Twenty-Year Trends and Urban-Rural Disparities in Smoking, Alcohol Consumption, and Dual Consumption Among Chinese Older Adults

China is a country with large urban-rural disparities. These disparities have been related to public health issues, including smoking/alcohol consumption among older adults. In this research, we used a large and representative dataset, the Chinese Longitudinal Healthy Longevity Survey (CLHLS), to examine the trends overall and urban-rural disparity of current and former smoking, alcohol consumption, or dual consumption from 1998 to 2018 (main analysis of current status n = 49,220; sub-analysis of former status: n = 34,608). Multinomial regressions were used as the main statistical analysis. Our results showed that urban residents had lower adjusted odds ratio (AOR) of reporting current smoking (AOR = 0.84, 95% CI: 0.78, 0.89), alcohol consumption (AOR = 0.80, 95% CI: 0.75, 0.85), and dual consumption (AOR = 0.65, 95% CI: 0.60, 0.70). Urban participants also were more likely to report former smoking and dual consumption status (all p < 0.05). No statistically significant urban-rural difference was observed in former alcohol consumption. In sum, despite the efforts from the Chinese central government to reduce the urban-rural disparities, the urban-rural disparities continue to persist in terms of smoking and alcohol consumption behaviors. Further public health interventions are required to help reduce current smoking and alcohol consumption behaviors among Chinese older adults, especially in rural areas.