China Twenty Years After: Substance Use Under Rapid Social Changes

Xiaozhao Y Yang, Purdue University


This dissertation discusses how China’s rapid modernization and social transformation over the last twenty years since a series of reforms at the end of 1980s contribute to the changes in substance use behaviors. Specifically, there are three individual empirical chapters in this dissertation, each exploring one dimension of social change and its association with substance use. First, I have demonstrated how substance use can be a protective factor against unemployment over the long term, especially against the background of massive layoffs among former socialist industrial workers and landless peasants during this period. Second, another chapter examines how social mobility (i.e. changes in a person’s social position in society) contributes to substance use. And finally, I have tested the impact of economic and social modernization on substance use, and considered the social disorganization aspects of community change. Using survival analysis, I have found that general drinking protected against unemployment risk for both men and women, while smoking, even heavy smoking, only protected men but penalized women. However, on the other hand, heavy drinking was not a significant factor against unemployment hazards. Possible explanations have been drawn from social capital theory and the social nature of substances. In order to disentangle the class assimilation effect and mobility effect from the overall differential distribution of substance use among classes, diagonal reference modeling has been employed in the second chapter to show that, overall, higher classes smoked and drank more than lower classes in China. While people, especially those who moved upward in the class ladder, tend to assimilate into their destination class’ drinking pattern, there was no assimilation effect for smoking among the upwardly mobile people. Instead, the independent mobility effect contributes to a higher level of smoking, suggesting that adaptive responses emerged during socially mobile events. I conclude that drinking has more socially vested interests for socially mobile people than smoking. Through multilevel modeling with a feature of growth curve analysis, this dissertation also assesses the influence of community-level social changes and modernization on substance use. I have found that there are certain “good” and “bad” dimensions of modernization, even though all dimensions have been growing together in the past twenty years. Economic modernization amplifies the income effect on substance use, making people with higher incomes smoke even more. Meanwhile, social modernization can mitigate the harmful effect of income on both drinking and smoking. With regard to inequality, its negative interaction with individual income also confirms our hypothesis that poor people tend to use substances more than the rich do in an unequal community. Furthermore, the modernization process has also elevated women’s risk of using substances.




Kelly, Purdue University.

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