Association between tobacco and alcohol consumption behavioral variation and healthcare expenses among Chinese older adults

Previous studies have identified associations between tobacco/alcohol consumption behaviors and healthcare expenses globally. Knowledge related to Chinese older adults, however, remains limited. This study examined the associations of tobacco and alcohol consumption behavioral variation with both outpatient and inpatient healthcare expenses among Chinese older adults. Drawing upon three waves of the Chinese Longitudinal Healthy Longevity Survey (2011-2012, 2014, and 2018), propensity score matching and ordered logistic regression served as the primary statistical analyses. Current smokers had lower odds of inpatient healthcare expenses than did non-current smokers (adjusted odds ratio [AOR] = 0.88, 95% CI: 0.78, 0.99; p < 0.05). Former smokers had higher odds of reporting both outpatient and inpatient healthcare expenses, compared with non-former smokers (all p < 0.05). Current alcohol users were less likely to report having both outpatient and inpatient healthcare expenses than non-former alcohol users (all p < 0.01). Former alcohol consumers had higher odds of reporting outpatient healthcare expenses than non-former alcohol consumers (AOR = 1.22, 95% CI: 1.09, 1.37; p < 0.01). Counterintuitive evidence should be carefully interpreted regarding implications for policymaking. Public health interventions should focus on the mechanisms underlying these associations between smoking/alcohol consumption behaviors and healthcare expenses among Chinese older adults.