The Impact of Urban Regeneration, Air Pollution, Green Space, and Paved Roads on Problematic Alcohol Use: A Population-Based Study Across 43 Cities in China.

BACKGROUND

Evidence on the association between urban regeneration and alcohol use remains limited. This study examines the impact of urban environmental factors, specifically air pollution (measured by PM2.5, a common indicator of fine particulate matter), traffic congestion, and limited green space, on problematic alcohol use, and explores potential social and behavioral mechanisms underlying these relationships.

METHODS

A cross-sectional survey was conducted among 11,954 students from 50 universities across 43 Chinese cities. Individual-level data were collected via self-report questionnaires, while regional environmental data were obtained from the National Bureau of Statistics. Structural equation modeling (SEM) was applied to analyze the mediating pathways.

RESULTS

The prevalence of problematic alcohol use was 7.3%. Multilevel logistic regression showed that higher PM2.5 levels were positively associated with alcohol use (ORs = 2.98, 3.48), while more green space (ORs = 0.55, 0.23) and a higher proportion of paved roads (OR = 0.37) were protective factors. SEM results indicated that PM2.5 exerted both a direct effect on alcohol use (β = 0.358, p < 0.01) and an indirect effect mediated by uncertainty stress (indirect β = 0.011). Paved road area had a direct effect (β = -0.009, p < 0.01) and indirect effects through uncertainty stress (indirect β = -0.007) and life stress (indirect β = -0.001). Green space directly reduced alcohol use (β = -0.188, p < 0.01) and also indirectly via lower uncertainty stress (indirect β = -0.011).

CONCLUSION

Improving urban environmental quality, especially reducing air pollution and expanding green infrastructure, may help mitigate problematic alcohol use and promote mental health.