ArticleSSM - population health2026
Unraveling the complexity of associations between tobacco culture in Chinese society and smokers' outcome expectancies: a network perspective.
Article in SSM - population health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Chinese unique sociocultural context surrounding tobacco reinforces smoking behaviors, potentially through its influence on smokers' expectancies of smoking-related outcomes. Network analysis effectively explores the intricate relationship between social tobacco cultural attitudes and smoking outcome expectancies among Chinese smokers. Methods: The study included 1382 current smokers. A mixed graphical model was employed to construct internal and combined networks of social tobacco cultural attitudes and smoking outcome expectancies. Additionally, node strength centrality, edge weights, and stability were analyzed. Results: In the network of social tobacco cultural attitudes, sharing cigarettes (jingyan or sanyan) was identified as the central node (Str = 0.855). For smoking outcome expectancies, stimulus/state enhancement exhibits the highest strength centrality (Str = 0.860). In the total integrated network of smoking outcome expectancies and social tobacco cultural attitudes, social facilitation outcome expectancies demonstrated the highest strength centrality between the two variables (Str = 0.894). Conclusions: In this study, social facilitation outcome expectancies were central in the combined network of social tobacco cultural attitudes and smoking outcome expectancies, showing a direct and positive link to multiple tobacco cultural attitudes. This finding illustrates how sociocultural factors are interconnected with individual expectancies of smoking outcomes, identifying the central positioning of social facilitation expectancies variables within the sociocultural attitudes-outcome expectancies network. These insights provide new perspectives for developing culturally adaptive tobacco control interventions, such as reshaping tobacco cultural symbols to promote "smoke-free weddings" and "refusing cigarette gifts."
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