions: The prevalence of smoking among Chinese women in the workforce was low. Smoking cessation programs for women in the workforce may benefit from taking into account the nature of their work, whether there were night shifts and overtime working. Implications: Smoking takes a huge toll on women, and women in the workforce face additional health challenges. Little is known about the specific factors associated with smoking among women in the workforce. Women who were field sales personnel, managers, working night or irregular shifts, and frequent overtime workers should be considered vulnerable subpopulations for smoking. Providing accessible workplace health services and resources is associated with a lower likelihood of smoking. Smoking cessation programs may consider the specific occupational and workplace factors that influence smoking behavior in this population, as well as address mental health needs.