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. 2025 Aug 19;13(1):940.
doi: 10.1186/s40359-025-03278-8.

Association between depressive symptoms and smoking intensity with ethnic minorities in Yunnan Province, China: a moderated mediation model

Xinping Wang  1 , Ying Chen  1 , Xuan Wen  1 , Yan Xiao  2 , Xiaoju Li  1 , Jie Chen  1 , Yuan Huang  3 , Rui Deng  4
Affiliations

Association between depressive symptoms and smoking intensity with ethnic minorities in Yunnan Province, China: a moderated mediation model

Xinping Wang et al. BMC Psychol. .

Abstract

Background: Previous research has indicated that depressive symptoms may contribute to an escalation in smoking intensity; however, our knowledge regarding the underlying mediating and moderating mechanisms of this association among ethnic minorities remains limited. This study aimed to investigate the relationship between depressive symptoms and smoking intensity among ethnic minorities residing in Yunnan Province, China. We examined the mediating role of meaning in life as well as the moderating influence of gender in this relationship.

Methods: Employing a cross-sectional design, data collection was conducted from July to December 2022 in five selected counties. The participants comprised 1723 ethnic minorities (864 males and 859 females)from three regions within Yunnan Province, China, who completed measures encompassing demographic information, smoking behavior information, the Patient Health Questionnaire-9, and the Purpose in Life Test-short form. The PROCESS models 4 and 14 were used to conduct a moderated mediation analysis.

Results: The findings revealed a positive correlation between depressive symptoms and smoking intensity. Additionally, meaning in life was found to partially mediate the link between depressive symptoms and smoking intensity. Moreover, gender moderated the mediating effect of meaning in life with a stronger impact observed among males.

Conclusion: This study enhances our understanding of how depressive symptoms contribute to increased smoking intensity for specific individuals and provides novel insights for interventions targeting tobacco use. It also underscores the significance of considering gender-related factors when developing prevention and intervention programs that address smoking intensity.

Keywords: Depressive symptoms; Ethnic minorities; Gender; Meaning in life; Smoking intensity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the ethics committee of the Kunming Medical University (NO. KMMU2021MEC095). At the beginning of the research, the researchers explained the project to the participants. The information included the aims of the study, potential advantages and disadvantages of participation, the expected benefits of carrying out the research, principles of privacy and confidentiality, and a declaration of voluntary participation. Participants were also informed that they could withdraw from the study at any time. For illiterate participants, informed assent was obtained from their legally authorized representatives or guardians. The study was conducted in accordance with the Declaration of Helsinki, and all participants signed informed consent forms. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Proposed moderated mediation model
Fig. 2
Fig. 2
Model of the mediating effect of meaning in life on the relationship between depressive symptoms and smoking intensity
Fig. 3
Fig. 3
Gender as a moderator of the relationship between meaning in life and smoking intensity
See this image and copyright information in PMC

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