Participation in mahjong and the associated smoking and alcohol consumption behaviors among Chinese older adults.

This study examined the relationship of playing mahjong with smoking and alcohol consumption behaviors among Chinese older adults. We used a large and nationally representative dataset, the 8th wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Older adults who were 65 years old or above were included in the final analysis sample ( n  = 10,954). Multivariable logistic regressions were used to examine the associations of playing mahjong with current and former smoking/alcohol consumption status. Additionally, we used negative binomial and multiple linear regressions to investigate the number of cigarettes smoked per day and the amount of alcohol consumed per day. Compared with older adults who did not play mahjong, those who played mahjong at least once per month were more likely to report both current and prior smoking/alcohol consumption habits (all p  < 0.05). The sub-analysis revealed that older adults who played mahjong at least once per week tended to smoke more cigarettes per day (all p  < 0.05) than those who did not play mahjong at all. When public health practitioners advocate for the health benefits of playing mahjong, they should also consider its associations with smoking/alcohol consumption behaviors among Chinese older adults.