Off-farm work, cigarette and alcohol expenditure, and body weight outcomes: Insights from Rural China

Abstract

Although the effects of off-farm work have been widely studied, its influence on cigarette and alcohol (CA) consumption in rural areas remains underexplored. Likewise, while the health impacts of CA consumption are well documented, limited evidence exists on how CA expenditures affect body weight outcomes, particularly among rural populations. This thesis addresses these research gaps by pursuing two key objectives: (1) to investigate how rural household heads’ off-farm work participation and intensity influence household expenditure on cigarettes and alcohol, and (2) to examine the subsequent effects of such expenditures on body weight outcomes, including underweight, normal weight, overweight, and obesity. Using data from 1,487 rural households in China, this thesis employs a conditional mixed process (CMP) model to address the endogeneity of off-farm work variables in the first part of the analysis. Off-farm work intensity is measured through time (months) allocated to off-farm employment and off-farm income. In the second part, this thesis applies a two-stage residual inclusion (2SRI) approach—using Tobit and multinomial logit models—to account for the endogeneity of CA expenditures when assessing their effects on body weight outcomes. Findings reveal that off-farm work participation significantly increases total CA expenditure by 52.7 yuan per capita per week, with cigarette expenditure rising by 63.1 yuan, while alcohol expenditure remains unaffected. Off-farm income, rather than time spent working, drives increased alcohol spending. Higher CA, cigarette, and alcohol expenditures are each significantly associated with a lower probability of being underweight or maintaining a normal weight and with an increased likelihood of obesity. These effects are particularly pronounced among male household heads, while no significant relationships are observed for female heads. The thesis highlights an important unintended consequence of promoting off-farm employment in rural settings: increased CA expenditure and the associated risk of obesity, particularly among men. These findings call for integrated rural development policies that align labor market incentives with public health objectives, ensuring that efforts to raise rural incomes do not inadvertently compromise long-term health and social well-being.