1
|
Manns A, Torregrossa H, Mahdjoub S, Gomajee R, Melchior M, El-Khoury Lesueur F. Do Determinants of Smoking Cessation and Relapse Differ between Men and Women? Data from a French National Study. Subst Use Misuse 2023; 59:167-176. [PMID: 37813814 DOI: 10.1080/10826084.2023.2267106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Introduction: There is limited understanding of different predictors of smoking cessation success (SCS) among women and men, despite well-documented differences in smoking behavior.Methods: Using data from DePICT (Description des Perceptions, Images, et Comportements liés au Tabagisme), a national survey of French adults which recruited 2377 regular and former smokers we investigated whether major determinants of SCS differed by sex. Factors associated with unsuccessful vs. No successful quit attempt; vs. SCS were studied using multivariate multinomial logistic regression analyses stratified by sex.Results: Women and men share some determinants of SCS including no cannabis use, living in a nonsmoker household and importance giving to being a nonsmoker. However, no e-cigarette use, low-to-moderate alcohol consumption, early smoking initiation, and higher education were associated with SCS only among women. No use of nicotine replacement, having family members who smoke, family opinion on smoking and current employment, were associated with SCS only among men. Neutral or negative friends' opinion on smoking or living with a smoker were associated with unsuccessful smoking attempts among men.Conclusions: Our results show differences between determinants of SCS according to sex, which highlights the importance of developing tailored interventions that account for sex/gender differences in smoking cessation.
Collapse
Affiliation(s)
- Aurélia Manns
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Hugo Torregrossa
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Sarah Mahdjoub
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Ramchandar Gomajee
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Maria Melchior
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Fabienne El-Khoury Lesueur
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| |
Collapse
|
2
|
Nguyen DT, Donnelly M, Van Hoang M, O'Neill C. The case for individualised public health interventions: Smoking prevalence and inequalities in Northern Ireland 1985-2015. Health Policy 2023; 135:104879. [PMID: 37441920 DOI: 10.1016/j.healthpol.2023.104879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND While smoking prevalence in high income countries has declined over time, socioeconomic inequalities in smoking have widened. This study is one of the few studies to examine the longitudinal pattern of income-related smoking inequalities and only the second using concentration indices in its analysis. METHOD Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups. FINDINGS Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period. CONCLUSION Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.
Collapse
Affiliation(s)
- Duyen Thuy Nguyen
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom; Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam.
| | - Michael Donnelly
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| | - Minh Van Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, no 1A Duc Thang street, North Tu Liem district, Hanoi 100000, Vietnam
| | - Ciaran O'Neill
- Center for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Science Block A, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom
| |
Collapse
|
3
|
Legleye S, Bricard D, Khlat M. Roles of parental smoking and family structure for the explanation of socio-economic inequalities in adolescent smoking. Addiction 2023; 118:149-159. [PMID: 35971293 DOI: 10.1111/add.16026] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 08/03/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio-economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. DESIGN Secondary analysis of survey data. SETTING A cross-sectional nation-wide exhaustive 12-day survey in March 2017 of French youth aged 17-18.5 years participating in the national mandatory civic information day. PARTICIPANTS A total of 13 314 adolescents answering a pen-and-paper questionnaire about their own tobacco consumption and the smoking of their parents. MEASUREMENTS Risk ratios (RRs) were computed using modified Poisson regressions, and population-attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. FINDINGS Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50-1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99-2.36) when both parents smoked, compared with non-smoking parents; the risk associated with living in a non-intact family was 1.35 (95% CI = 1.26-1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10-1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68-1.98) and RR = 2.10, 95% CI = 1.92-2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. CONCLUSION In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio-economic status is small in comparison.
Collapse
Affiliation(s)
- Stéphane Legleye
- Université Paris-Saclay, Faculté de médecine UVSQ, Université Paris-Sud, Villejuif, France.,Institut national de la statistique et des études économiques, Montrouge, France
| | - Damien Bricard
- Institut de recherche et documentation en économie de la santé (Irdes), Paris, France
| | - Myriam Khlat
- Institut national d'études démographiques (INED), Aubervilliers, France
| |
Collapse
|
4
|
Janssen E, Le Nézet O, Shah J, Chyderiotis S, Brissot A, Philippon A, Legleye S, Spilka S. Increasing socioeconomic disparities in tobacco smoking decline among French adolescents (2000-2017). J Public Health (Oxf) 2021; 42:e449-e457. [PMID: 31774505 DOI: 10.1093/pubmed/fdz135] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use. METHODS A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances. RESULTS Although lifetime cigarette smoking and daily cigarette smoking decreased significantly over the studied time span, suggesting a positive impact of prevention policies, disadvantaged adolescents were consistently more prone to engage in daily cigarette smoking, more so in 2017 than 15 years earlier. In the same time span, transitions from initiation to daily cigarette smoking have shortened, with an accelerated pace among underprivileged adolescents. CONCLUSIONS Accelerated transitions from initiation to daily cigarette use are a prevalent trend among disadvantaged adolescents in France. Efforts to mitigate the impact of marketing strategies and to promote health literacy should be pursued to reduce social inequalities in health.
Collapse
Affiliation(s)
- Eric Janssen
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Olivier Le Nézet
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Jalpa Shah
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Sandra Chyderiotis
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France.,Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France
| | - Alex Brissot
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Antoine Philippon
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France
| | - Stéphane Legleye
- Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France.,National Institute of Statistics and Economic Studies (INSEE), 92120 Montrouge, France
| | - Stanislas Spilka
- French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies-OFDT), 75007 Paris, France.,Research Centre on Population Epidemiology and Health (CESP), Faculty of Medicine-University of Paris-Sud, Faculty of Medicine-University of Versailles Saint-Quentin, Unit 1018, INSERM, University Paris-Saclay, 94800 Villejuif, France
| |
Collapse
|
5
|
Donfouet HPP, Mohamed SF, Malin E. Socioeconomic inequality in tobacco use in Kenya: a concentration analysis. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2021; 21:247-269. [PMID: 33394340 DOI: 10.1007/s10754-020-09292-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
This paper aims at assessing and exploring socioeconomic inequalities in tobacco use in Kenya. Using the theory of fundamental causes, and concentration index, we investigate the determinants of tobacco use, and whether it disproportionately affects the poor. All data used in this study emanated from the 2014 Global Adult Tobacco Survey implemented in Kenya on a nationally representative sample of men and women aged 15 years and older. Our results suggest a link between tobacco use and socioeconomic inequality. Overall, poorer households are more affected by tobacco use than richer households. This socioeconomic inequality is more evident among men and households living in urban areas. The decomposition of the concentration index indicates that the overall socioeconomic inequality for current tobacco smokers is explained by 69.11% of household wealth. To reduce the prevalence rate of smoking in Kenya, policymakers could design and implement tobacco control programs through the equity lens. Community health workers could be used to promote non-smoking behaviors among the poor.
Collapse
Affiliation(s)
- Hermann Pythagore Pierre Donfouet
- African Population Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya.
| | - Shukri F Mohamed
- African Population Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box: 10787-00100, Nairobi, Kenya
| | - Eric Malin
- CREM UMR CNRS 6211, University of Rennes 1, Rennes, France
| |
Collapse
|
6
|
Grignon M, Renaud T, Guerrouche K. Prise en compte de la durée et de l’intensité du tabagisme dans l’estimation de la mortalité attribuable au tabac : une nouvelle méthode appliquée au cancer du poumon en France. POPULATION 2021. [DOI: 10.3917/popu.2004.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
7
|
Lesueur FEK, Torregrossa H, Gomajee R, Bolze C, Melchior M. Sex differences in cigarette brand purchases among adult smokers: results from the DePICT national repeated survey of French adults (2016-2017). THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:223-228. [PMID: 33386472 DOI: 10.1007/s10198-020-01244-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/29/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The tobacco industry has been reported to employ sex-specific marketing strategies, which include different types of tobacco packaging, publicity, as well as price strategies. We examined whether characteristics associated with the purchase of more expensive cigarette brands varied by sex, in the context of the introduction of plain tobacco packaging and the strengthening of tobacco control policies in France. METHODS Our study population consists of 1380 regular smokers of manufactured cigarettes from the DePICT study, a nation-wide two-wave survey of French adults aged 18-64 years. Participants were interviewed by telephone in 2016 and 2017. Factors associated with the use of more vs. less expensive cigarette brands were determined by multivariable logistic regression stratified by sex. RESULTS Several sex-specific factors were associated with the purchase of more expensive cigarette brands. In women, those factors included higher education, cannabis use, and no use of roll-your-own tobacco. While in men purchase of more expensive cigarette brands was linked to younger age, being born outside of France, living with a non-smoker, and attachment to the cigarette brand. DISCUSSION Factors which predict tobacco purchase patterns are different in women and men, highlighting the need for sex-specific tobacco control initiatives to counter the tobacco industry's gendered marketing.
Collapse
Affiliation(s)
- Fabienne El-Khoury Lesueur
- INSERM, Sorbonne Université, Institut Pierre Louis D'Epidémiologie Et de Santé Publique IPLESP, Department of Social Epidemiology, 75012, Paris, France.
| | - Hugo Torregrossa
- INSERM, Sorbonne Université, Institut Pierre Louis D'Epidémiologie Et de Santé Publique IPLESP, Department of Social Epidemiology, 75012, Paris, France
| | - Ramchandar Gomajee
- INSERM, Sorbonne Université, Institut Pierre Louis D'Epidémiologie Et de Santé Publique IPLESP, Department of Social Epidemiology, 75012, Paris, France
| | - Camille Bolze
- INSERM, Sorbonne Université, Institut Pierre Louis D'Epidémiologie Et de Santé Publique IPLESP, Department of Social Epidemiology, 75012, Paris, France
| | - Maria Melchior
- INSERM, Sorbonne Université, Institut Pierre Louis D'Epidémiologie Et de Santé Publique IPLESP, Department of Social Epidemiology, 75012, Paris, France
| |
Collapse
|
8
|
The social gradient in smoking: individual behaviour, norms and nicotine dependence in the later stages of the cigarette epidemic. SOCIAL THEORY & HEALTH 2021. [DOI: 10.1057/s41285-021-00159-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AbstractThe cigarette epidemic tends to develop in a similar pattern across diverse populations in different parts of the world. First, the prevalence of smoking increases, then it plateaus and finally it declines. The decline in smoking prevalence tends to be more pronounced in higher social strata. The later stages of the cigarette epidemic are characterized by emerging and persisting socioeconomic gradients in smoking. Due to its detrimental health consequences, smoking has been the subject of extensive research in a broad range of academic disciplines. I draw on literature from both the social and medical sciences in order to develop a model in which physiological nicotine dependence, individual smoking behaviour and norms surrounding smoking in the immediate social environment are related through reflexive processes. I argue that the emergence and persistence of social gradients in smoking at the later stages of the cigarette epidemic can be attributed to a combination of the pharmacological properties of nicotine, network homophily and the unequal distribution of material and non-material resources across social strata.
Collapse
|
9
|
Long D, Mackenbach J, Martikainen P, Lundberg O, Brønnum-Hansen H, Bopp M, Costa G, Kovács K, Leinsalu M, Rodríguez-Sanz M, Menvielle G, Nusselder W. Smoking and inequalities in mortality in 11 European countries: a birth cohort analysis. Popul Health Metr 2021; 19:3. [PMID: 33516235 PMCID: PMC7847590 DOI: 10.1186/s12963-021-00247-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/21/2021] [Indexed: 01/17/2023] Open
Abstract
Purpose To study the trends of smoking-attributable mortality among the low and high educated in consecutive birth cohorts in 11 European countries. Methods Register-based mortality data were collected among adults aged 30 to 79 years in 11 European countries between 1971 and 2012. Smoking-attributable deaths were estimated indirectly from lung cancer mortality rates using the Preston-Glei-Wilmoth method. Rate ratios and rate differences among the low and high-educated were estimated and used to estimate the contribution of inequality in smoking-attributable mortality to inequality in total mortality. Results In most countries, smoking-attributable mortality decreased in consecutive birth cohorts born between 1906 and 1961 among low- and high-educated men and high-educated women, but not among low-educated women among whom it increased. Relative educational inequalities in smoking-attributable mortality increased among both men and women with no signs of turning points. Absolute inequalities were stable among men but slightly increased among women. The contribution of inequality in smoking-attributable mortality to inequality in total mortality decreased in consecutive generations among men but increased among women. Conclusions Smoking might become less important as a driver of inequalities in total mortality among men in the future. However, among women, smoking threatens to further widen inequalities in total mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00247-2.
Collapse
Affiliation(s)
- Di Long
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Johan Mackenbach
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Olle Lundberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | | | - Matthias Bopp
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Giuseppe Costa
- Department of Clinical Medicine and Biology, University of Turin, Torino, Italy
| | | | - Mall Leinsalu
- Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden.,Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Maica Rodríguez-Sanz
- Agència de Salut Pública de Barcelona, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Wilma Nusselder
- Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| |
Collapse
|
10
|
Khlat M, Legleye S, Bricard D. Migration-related changes in smoking among non-Western immigrants in France. Eur J Public Health 2020; 29:453-457. [PMID: 30398617 PMCID: PMC6532831 DOI: 10.1093/eurpub/cky230] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Migrants make up a growing share of European populations, and very little is known about the impact of migration on their smoking patterns. We develop a longitudinal analysis of smoking prevalence among native-born and immigrants in France based on retrospective data collected in the 2010 national Baromètre santé health survey. Methods Analyses concerned 19 578 individuals aged 18–70 years and born in metropolitan France, in the Maghreb or in sub-Saharan Africa. Person-years with and without smoking were reconstructed using migration and smoking histories and analyzed with discrete-time regression models. Results Prior to migration, immigrants from both the Maghreb and sub-Saharan Africa had lower smoking prevalence than the native-born of similar birth cohort, age and education. After migration, the prevalence increased over time among Maghrebin men up to levels beyond those of the native-born (odds ratio: 1.54 [1.09–2.17] for 10 years of residence or more), while it remained much lower throughout among men from sub-Saharan Africa (odds ratio: 0.36 [0.19–0.68] for 10 years of residence or more). Starting at extremely low levels, the prevalence in both groups of women rose considerably after migration. Women from sub-Saharan Africa nearly caught up to the native-born (odds ratio: 0.70 [0.37–1.32] for 10 years of residence or more), but this was not the case for those from the Maghreb (odds ratio: 0.52 [0.33–0.81] for 10 years of residence or more). Conclusion The findings uncover the low pre-migration prevalence and the diversity of post-migration trajectories. Tobacco control programs targeting recently arrived migrants would contribute to prevent unhealthy assimilation.
Collapse
Affiliation(s)
- M Khlat
- Mortality, Health, Epidemiology Unit, Institut National d'Études Démographiques (INED), Paris, France
| | - S Legleye
- Institut National de la Statistique et des Etudes Economiques (Insee), Montrouge, France.,CESP, Faculté de Médecine, Université Paris Sud; Faculté de Médecine UVSQ; Inserm; Université Paris Saclay, Villejuif, France
| | - D Bricard
- Mortality, Health, Epidemiology Unit, Institut National d'Études Démographiques (INED), Paris, France.,Institut de Recherche et Documentation en Economie de la Santé (Irdes), Paris, France
| |
Collapse
|
11
|
Analysis of the relationship between smoking and chronic respiratory symptoms, level of income and education. JOURNAL OF CONTEMPORARY MEDICINE 2020. [DOI: 10.16899/jcm.658655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
12
|
Rajabi A, Arefnezhad M, Erfanpoor S, Esmaeilzadeh F, Arefnezhad M, Hasani J. Cigarette Smoking and Health-related Quality of Life in the General Population of Iran: Independent Associations According to Gender. Int J Prev Med 2019; 10:188. [PMID: 31807258 PMCID: PMC6852195 DOI: 10.4103/ijpvm.ijpvm_526_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 05/07/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Associations between smoking and health-related quality of life (HRQoL) in the general population remain unclear. The aim of the study was to quantify the independent associations between smoking and HRQoL. Methods: A cross-sectional population-based study was conducted on a total sample of 2197 participants obtained by multistage sampling to investigate the associations between smoking and HRQoL in the general population of southeast and southwest of Iran, aged 18–100 years in 2012–2013. Data were collected using a self-administrated of the 36-Item Short Form Survey (SF-36) questionnaire. Linear regression analyses were used to evaluate the associations between HRQoL and smoking while adjusting for various socioeconomic variables. In this study, P < 0.05 was considered a significant difference. Results: Out of the total of 2197 participants, current smokers and never smokers accounted for 13% and 87%, respectively. The mean HRQoL indices were for the current smokers 66.66 ± 17.86, and never smokers 71.35 ± 18.47 (P < 0.001). Independent associations between smoking and HRQoL were found, including negative associations (P < 0.001). The multivariate associations between smoking status and HRQoL, male smokers had a lower physical functioning, mental health, and total SF-36 score. Conclusions: Smoking was independently related to HRQoL, with large differences according to the gender. This study showed that there is a significant difference in the quality of life related to health in male smokers compared to male nonsmokers.
Collapse
Affiliation(s)
- Abdolhalim Rajabi
- Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masoud Arefnezhad
- Department of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Saeed Erfanpoor
- Department of Community Medicine, Faculty of Medicine School, Gonabad University of Medical Science, Gonabad, Iran
| | - Firooz Esmaeilzadeh
- Department of Public Health, School of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Masoumeh Arefnezhad
- Department of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Jalil Hasani
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| |
Collapse
|
13
|
Kinouani S, Leflot C, Vanderkam P, Auriacombe M, Langlois E, Tzourio C. Motivations for using electronic cigarettes in young adults: A systematic review. Subst Abus 2019; 41:315-322. [PMID: 31638872 DOI: 10.1080/08897077.2019.1671937] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: The most common reasons why adults use e-cigarettes are to stop or reduce tobacco smoking. However, it is unclear if this reason is evenly distributed between young and older adults. Objectives: describe the motivations for e-cigarette use amongst young adults aged 18-25 and compare the reasons for using e-cigarettes of people who currently or formerly used tobacco products to those who had never smoked tobacco prior e-cigarette use. Methods: PubMed®, Scopus®, Cochrane Library®, SocINDEX®, PsycARTICLES®, Psychology and Behavioral Sciences Collection® and PsycINFO® databases were used. English written articles were screened up to March 2018. Depending on study design, quality was assessed using The STROBE or RATS checklists. Results: Six articles were included in the review, all with a moderate quality of evidence. Independently of smoking status, curiosity was the most frequently reported reason for initiating the use of e-cigarettes in young adults. Reasons for continuing to use e-cigarettes were various. The continued use of e-cigarettes could be either a means to replicate smoking habits, or a way for a different and personalized use of nicotine by inhalation. Conclusions: Reasons for using e-cigarettes in young adults are varied and are not limited to stopping smoking.
Collapse
Affiliation(s)
- Shérazade Kinouani
- University Bordeaux, Bordeaux, France.,Inserm, Bordeaux Population Health Research Center, Team HEALTHY, University Bordeaux, Bordeaux, France.,Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Chloé Leflot
- University Bordeaux, Bordeaux, France.,Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Paul Vanderkam
- Department of General Practice, Faculty of Medicine, Poitiers, France
| | - Marc Auriacombe
- University Bordeaux, Bordeaux, France.,SANPSY, Bordeaux, France.,Pôle Addictologie, Bordeaux, France
| | - Emmanuel Langlois
- University Bordeaux, Bordeaux, France.,Centre Émile Durkheim, University Bordeaux, Bordeaux, France
| | - Christophe Tzourio
- University Bordeaux, Bordeaux, France.,Inserm, Bordeaux Population Health Research Center, Team HEALTHY, University Bordeaux, Bordeaux, France
| |
Collapse
|
14
|
Pourtau L, Martin E, Menvielle G, El Khoury-Lesueur F, Melchior M. To smoke or not to smoke? A qualitative study among young adults. Prev Med Rep 2019; 15:100927. [PMID: 31321203 PMCID: PMC6612927 DOI: 10.1016/j.pmedr.2019.100927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/12/2019] [Accepted: 06/21/2019] [Indexed: 11/10/2022] Open
Abstract
Smoking is the major preventable cause of disease and premature death in many countries, including France, where approximately 30% of adults are daily smokers. About 60% of them want to quit, however, long-term smoking cessation rates are low, particularly among individuals with low socio-economic position. The aim of this study is to examine whether motivations for smoking cessation among young adults differ across socio-economic groups. 3 focus groups of smokers and former smokers aged 22–40 years were constituted and conducted in November 2014 in Paris. Data from the focus groups were analyzed thematically and in a cross-cutting manner. Our study shows the existence of social “communities” of smokers, in occupational and festive contexts. In addition, new forms of resistance to public health messages are observed (“neutralization”), particularly among smokers with low socioeconomic position. Finally, stress is often cited as a source of unsuccessful smoking cessation or smoking relapse. Tobacco smoking is a social behavior and is associated with symbolic as well as relational benefits, particularly among smokers who have low socioeconomic position. To be effective, interventions aiming to decrease smoking levels in the population should aim to create group dynamics encouraging smokers to quit and address the physical as well as the psychological consequences of smoking withdrawal. Young adults who smoke congregate in social “communities”, at work or at parties. Persons with low socioeconomic status “neutralize” the risks related to smoking. Smoking is a social behavior, associated with symbolic and relational benefits.
Collapse
Affiliation(s)
- Lionel Pourtau
- Université Paris Sud/Paris Saclay, Laboratoire EA 1610, équipe ES3, Kremlin-Bicêtre, France
| | - Elise Martin
- Université Paris Sud/Paris Saclay, Laboratoire EA 1610, équipe ES3, Kremlin-Bicêtre, France
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012 Paris, France
| | - Fabienne El Khoury-Lesueur
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012 Paris, France
| | - Maria Melchior
- INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Department of Social Epidemiology, F75012 Paris, France
| |
Collapse
|
15
|
Fujita T, Babazono A, Harano Y, Jiang P. Influence of Occupational Background on Smoking Prevalence as a Health Inequality Among Employees of Medium- and Small-Sized Companies in Japan. Popul Health Manag 2019; 23:183-193. [PMID: 31207197 PMCID: PMC7074897 DOI: 10.1089/pop.2019.0021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tobacco smoking is a major public health problem. In addition, the influence of socioeconomic status on health inequalities has received great attention worldwide. The authors used insurance data of beneficiaries employed in medium- and small-sized Japanese companies to investigate the influence of occupational background on smoking prevalence as a health inequality among workers in Japan. Participants were aged 35–74 years and underwent health examinations in 2015. Smoking prevalence was estimated for each occupational group according to sex, age, and income. Logistic regression analysis was used to assess the association between smoking status and occupational groups. A total of 385,945 participants were included. Overall smoking prevalence was 36.3%, higher than average in Japan. Smoking prevalence was lowest among workers in the education and learning support category; all other occupational groups had significantly high prevalence, with the highest for transport and postal services (odds ratio 2.69, 95% confidence interval 2.53–2.86). There were few differences in smoking prevalence at higher income levels among female participants, but differences were remarkably significant at lower income levels. For health inequalities related to smoking, occupational background was associated with smoking prevalence. In particular, there was high smoking prevalence in workplaces not covered by smoke-free policies. These results also demonstrated differences between the sexes; smoking prevalence among female workers with lower income levels was strongly associated with occupational background whereas there were no large differences among male workers by income. These findings suggest that the government should encourage companies to adopt smoke-free policies in the workplace.
Collapse
Affiliation(s)
- Takako Fujita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.,Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Babazono
- Department of Healthcare Administration and Management, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yumi Harano
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Peng Jiang
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
16
|
King G, Guignard R, Reeder E, Beck F, Conserve DF, Arwidson P, Bendel RB, Moolchan E. Fumes-tu encore? Quitting among French and American smokers: 2000-2010. Ann Epidemiol 2019; 34:26-32. [PMID: 31101457 DOI: 10.1016/j.annepidem.2019.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This article examines sociodemographic correlates of initiation and quitting among French and American smokers. METHODS National surveys in France and the United States in 2000, 2005, and 2010 were analyzed of ever smokers, 20-75 years old. Bivariate and multivariate logistic regression analyses were conducted on age of initiation and quitting. RESULTS Smoking prevalence decreased for Americans each survey year (25.2%, 22.9%, and 17.9%), whereas the comparable figures for the French were 33.9%, 31.5%, and 33.8%. French smokers consumed fewer cigarettes per day (12.9 vs. 14.4 in 2000, 13.5. vs. 16.8 in 2005, and 12.2 vs. 15.1 in 2010), began consuming at a later age, and smoked for a shorter duration. Multiple logistic regression results revealed significant differences in the odds ratios, indicating the relative influence of sociodemographic variables on age of initiation and quitting. CONCLUSIONS Quitting smoking continues to be a major challenge, varying by similar factors, particularly education, in both France and the United States. POLICY IMPLICATIONS Public policy initiatives to promote quitting must be strengthened, including the need to address population-specific inequalities and disparities in tobacco use and consequences.
Collapse
Affiliation(s)
- Gary King
- Pennsylvania State University, University Park, PA.
| | - Romain Guignard
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | - Ethan Reeder
- Pennsylvania State University, University Park, PA
| | - François Beck
- National Institute of Statistics and Economic Studies (INSEE), Montrouge, France; Faculté de Médecine, Faculté de Médecine UVSQ, Inserm, CESP, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Pierre Arwidson
- Santé Publique France, French National Public Health Agency, Saint-Maurice, France
| | | | | |
Collapse
|
17
|
Galea S, Vaughan R. Tradeoffs Between Equity and Efficiency at the Heart of Population Health Science: A Public Health of Consequence, April 2019. Am J Public Health 2019; 109:541-542. [PMID: 30865497 DOI: 10.2105/ajph.2019.304982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sandro Galea
- Sandro Galea is with the School of Public Health, Boston University, Boston, MA. Roger Vaughan is with the Department of Biostatistics, The Rockefeller University, New York, NY
| | - Roger Vaughan
- Sandro Galea is with the School of Public Health, Boston University, Boston, MA. Roger Vaughan is with the Department of Biostatistics, The Rockefeller University, New York, NY
| |
Collapse
|
18
|
Sabbath EL, Yang J, Dennerlein JT, Boden LI, Hashimoto D, Sorensen G. Paradoxical Impact of a Patient-Handling Intervention on Injury Rate Disparity Among Hospital Workers. Am J Public Health 2019; 109:618-625. [PMID: 30789763 DOI: 10.2105/ajph.2018.304929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To test whether a comprehensive safe patient-handling intervention, which successfully reduced overall injury rates among hospital workers in a prior study, was differentially effective for higher-wage workers (nurses) versus low-wage workers (patient care associates [PCAs]). METHODS Data were from a cohort of nurses and PCAs at 2 large hospitals in Boston, Massachusetts. One hospital received the intervention in 2013; the other did not. Using longitudinal survey data from 2012 and 2014 plus longitudinal administrative injury and payroll data, we tested for socioeconomic differences in changes in self-reported safe patient-handling practices, and for socioeconomic differences in changes in injury rates using administrative data. RESULTS After the intervention, improvements in self-reported patient-handling practices were equivalent for PCAs and for nurses. However, in administrative data, lifting and exertion injuries decreased among nurses (rate ratio [RR] = 0.64; 95% confidence interval [CI] = 0.41, 1.00) but not PCAs (RR = 1.10; 95% CI = 0.74,1.63; P for occupation × intervention interaction = 0.02). CONCLUSIONS Although the population-level injury rate decreased after the intervention, most improvements were among higher-wage workers, widening the socioeconomic gap in injury and exemplifying the inequality paradox. Results have implications for public health intervention development, implementation, and analysis.
Collapse
Affiliation(s)
- Erika L Sabbath
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jie Yang
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jack T Dennerlein
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Leslie I Boden
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Dean Hashimoto
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Glorian Sorensen
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| |
Collapse
|
19
|
Menvielle G, Kulhánová I, Bryère J, Launoy G, Eilstein D, Delpierre C, Soerjomataram I. Tobacco-attributable burden of cancer according to socioeconomic position in France. Int J Cancer 2018; 143:478-485. [PMID: 29457849 DOI: 10.1002/ijc.31328] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 02/05/2023]
Abstract
Smoking is a major preventable cause of cancers and is increasingly concentrated among the most deprived individuals leading to increasing socioeconomic inequalities in the incidence of cancers linked to smoking. We aimed to estimate the tobacco-attributable cancer burden according to socioeconomic position in France. The analysis was restricted to cancer sites for which tobacco smoking was recognized as a risk factor. Cancer cases by sex, age group and European Deprivation Index (EDI) among people aged 30-74 between 2006 and 2009 were obtained from cancer registries covering ∼20% of the French population. The tobacco-attributable burden of cancer according to EDI was estimated applying the population attributable fraction (PAF) computed with the Peto-Lopez method. The PAF increased from 56% in the least deprived EDI quintile to 70% in the most deprived EDI quintile among men and from 26% to 38% among women. In total, 28% of the excess cancer cases in the four most deprived EDI quintiles in men and 43% in women could be prevented if smoking in these 4 EDI quintiles was similar to that of the least deprived EDI quintile. A substantial smoking-attributable burden of cancer by socioeconomic position was observed in France. The results highlight the need for policies reducing tobacco consumption. More comprehensive interventions integrating the various dimensions of health determinants and proportionate according to socioeconomic position may essentially contribute to the reduction of socioeconomic inequalities in cancer.
Collapse
Affiliation(s)
- Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique IPLESP, 75012, Paris, France
| | - Ivana Kulhánová
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Joséphine Bryère
- Cancers and Preventions, U1086 INSERM-UCN, Centre François Baclesse, Caen, France
| | - Guy Launoy
- Cancers and Preventions, U1086 INSERM-UCN, Centre François Baclesse, Caen, France
- University Hospital Center (CHU) of Caen, Caen, France
- University of Caen Normandy, Caen, France
| | | | - Cyrille Delpierre
- UMR 1027 INSERM, Faculty of medicine, Toulouse, France
- University of Toulouse III - Paul Sabatier, Toulouse, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| |
Collapse
|
20
|
Melchior M, Azevedo da Silva M. Commentary on Chan et al. (2018): Cannabis use and educational level-which is the chicken and which is the egg? Addiction 2018; 113:462-463. [PMID: 29423992 DOI: 10.1111/add.14099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 10/11/2017] [Accepted: 11/06/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Melchior
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Marine Azevedo da Silva
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| |
Collapse
|
21
|
Wang Q, Shen JJ, Sotero M, Li CA, Hou Z. Income, occupation and education: Are they related to smoking behaviors in China? PLoS One 2018; 13:e0192571. [PMID: 29420649 PMCID: PMC5805321 DOI: 10.1371/journal.pone.0192571] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 01/25/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association between socioeconomic status (SES) and smoking behaviors may differ across countries. This study aimed to estimate the association between socioeconomic status (income, occupation and education) and multiple measures of smoking behaviors among the Chinese elderly population. METHODS Using data from the China Health and Retirement Longitudinal Study in 2013, we examined the relationship between socioeconomic status and smoking behaviors through multivariate regression analysis. Sample selection models were applied to correct for sample selection bias. Smoking behaviors were measured by four indicators: smoking status, cigarette consumption, health risks related to smoking, and smoking dependence. Analyses were stratified by gender and urban-rural residence. RESULTS Among Chinese people aged 45 years or older, smokers accounted for 40% of the population in 2013, smoking 19 cigarettes per day. It was also found that 79% of smokers were at an increased health risk. Overall, although the influence of income on smoking behaviors was small and even insignificant, occupation and education levels were significantly associated with smoking behaviors. Managers or professionals were more likely to smoke, however there was no significant relationship with smoking dependence. Individuals with higher educational attainment were less likely to be associated with smoking behaviors. In addition, gender and urban-rural differences existed in the relationship between SES and smoking behaviors. CONCLUSIONS Smoking disparities among diverse levels of socioeconomic status existed but varied greatly by SES indicators and population characteristics. Tobacco control policies in China should be increasingly focused on populations with low socioeconomic status in order to break the link between socioeconomic disadvantage and smoking behaviors. Further actions should mitigate inequalities in education, improve the social culture of cigarette use, and tailor interventions based on characteristics of the population.
Collapse
Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin, Liaoning, China
| | - Jay J. Shen
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Michelle Sotero
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Casey A. Li
- Green Valley High School, Henderson, Nevada, United States of America
| | - Zhiyuan Hou
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China
- National Key Laboratory of Health Technology Assessment (Health and Family Planning Commission), Fudan University, Shanghai, China
- Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China
| |
Collapse
|
22
|
Kandasamy S, Anand SS. Cardiovascular Disease Among Women From Vulnerable Populations: A Review. Can J Cardiol 2018; 34:450-457. [PMID: 29571426 DOI: 10.1016/j.cjca.2018.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 12/14/2022] Open
Abstract
On a global scale, cardiovascular disease (CVD) is the leading cause of mortality. It is also the number 1 cause of death among women, resulting in 8.6 million deaths annually and constituting one third of all deaths in women worldwide. The burden of CVD and related risk factors has taken priority in the policy development for noncommunicable diseases. However, vulnerable populations, defined here as women who are socially or economically disadvantaged (eg, low income), nonwhite (specifically South Asian and indigenous women), and those who are elderly have often been overlooked in these discussions. These additional vulnerabilities, which may exist independently or in combination, place such women at higher risk for CVD. Specifically, these vulnerabilities include low socioeconomic status, a low sense of control, high stress, South Asian or indigenous ancestry, and increased age. Thus it is vital that we initiate a multipronged approach to CVD prevention that includes rigorous monitoring of CVD risk factors in high-risk populations and the implementation of timely, accurate, and contextually tailored prevention programs, services, and treatments. Well-trained nonphysician health care workers can support the accurate monitoring and management of CVD and CVD risk factors so that groups of women who may otherwise be overlooked can receive adequate attention.
Collapse
Affiliation(s)
- Sujane Kandasamy
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S Anand
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
| |
Collapse
|
23
|
Temam S, Varraso R, Pornet C, Sanchez M, Affret A, Jacquemin B, Clavel-Chapelon F, Rey G, Rican S, Le Moual N. Ability of ecological deprivation indices to measure social inequalities in a French cohort. BMC Public Health 2017; 17:956. [PMID: 29246202 PMCID: PMC5732455 DOI: 10.1186/s12889-017-4967-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 11/29/2017] [Indexed: 11/18/2022] Open
Abstract
Background Despite the increasing interest in place effect to explain health inequalities, there is currently no consensus on which kind of area-based socioeconomic measures researchers should use to assess neighborhood socioeconomic position (SEP). The study aimed to evaluate the reliability of different area-based deprivation indices (DIs) in capturing socioeconomic residential conditions of French elderly women cohort. Methods We assessed area-based SEP using 3 DIs: Townsend Index, French European Deprivation Index (FEDI) and French Deprivation index (FDep), among women from E3N (Etude épidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale). DIs were derived from the 2009 French census at IRIS level (smallest geographical units in France). Educational level was used to evaluate individual-SEP. To evaluate external validity of the 3 DIs, associations between two well-established socially patterned outcomes among French elderly women (smoking and overweight) and SEP, were compared. Odd ratios were computed with generalized estimating equations to control for clustering effects from participants within the same IRIS. Results The analysis was performed among 63,888 women (aged 64, 47% ever smokers and 30% overweight). Substantial agreement was observed between the two French DIs (Kappa coefficient = 0.61) and between Townsend and FEDI (0.74) and fair agreement between Townsend and FDep (0.21). As expected among French elderly women, those with lower educational level were significantly less prone to be ever smoker (Low vs. High; OR [95% CI] = 0.43 [0.40–0.46]) and more prone to being overweight (1.89 [1.77–2.01]) than women higher educated. FDep showed expected associations at area-level for both smoking (most deprived vs. least deprived quintile; 0.77 [0.73–0.81]) and overweight (1.52 [1.44–1.62]). For FEDI opposite associations with smoking (1.13 [1.07–1.19]) and expected association with overweight (1.20 [1.13–1.28]) were observed. Townsend showed opposite associations to those expected for both smoking and overweight (1.51 [1.43–1.59]; 0.93 [0.88–0.99], respectively). Conclusion FDep seemed reliable to capture socioeconomic residential conditions of the E3N women, more educated in average than general French population. Results varied strongly according to the DI with unexpected results for some of them, which suggested the importance to test external validity before studying social disparities in health in specific populations. Electronic supplementary material The online version of this article (10.1186/s12889-017-4967-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sofia Temam
- INSERM, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, 16 Avenue Paul-Vaillant Couturier, F-94807, VILLEJUIF, Cedex, France. .,Univ Paris Sud, Le Kremlin-Bicêtre, France. .,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.
| | - Raphaëlle Varraso
- INSERM, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, 16 Avenue Paul-Vaillant Couturier, F-94807, VILLEJUIF, Cedex, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| | - Carole Pornet
- Agence Régionale de Santé (ARS) Basse-Normandie, Caen, France
| | - Margaux Sanchez
- INSERM, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, 16 Avenue Paul-Vaillant Couturier, F-94807, VILLEJUIF, Cedex, France.,Univ Paris Sud, Le Kremlin-Bicêtre, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| | - Aurélie Affret
- Univ Paris Sud, Le Kremlin-Bicêtre, France.,Centre for Research in Epidemiology and Population Health (CESP), Mode de vie, gènes et santé: épidémiologie intégrée trans-générationnelle, INSERM, U1018, Villejuif, France
| | - Bénédicte Jacquemin
- INSERM, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, 16 Avenue Paul-Vaillant Couturier, F-94807, VILLEJUIF, Cedex, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France.,Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Françoise Clavel-Chapelon
- Univ Paris Sud, Le Kremlin-Bicêtre, France.,Centre for Research in Epidemiology and Population Health (CESP), Mode de vie, gènes et santé: épidémiologie intégrée trans-générationnelle, INSERM, U1018, Villejuif, France
| | | | - Stéphane Rican
- LADYSS, Laboratoire dynamiques sociales et recompositions des espaces, Université Paris Ouest Nanterre La Défense, Nanterre, France
| | - Nicole Le Moual
- INSERM, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, 16 Avenue Paul-Vaillant Couturier, F-94807, VILLEJUIF, Cedex, France.,Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
| |
Collapse
|
24
|
Bricard D, Legleye S, Khlat M. Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060610. [PMID: 28590412 PMCID: PMC5486296 DOI: 10.3390/ijerph14060610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/22/2017] [Accepted: 05/31/2017] [Indexed: 11/16/2022]
Abstract
The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration.
Collapse
Affiliation(s)
- Damien Bricard
- Institut de Recherche et Documentation en Économie de la Santé (Irdes), 117 bis rue Manin, 75019 Paris, France.
- Institut National d'Études Démographiques (Ined), 133 boulevard Davout, 75020 Paris, France.
| | - Stéphane Legleye
- Institut National de la Statistique et des Études Économiques (Insee), 6 Rue Legrand, 92240 Malakoff, France.
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Faculté de Médecine-Université Paris-Sud, Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif, France.
| | - Myriam Khlat
- Institut National d'Études Démographiques (Ined), 133 boulevard Davout, 75020 Paris, France.
| |
Collapse
|
25
|
Burford O, Kindarji S, Parsons R, Falcoff H. Using visual demonstrations in young adults to promote smoking cessation: Preliminary findings from a French pilot study. Res Social Adm Pharm 2017; 14:398-400. [PMID: 28495124 DOI: 10.1016/j.sapharm.2017.04.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND A personalised, smoking cessation message was successfully delivered in Australian community pharmacies to motivate behavioural change in young smoking adults. OBJECTIVE The purpose of this pilot study was to test the acceptability and effectiveness of the innovative, proven smoking cessation intervention to another population of young adults with a higher prevalence of smoking and associated morbidities. METHODS Ninety eight university students in Paris, France were recruited to a pilot study (50 intervention: 48 control). All students received smoking cessation counselling sessions and half also received a visual demonstration of themselves, both as a lifelong smoker and non-smoker. RESULTS There was no statistical significant difference between the groups in smoking dependence at recruitment. At the three month follow-up, the proportion who had attempted to quit smoking were 37% (control) vs 46% (intervention). These percentages suggested a positive result for the intervention, although the difference was not statistically significant (p = 0.39). CONCLUSION This is one of the first studies conducted in France using visual demonstrations combined with healthcare counselling to promote smoking cessation amongst young adult smokers. Further research, recruiting from the general French public, is needed to better understand if the innovative personalised health message can motivate young French adult smokers to quit.
Collapse
Affiliation(s)
- Oksana Burford
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia.
| | - Souraya Kindarji
- Faculty of Medicine, Paris Descartes University, Paris cedex 06, 75270, France
| | - Richard Parsons
- School of Pharmacy, Faculty of Health Sciences, Curtin University, Perth, WA, 6845, Australia
| | - Hector Falcoff
- Faculty of Medicine, Paris Descartes University, Paris cedex 06, 75270, France
| |
Collapse
|
26
|
Gagné T, Veenstra G. Trends in smoking initiation in Canada: Does non-inclusion of young adults in tobacco control strategies represent a missed opportunity? Canadian Journal of Public Health 2017; 108:e14-e20. [PMID: 28425894 DOI: 10.17269/cjph.108.5839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/12/2017] [Accepted: 11/02/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Young adults face high prevalence rates for smoking. Recent evidence suggests that many people initiate smoking during young adulthood, but little is currently known about trends in initiation rates for this age group. METHODS We examined rates of initiation to first cigarette (FC) and daily smoking (DS) during youth (5-17 years) and young adulthood (18-25 years) using nationally representative data from the 2001, 2003, 2005, 2007, 2009, 2011 and 2013 cycles of the Canadian Community Health Survey. We included all participants aged 25-26 to obtain seven mutually exclusive retrospective cohorts (n = 16 216). We used logistic regression to examine four correlates of smoking - sex, education, poverty status, and immigration status - and whether these factors modify time trends in smoking. RESULTS We found that initiation rates decreased during youth (p < 0.001 for FC, p = 0.02 for DS) but not during young adulthood (p = 0.94 for FC, p = 0.28 for DS). We found that men and respondents with fewer educational credentials had relatively higher odds of initiating during young adulthood. Trends in young adulthood stayed constant across subgroups. Trends in youth were modified by education: participants who did not complete high school had no decrease in initiation to FC and DS while those with post-secondary education experienced a decrease in both outcomes. CONCLUSION Tobacco control has failed to address smoking initiation during young adulthood. Given the considerable amount of initiation that occurs during this period, practitioners and policy-makers should direct more of their planning toward young adults.
Collapse
Affiliation(s)
- Thierry Gagné
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM); Département de médicine sociale et préventive, Université de Montréal, Montréal, QC.
| | | |
Collapse
|
27
|
Pampel FC, Bricard D, Khlat M, Legleye S. Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:309-330. [PMID: 29056801 DOI: 10.1007/s11113-016-9424-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the United States) using smoking history measures from the 2010 French Health Barometer (N = 20,940) and the 2010 U.S. National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: Age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.
Collapse
Affiliation(s)
- Fred C Pampel
- Institute of Behavioral Science, University of Colorado, Boulder, 80309-0483 USA
| | - Damien Bricard
- Institut de Recherche et Documentation en Economie de la Santé (IRDES), Paris, France
| | - Myriam Khlat
- Institut National d'Etudes Demographiques, 133, boulevard Davout - 75020 Paris, France
| | - Stéphane Legleye
- INSERM U1178, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France
| |
Collapse
|
28
|
Legleye S, Richard JB, Rey G, Beck F. L’acceptabilité de la déclaration d’informations identifiantes dans une enquête transversale en population générale. POPULATION 2017. [DOI: 10.3917/popu.1704.0729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
29
|
Droomers M, Huang X, Fu W, Yang Y, Li H, Zheng P. Educational disparities in the intention to quit smoking among male smokers in China: a cross-sectional survey on the explanations provided by the theory of planned behaviour. BMJ Open 2016; 6:e011058. [PMID: 27855086 PMCID: PMC5073514 DOI: 10.1136/bmjopen-2016-011058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES We aim to describe the intention to quit smoking among Chinese male smokers from different educational backgrounds and to explain this intention from their attitude, perceived social norms and self-efficacy regarding smoking cessation. SETTING Participants were recruited from workplaces and communities to reflect the occupational distribution in three cities (Shanghai, Nanning and Mudanjiang) in China. DESIGN AND PARTICIPANTS In 2013 interviews were conducted with 3676 male smokers aged 18 years and older. OUTCOME MEASURES Multivariate logistic regression analyses calculated educational differences in the intention to quit smoking as well as the association between the intention to quit smoking and attitude, subjective norms, and self-efficacy. Bootstrapping estimated to what extent the educational disparities in the intention to quit smoking were mediated by these three determinants. RESULTS No educational disparities in the intention to quit smoking within 1 or 6 months were observed among male Chinese smokers (p=0.623 and p=0.153, respectively). A less negative attitude, a higher perceived subjective norm towards smoking cessation, and a higher perceived self-efficacy to quit smoking were all associated with intention to quit (all p values <0.001). Perceived subjective norms were the only component of the theory of planned behaviour that statistically significantly mediated the differences in the intention to quit smoking (within 1 or 6 months) between the lowest educated Chinese men and the groups with lower (β=0.039, 95% CI 0.017 to 0.071 and β=0.043, 95% CI 0.019 to 0.073), higher (β=0.041, 95% CI 0.017 to 0.075 and β=0.045, 95% CI 0.019 to 0.077) and the highest education (β=0.045, 95% CI 0.019 to 0.080 and β=0.050, 95% CI 0.023 to 0.083). CONCLUSIONS In order to prevent future socioeconomic disparities in smoking cessation, investment in a more stimulating social environment and norms towards smoking cessation among particularly the lowest educated Chinese men is warranted.
Collapse
Affiliation(s)
- Mariël Droomers
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Xinyuan Huang
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Wenjie Fu
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Center of Disease Control, Pudong District, Shanghai, China
| | - Yong Yang
- Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Hong Li
- Nanning Medical University, Guangxi Zhuang Autonomous Region, China
| | - Pinpin Zheng
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| |
Collapse
|
30
|
Legleye S, Khlat M, Mayet A, Beck F, Falissard B, Chau N, Peretti-Watel P. From cannabis initiation to daily use: educational inequalities in consumption behaviours over three generations in France. Addiction 2016; 111:1856-66. [PMID: 27206790 DOI: 10.1111/add.13461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/04/2016] [Accepted: 05/13/2016] [Indexed: 11/30/2022]
Abstract
AIMS The diffusion of cannabis initiation has been accompanied by a reversal in the educational gradient: contrary to older generations, the less educated in recent generations are more likely to initiate than the more educated. We tested whether the educational gradient for the transition from initiation to daily use evolved in the same way. DESIGN/SETTING A French telephone random survey conducted in 2010 (21 818 respondents aged 15-64 years), asking interviewees about their ages at initiation to daily use, if any. PARTICIPANTS A total of 6824 cannabis initiators aged 18-64 years at data collection. Three birth cohort groups (generations) were compared: 1946-60 (n = 767), 1961-75 (n = 2632) and 1976-92 (n = 3425) with, respectively, 47, 42 and 45% of women. MEASURES Risks of transition to daily use from ages 11-34 were compared through time-discrete logistic regressions and educational gradients were quantified through a relative index of inequality (RII). Control variables include age and time-varying variables (ages at tobacco daily use, at first drunkenness and at first other use of an illicit drug in a list of 13 products). FINDINGS Twenty-four per cent of the initiators reported daily use before age 35, the proportions tripling from the oldest to the youngest generation (from 11.7 to 38.6% in men, from 7.7 to 22.2% in women). Whatever the generation, the less educated initiators more often shifted to daily use than the most educated: from the oldest to the youngest generation, RII = 2.13, 95% confidence interval (CI) = [0.65, 7.02]; 2.19 95% CI = [1.33, 3.63]; and 2.24, 95% CI = [1.60, 3.15] in men; RII = 3.31, 95% CI = [0.75, 14.68]; 3.17, 95% CI = [1.49, 6.76]; and 3.56, 95% CI = [2.07, 6.14] in women, respectively. CONCLUSION In France, the risk of transition from cannabis initiation to daily use has remained consistently higher among less educated cannabis initiators over three generations (1946-60, 1961-75, 1976-92), in contrast to what is observed for initiation.
Collapse
Affiliation(s)
- Stéphane Legleye
- INSERM, Mental Health in Public Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. .,Institut national des études démographiques, Paris, France.
| | - Myriam Khlat
- Institut national des études démographiques, Paris, France
| | - Aurélie Mayet
- INSERM, Mental Health in Public Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.,Centre d'épidémiologie et de santé publique des armées, Marseille, France
| | - François Beck
- Centre de recherche, médecine, sciences, santé, santé mentale, Université Paris Descartes, Paris, France.,Observatoire français des drogues et des toxicomanies, Saint-Denis, France
| | - Bruno Falissard
- INSERM, Mental Health in Public Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Nearkasen Chau
- INSERM, Mental Health in Public Health, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Patrick Peretti-Watel
- INSERM, 'Economics and Social Sciences Applied to Health and Analysis of Medical Information' (SESSTIM), Marseille, France.,ORS PACA, Southeastern Health Regional Observatory, Marseille, France
| |
Collapse
|
31
|
Menvielle G, Franck JE, Radoï L, Sanchez M, Févotte J, Guizard AV, Stücker I, Luce D. Quantifying the mediating effects of smoking and occupational exposures in the relation between education and lung cancer: the ICARE study. Eur J Epidemiol 2016; 31:1213-1221. [PMID: 27417979 DOI: 10.1007/s10654-016-0182-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Abstract
Smoking only partly explains the higher lung cancer incidence observed among socially deprived people. Occupational exposures may account for part of these inequalities, but this issue has been little investigated. We investigated the extent to which smoking and occupational exposures to asbestos, silica and diesel motor exhaust mediated the association between education and lung cancer incidence in men. We analyzed data from a large French population-based case-control study (1976 lung cancers, 2648 controls). Detailed information on lifelong tobacco consumption and occupational exposures to various carcinogens was collected. We conducted inverse probability-weighted marginal structural models. A strong association was observed between education and lung cancer. The indirect effect through smoking varied by educational level, with the strongest indirect effect observed for those with the lowest education (OR = 1.34 (1.14-1.57)). The indirect effect through occupational exposures was substantial among men with primary (OR = 1.22 (1.15-1.30) for asbestos and silica) or vocational secondary education (OR = 1.18 (1.12-1.25)). The contribution of smoking to educational differences in lung cancer incidence ranged from 22 % (10-34) for men with primary education to 31 % (-3 to 84) for men with a high school degree. The contribution of occupational exposures to asbestos and silica ranged from 15 % (10-20) for men with a high school degree to 20 % (13-28) for men with vocational secondary education. Our results highlight the urgent need for public health policies that aim at decreasing exposure to carcinogens at work, in addition to tobacco control policies, if we want to reduce socioeconomic inequalities in the cancer field.
Collapse
Affiliation(s)
- Gwenn Menvielle
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France.
| | - Jeanna-Eve Franck
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), 75012, Paris, France
| | - Loredana Radoï
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Descartes, Paris, France
| | - Marie Sanchez
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Joëlle Févotte
- Unité Mixte de Recherche Épidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Université Claude Bernard Lyon 1, 69373, Lyon, France
| | | | - Isabelle Stücker
- Inserm UMRS 1018, CESP Centre for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
- University of Paris Sud 11, Kremlin-Bicêtre, France
| | - Danièle Luce
- Inserm U 1085, IRSET, Pointe-à-Pitre, France
- University of Rennes 1, Rennes, France
| |
Collapse
|
32
|
Kaleta D, Usidame B, Dziankowska-Zaborszczyk E, Makowiec-Dąbrowska T. Socioeconomic Disparities in Age of Initiation and Ever Tobacco Smoking: Findings from Romania. Cent Eur J Public Health 2016; 23:299-305. [PMID: 26841142 DOI: 10.21101/cejph.a4067] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 03/07/2015] [Indexed: 11/15/2022]
Abstract
AIM Smoking initiation is considered the fundamental behaviour that determines the future health burden of tobacco smoking in a society. The aim of the study was to evaluate the socio-demographic factors associated with initiation of regular smoking among adults. METHODS The data source was the 2011 Global Adult Tobacco Survey Romania (GATS), which is a cross-sectional, nationally representative study. Multivariate logistic regression model was applied for relevant analysis. RESULTS Among males, the regular smoking initiation rate was significantly higher compared to females (52.4% vs. 18.5%; p<0.001). Mean age of smoking initiation was lower in men compared to women (18.4±4.8 vs. 21.5±6.8; p<0.001). Age in men, awareness of environmental tobacco smoke consequences and place of living for women as well as educational attainment and employment status in both genders were associated with ever regular smoking. Moreover, cohabitation with a smoker was associated with greater odds for initiating smoking among both genders. CONCLUSIONS GATS revealed a significant but diverse role of socioeconomic factors in initiation of regular smoking among adult Romanians.
Collapse
Affiliation(s)
- Dorota Kaleta
- Tobacco Control Department, Department of Preventive Medicine, Medical University of Łódź, Łódź, Poland
| | - Bukola Usidame
- Department of Public Policy, University of Massachusetts, Boston, United States
| | | | - Teresa Makowiec-Dąbrowska
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Łódź, Poland
| |
Collapse
|
33
|
Cambois E. [Social inequalities in health less pronounced in women than in men: A question of measurements?]. Rev Epidemiol Sante Publique 2016; 64 Suppl 2:S75-85. [PMID: 27038907 DOI: 10.1016/j.respe.2016.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Social inequalities in mortality are generally less pronounced for women than for men. Are women's health risks and behaviours more homogeneous, or does this pattern arise from a measurement issue inducing an under-estimation of these inequalities? This article reviews a number of studies covering different dimensions of health and different dimensions of social status. Their findings show that there are large social inequalities in health among women. The focus on the working careers, family histories and conciliation of multiple activities provides evidence of major social determinants of health to which women are widely exposed. This article highlights the need to broaden the notion of social inequality and to redefine the social categories, notably by considering the distinct trajectories of men and women and their different spheres of activity. It highlights that gender differences in health are themselves partly socially constructed, as suggested by the gender approaches in the social sciences.
Collapse
Affiliation(s)
- E Cambois
- Institut national d'études démographiques, 133, boulevard Davout, 75020 Paris, France.
| |
Collapse
|
34
|
Educational inequalities in smoking over the life cycle: an analysis by cohort and gender. Int J Public Health 2015; 61:101-109. [DOI: 10.1007/s00038-015-0731-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 11/26/2022] Open
|
35
|
Hovdestad W, Campeau A, Potter D, Tonmyr L. A systematic review of childhood maltreatment assessments in population-representative surveys since 1990. PLoS One 2015; 10:e0123366. [PMID: 25993481 PMCID: PMC4436275 DOI: 10.1371/journal.pone.0123366] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 02/22/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Population-representative surveys that assess childhood maltreatment and health are a valuable resource to explore the implications of child maltreatment for population health. Systematic identification and evaluation of such surveys is needed to facilitate optimal use of their data and to inform future research. OBJECTIVES To inform researchers of the existence and nature of population-representative surveys relevant to understanding links between childhood maltreatment and health; to evaluate the assessment of childhood maltreatment in this body of work. METHODS We included surveys that: 1) were representative of the non-institutionalized population of any size nation or of any geopolitical region ≥ 10 million people; 2) included a broad age range (≥ 40 years); 3) measured health; 4) assessed childhood maltreatment retrospectively; and 5) were conducted since 1990. We used Internet and database searching (including CINAHL, Embase, ERIC, Global Health, MEDLINE, PsycINFO, Scopus, Social Policy and Practice: January 1990 to March 2014), expert consultation, and other means to identify surveys and associated documentation. Translations of non-English survey content were verified by fluent readers of survey languages. We developed checklists to abstract and evaluate childhood maltreatment content. RESULTS Fifty-four surveys from 39 countries met inclusion criteria. Sample sizes ranged from 1,287-51,945 and response rates from 15%-96%. Thirteen surveys assessed neglect, 15 emotional abuse; 18 exposure to family violence; 26 physical abuse; 48 sexual abuse. Fourteen surveys assessed more than three types; six of these were conducted since 2010. In nine surveys childhood maltreatment assessments were detailed (+10 items for at least one type of maltreatment). Seven surveys' assessments had known reliability and/or validity. CONCLUSIONS AND IMPLICATIONS Data from 54 surveys can be used to explore the population health relevance of child maltreatment. Assessment of childhood maltreatment is not comprehensive but there is evidence of recent improvement.
Collapse
Affiliation(s)
- Wendy Hovdestad
- Public Health Agency of Canada, Government of Canada, Ottawa, Canada
| | | | | | - Lil Tonmyr
- Public Health Agency of Canada, Government of Canada, Ottawa, Canada
| |
Collapse
|
36
|
Bosdriesz JR, Willemsen MC, Stronks K, Kunst AE. Socioeconomic inequalities in smoking cessation in 11 European countries from 1987 to 2012. J Epidemiol Community Health 2015; 69:886-92. [PMID: 25841241 DOI: 10.1136/jech-2014-205171] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/13/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND During the 1990s, inequalities in smoking prevalence by socioeconomic status (SES) have widened in Europe. Since then, many tobacco control policies have been implemented. Yet, European overviews of recent trends in smoking inequalities are lacking. This paper aims to provide an overview of long-term trends of socioeconomic inequalities in smoking cessation in Europe. METHODS We used data for 11 countries taken from Eurobarometer surveys from 1987 to 1995 and 2002-2012, with a total study sample of 63 737 respondents. We performed multilevel logistic regression to model associations of the quit ratio (proportion former smokers of ever smokers) with SES, measured by education and occupation separately, with adjustments for age, sex and time. RESULTS We found a significant, positive association for education and occupation with the quit ratio. The strength of the association decreased slightly from 1987 to 1995 and increased again from 2002 to 2012. Inequalities increased between the two periods in most countries and decreased in only one country. While in 1987-1995, the quit ratio increased among all SES groups and most strongly among the low SES group, in 2002-2012 it increased only among the high-education group (OR=1.38, 95% CI 1.02 to 1.87), and non-manual occupation group (OR=1.59, 95% CI 1.19 to 2.12). CONCLUSIONS Socioeconomic inequalities in smoking cessation rates have strongly increased since the 1990s and during the 2000s. This suggests that the tobacco control policies implemented during the 2000s have not been able to counter the trend in increasing inequalities.
Collapse
Affiliation(s)
- Jizzo R Bosdriesz
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands Alliance Smokefree Holland, The Hague, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
37
|
Legleye S, Piontek D, Pampel F, Goffette C, Khlat M, Kraus L. Is there a cannabis epidemic model? Evidence from France, Germany and USA. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 25:1103-12. [DOI: 10.1016/j.drugpo.2014.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/30/2014] [Accepted: 07/02/2014] [Indexed: 11/16/2022]
|
38
|
Peretti-Watel P, Seror V, Verger P, Guignard R, Legleye S, Beck F. Smokers' risk perception, socioeconomic status and source of information on cancer. Addict Behav 2014; 39:1304-10. [PMID: 24836161 DOI: 10.1016/j.addbeh.2014.04.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 04/03/2014] [Accepted: 04/10/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND In many countries, the decline in smoking prevalence has coincided with a growing concentration of smoking among people with lower socioeconomic status (SES). This concentration may reflect the social differentiation of risk perceptions. We investigated the factors associated with risk perception and fear of cancer, paying particular attention to SES indicators and health information seeking. METHODOLOGY A cross-sectional telephone survey conducted in France in 2010 (including 826 current smokers aged 18-75) assessing how smokers perceive the risk of smoking-related cancer in terms of daily consumption and duration thresholds. RESULTS Among current smokers, 38% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 22% stated that tobacco-related cancer risk only becomes high for a longer smoking duration than their personal one. Predictors of such risk perceptions included low SES, material deprivation and mentioning either the internet or their relatives as one's main source of information on cancer. The same characteristics were also predictive of personal fear of tobacco-related cancer. CONCLUSION Our results illustrate the challenges faced by prevention campaigns in the internet society, as information found on the web may fuel smokers' risk denial. Anti-tobacco policies should tailor interventions to people with low SES, who may be especially impervious to standard prevention campaigns because of material deprivation, and they should also address and challenge smokers' risk denial beliefs.
Collapse
Affiliation(s)
- Patrick Peretti-Watel
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France.
| | - Valérie Seror
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France
| | - Pierre Verger
- INSERM, UMR912 "Economics and Social Sciences Applied to Health & Analysis of Medical Information" (SESSTIM), 13006 Marseille, France; Aix Marseille University, UMR_S912, IRD, 13006 Marseille, France; ORS PACA, Southeastern Health Regional Observatory, 13006 Marseille, France
| | - Romain Guignard
- Institut National de Prévention et d'Education pour la Santé (INPES), 93203 St Denis Cedex, France
| | - Stéphane Legleye
- Institut National des études Démographiques (Ined), Paris, France; Inserm, U669, Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France
| | - François Beck
- Institut National de Prévention et d'Education pour la Santé (INPES), 93203 St Denis Cedex, France; Cermes3 - Equipe Cesames (Centre de recherche Médecine, Sciences, Santé, Santé mentale, Société, Université Paris Descartes, Sorbonne Paris Cité/CNRS UMR 8211/Inserm U988/EHESS), Paris Cedex 06, France
| |
Collapse
|
39
|
Pampel F, Legleye S, Goffette C, Piontek D, Kraus L, Khlat M. Cohort changes in educational disparities in smoking: France, Germany and the United States. Soc Sci Med 2014; 127:41-50. [PMID: 25037853 DOI: 10.1016/j.socscimed.2014.06.033] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 05/27/2014] [Accepted: 06/20/2014] [Indexed: 12/21/2022]
Abstract
This study investigates the evolution of educational disparities in smoking uptake across cohorts for men and women in three countries. Nationally representative surveys of adults in France, Germany and the United States in 2009-2010 include retrospective measures of age of uptake that are compared for three cohorts (born 1946-1960, 1961-1975, and 1976-1992). Discrete logistic regressions and a relative measure of education are used to model smoking histories until age 34. The following patterns are found: a strengthening of educational disparities in the timing of uptake from older to younger cohorts; an earlier occurrence of the strengthening for men than women and for the United States than France or Germany; a faster pace of the epidemic in France than in the United States, and; a divide between the highest level of education and the others in the United States, as opposed to a gradient across categories in France. Those differences in smoking disparities across cohorts, genders and countries help identify the national and temporal circumstances that shape the size and direction of the relationship between education and health and the need for policies that target educational disparities.
Collapse
Affiliation(s)
| | - Stephane Legleye
- Institut national d'études démographiques, Paris, France; Inserm U669, Paris, France; University Paris-Sud and University Paris Descartes, UMR-S0669, Paris, France
| | | | | | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany; Centre for Social Research on Alcohol and Drugs, SoRAD, Stockholm University, Stockholm, Sweden
| | - Myriam Khlat
- Institut national d'études démographiques, Paris, France.
| |
Collapse
|
40
|
Coste J, Quinquis L, D'Almeida S, Audureau E. Smoking and health-related quality of life in the general population. Independent relationships and large differences according to patterns and quantity of smoking and to gender. PLoS One 2014; 9:e91562. [PMID: 24637739 PMCID: PMC3956698 DOI: 10.1371/journal.pone.0091562] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/12/2014] [Indexed: 11/23/2022] Open
Abstract
Background Relationships between smoking and health-related quality of life (HRQoL) in the general population remain unclear. Objectives To quantify the independent associations between smoking patterns and HRQoL and to identify any threshold or non-linear tendencies in these associations. Methods A national representative, cross-sectional household survey of the French general non institutionalized population included 7525 men and 8486 women, aged 25–64 year in 2003. Scores on the eight subscales of the Medical Outcomes Study 36-item Short Form were the primary outcomes. Linear regression analyses were used to evaluate the associations between HRQoL and smoking history, quantity of smoking and smoking cessation while controlling for various socio-economic variables, depression, alcohol dependence and pathological conditions. Analyses were conducted in 2013. Results Independent associations between smoking and HRQoL were found, including small positive associations for occasional or light smoking (up to 5 cigarettes per day), and larger and diffuse negative associations above this threshold. Much weaker associations and higher thresholds for negative HRQoL were found for women than for men. For ex-smokers of both genders, HRQoL was found to be better between 2 and 5 years after quitting. Conclusions Smoking was independently related to HRQoL, with large differences according to the pattern and quantity of smoking, and to gender. These results may have considerable relevance both for public health action and care of smokers.
Collapse
Affiliation(s)
- Joël Coste
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France
- Research unit APEMAC, EA 4360, Université Paris-Descartes, Sorbonne Paris Cité, Lorraine Université, Paris, France
- * E-mail:
| | - Laurent Quinquis
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France
| | - Samuel D'Almeida
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France
| | - Etienne Audureau
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris, France
| |
Collapse
|
41
|
Merson F, Perriot J, Underner M, Peiffer G, Fieulaine N. [Smoking cessation and social deprivation]. Rev Mal Respir 2014; 31:916-36. [PMID: 25496789 DOI: 10.1016/j.rmr.2013.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 12/28/2013] [Indexed: 02/05/2023]
Abstract
Smoking is a major of public health policy issue; one in two lifelong smokers will die from a disease related to tobacco use. In France, smoking is responsible for more than 70,000 deaths every year. The benefits linked to stopping smoking include reduced mortality and morbidity related to the use of tobacco. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. Tobacco control needs a better understanding of the determinants of smoking in this population, which are also factors in the failure of cessation attempts. Based on international literature, this review specifies the educational and socioeconomic factors involved in tobacco smoking and in the result of an attempt to quit. Its aim is to propose ways to improve the management of smoking cessation in a socially deprived population.
Collapse
Affiliation(s)
- F Merson
- Dispensaire Emile-Roux, centre d'aide à l'arrêt du tabagisme, centre de lutte antituberculeuse (CLAT 63), 11, rue Vaucanson, 63100 Clermont-Ferrand, France; Laboratoire GRePS, institut de psychologie, université de Lyon-2, 69676 Bron, France.
| | - J Perriot
- Dispensaire Emile-Roux, centre d'aide à l'arrêt du tabagisme, centre de lutte antituberculeuse (CLAT 63), 11, rue Vaucanson, 63100 Clermont-Ferrand, France
| | - M Underner
- Service de pneumologie, unité de tabacologie, centre de lutte antituberculeuse (CLAT 86), CHU de Poitiers, 86021 Poitiers, France
| | - G Peiffer
- Service de pneumologie, unité de tabacologie, CHR de Metz-Thionville, 57038 Metz, France
| | - N Fieulaine
- Laboratoire GRePS, institut de psychologie, université de Lyon-2, 69676 Bron, France
| |
Collapse
|
42
|
Corsi DJ, Boyle MH, Lear SA, Chow CK, Teo KK, Subramanian SV. Trends in smoking in Canada from 1950 to 2011: progression of the tobacco epidemic according to socioeconomic status and geography. Cancer Causes Control 2014; 25:45-57. [PMID: 24158778 DOI: 10.1007/s10552-013-0307-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 10/11/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Smoking has declined in Canada in recent years. However, it is not clear whether differences in current smoking by socioeconomic status have increased, decreased, or remained unchanged in Canada. METHODS We examined rates of current smoking by sex, education, and province from 1950 to 2011. Differences in current smoking, initiation, and cessation were summarized using relative and absolute measures. RESULTS Between 1950 and 2011, the prevalence of current smoking (including daily and non-daily) among adults aged 20 years and older decreased steadily in men from 68.9 % (95 % CI 63.9-73.3) to 18.6 % (14.9-22.1) but in women increased slightly from 38.2 % (32.3-42.2) in 1950 to 39.1 % (36.4-41.2) in 1959 before declining to 15.4 % (11.9-18.9) in 2011. Among men, there was an inverse association between educational attainment and smoking which was consistent from 1950 to 2011. A similar gradient emerged in the mid-1960s in women. Absolute differences in rates of smoking across levels of education increased despite overall declines in smoking across all levels of education. Rates of smoking in women and men were higher in the Atlantic Provinces and Quebec, although in men these differences have declined since the 1990s. In a subset of data from 1999 to 2011, those with lower levels of education had higher levels of smoking initiation and lower levels of cessation. CONCLUSIONS Smoking rates have fallen over time but socioeconomic differences have increased. Smoking prevalence peaked later in lower socioeconomic status (SES) groups, and rates of decline in lower SES groups and certain provinces have been less steep. This suggests that SES gradients emerge rapidly in later stages of the tobacco epidemic and may have increased through greater efficacy of tobacco control policies in reducing smoking among those of higher SES compared to those of lower SES. Tailored approaches may be required to reduce smoking rates in those of lower SES and narrow SES differences.
Collapse
Affiliation(s)
- Daniel J Corsi
- Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, MA, 02138, USA,
| | | | | | | | | | | |
Collapse
|
43
|
Menvielle G, Rey G, Jougla E, Luce D. Diverging trends in educational inequalities in cancer mortality between men and women in the 2000s in France. BMC Public Health 2013; 13:823. [PMID: 24015917 PMCID: PMC3847008 DOI: 10.1186/1471-2458-13-823] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 09/03/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in cancer mortality have been observed in different European countries and the US until the end of the 1990s, with changes over time in the magnitude of these inequalities and contrasted situations between countries. The aim of this study is to estimate relative and absolute educational differences in cancer mortality in France between 1999 and 2007, and to compare these inequalities with those reported during the 1990s. METHODS Data from a representative sample including 1% of the French population were analysed. Educational differences among people aged 30-74 were quantified with hazard ratios and relative indices of inequality (RII) computed using Cox regression models as well as mortality rate difference and population attributable fraction. RESULTS In the period 1999-2007, large relative inequalities were found among men for total cancer and smoking and/or alcohol related cancers mortality (lung, head and neck, oesophagus). Among women, educational differences were reported for total cancer, head and neck and uterus cancer mortality. No association was found between education and breast cancer mortality. Slight educational differences in colorectal cancer mortality were observed in men and women. For most frequent cancers, no change was observed in the magnitude of relative inequalities in mortality between the 1990s and the 2000s, although the RII for lung cancer increased both in men and women. Among women, a large increase in absolute inequalities in mortality was observed for all cancers combined, lung, head and neck and colorectal cancer. In contrast, among men, absolute inequalities in mortality decreased for all smoking and/or alcohol related cancers. CONCLUSION Although social inequalities in cancer mortality are still high among men, an encouraging trend is observed. Among women though, the situation regarding social inequalities is less favourable, mainly due to a health improvement limited to higher educated women. These inequalities may be expected to further increase in future years.
Collapse
Affiliation(s)
- Gwenn Menvielle
- Inserm U1018, Center for Epidemiology and Population Health, Occupational and social determinants of health, Bat 15/16 Hôpital Paul Brousse, 16 ave Paul Vaillant Couturier, Villejuif Cedex 94807, France
- University of Versailles Saint Quentin, UMRS 1018, France
| | | | | | - Danièle Luce
- Inserm U1018, Center for Epidemiology and Population Health, Occupational and social determinants of health, Bat 15/16 Hôpital Paul Brousse, 16 ave Paul Vaillant Couturier, Villejuif Cedex 94807, France
- University of Versailles Saint Quentin, UMRS 1018, France
- Inserm U1085, Irset, Pointe-à-Pitre, Guadeloupe, French West Indies
| |
Collapse
|
44
|
Fidler J, Ferguson SG, Brown J, Stapleton J, West R. How does rate of smoking cessation vary by age, gender and social grade? Findings from a population survey in England. Addiction 2013; 108:1680-5. [PMID: 23668684 DOI: 10.1111/add.12241] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 11/14/2012] [Accepted: 04/30/2013] [Indexed: 11/29/2022]
Abstract
AIMS To assess the incidence of long-term smoking cessation as a function of age, gender, social grade and their interactions. DESIGN AND SETTING Cross-sectional surveys of population representative samples of smokers in England. PARTICIPANTS A total of 24 094 ever smokers (≥21 and ≤60 years of age) participating in household surveys between November 2006 and February 2011. MEASUREMENTS The ratio of long-term (>1 year) ex-smokers to ever-smokers was calculated for each age. Regression analyses were used to model the association between age and quit ratio, with the change in quit ratio by year of age n years versus all years up to n-1 years, yielding an estimate of the quitting incidence at that age. Analyses were conducted for the entire sample and then for the sample stratified by gender and social grade, and interactions assessed between these variables. FINDINGS A cubic trend was needed to fit the data. The estimated quitting incidence between ages 21 and 30 was 1.5% (95% CI: 1.0%-2.0%), between 31 and 50 it was 0.3% (95% CI: 0.2%-0.5%) and between 51 and 60 it was 1.2% (95% CI: 0.7%-1.7%). Age interacted with gender and social grade: women and smokers from higher social grades had a higher incidence of quitting than men and those from lower social grades specifically in young adulthood. CONCLUSIONS : The incidence of smoking cessation in England appears to be greater in young and old adults compared with those in middle age. Women and higher social grade smokers show a greater incidence of quitting than men and those from lower social grades specifically in young adulthood.
Collapse
Affiliation(s)
- Jennifer Fidler
- Department of Epidemiology and Public Health, Cancer Research UK Health Behaviour Research Centre, University College London, London, UK
| | | | | | | | | |
Collapse
|
45
|
Peretti-Watel P. La prévention primaire contribue-t-elle à accroître les inégalités sociales de santé ? Rev Epidemiol Sante Publique 2013; 61 Suppl 3:S158-62. [DOI: 10.1016/j.respe.2013.05.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/28/2013] [Indexed: 11/27/2022] Open
|
46
|
Jusot F, Khlat M. The role of time and risk preferences in smoking inequalities: a population-based study. Addict Behav 2013; 38:2167-73. [PMID: 23454881 DOI: 10.1016/j.addbeh.2012.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 12/10/2012] [Accepted: 12/16/2012] [Indexed: 10/27/2022]
Abstract
Heterogeneity in time and risk preferences has been proposed as one of the mechanisms involved in the educational gradient in smoking, but this mechanism has scarcely been explored empirically. Subjective scales were introduced in the 2008 French National Health, Health Care and Insurance Survey in order to elicit measures of time and risk preferences for a representative sample of 5188 men and 5684 women. Men and women were treated separately. First, logistic regressions were used to test the associations between preferences and education and between preferences and smoking. Second, nested logistic models were built to investigate the mediating role of preferences in the educational gradient in smoking, with an econometric treatment of the rescaling problem. Preference for the present and risk loving were found to be: inversely related to educational level; strongly related to each other, and; strongly associated to current smoking, even after adjustment for educational level. There was a weakening of the educational gradient after the control for preferences, which supports the role of these two preferences as partial mediators in the educational gradient in smoking. Among men, time preference was more strongly associated with smoking than risk aversion, while the reverse was found for women. We provide convincing evidence in favour of the mediating role of time preference and risk aversion in educational inequalities in smoking and highlight the connection between those two dimensions. Gender patterns are discussed and potential implications in terms of designing targeted anti-tobacco programmes are delineated.
Collapse
|
47
|
Cambois E, Blachier A, Robine JM. Aging and health in France: an unexpected expansion of disability in mid-adulthood over recent years. Eur J Public Health 2012; 23:575-81. [PMID: 23042230 DOI: 10.1093/eurpub/cks136] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The study presents new disability-free life expectancies (DFLE) estimates for France and discusses recent trends in the framework of the three 'health and aging' theories of compression, dynamic equilibrium and expansion of disability. The objectives are to update information for France and to compare two methods to analyse recent trends. METHODS DFLE at ages 50, 65 and in the 50-65 age group are computed for several disability dimensions, using data from five French surveys over the 2000s. Owing to scarce time series, we used two methods to assess trends and consolidate our conclusions: (i) decomposition of the DFLE changes using the available time series; (ii) linear regression using all the available estimates, classified by disability dimensions. RESULTS Trends in DFLE65 prolonged the dynamic equilibrium of the previous decades: increasing life expectancy with functional limitations but not with activity restrictions. Meanwhile, partial DFLE50-65 has decreased for various disability dimensions, including some activity restrictions, especially for women. CONCLUSION France has recently experienced an unexpected expansion of disability in mid-adulthood while it is still on a trend of dynamic equilibrium at older ages. The study highlights the importance of monitoring trends in DFLE for various disability dimensions and broadens the scope of interest to the mid-adulthood.
Collapse
Affiliation(s)
- Emmanuelle Cambois
- Institut National d'Études Démographiques, Mortality, health and epidemiology, Paris, France.
| | | | | |
Collapse
|
48
|
Bacigalupe A, Esnaola S, Martín U, Borrell C. Two decades of inequalities in smoking prevalence, initiation and cessation in a southern European region: 1986-2007. Eur J Public Health 2012; 23:552-8. [PMID: 22874737 DOI: 10.1093/eurpub/cks104] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The smoking epidemic is still progressing in southern Europe. We aimed to analyse the magnitude and trend of social inequalities in smoking prevalence, initiation and cessation in the Basque Country, a southern European region, from 1986 to 2007, determining the patterns by sex and age. METHODS This was a cross-sectional time trend study on the population aged >24 years using the Basque Country Health Surveys of 1986, 1992, 1997, 2002 and 2007. Age-adjusted prevalence of current and ever smoking and cessation were calculated, as were relative index of inequality and population-attributable risk by occupational social class and educational level. Relative risk of starting smoking was estimated using Cox proportional hazard regression models. Calculations were performed separately by sex and for two age groups (25-44 years and >44 years). RESULTS Men and young women in the Basque Country have evolved towards the last stage of the epidemic, with an increasing concentration of smoking in disadvantaged groups, by educational level, especially among the youngest population. In older women, smoking continues rising, especially among higher socio-economic groups, though differences between groups are diminishing. The role of initiation and cessation inequalities as determinants of smoking inequalities differed considerably by age and sex. CONCLUSION Inequalities in smoking prevalence widened from 1986 to 2007 in the Basque Country, especially among the youngest population. The changing pattern of these inequalities and the different roles of initiation and cessation dynamics need to be taken into account to improve the results of tobacco control policies and their effect on smoking inequalities.
Collapse
Affiliation(s)
- Amaia Bacigalupe
- Health Studies and Research Unit, Department of Health and Consumer Affairs, Basque Government, Vitoria-Gasteiz, Spain.
| | | | | | | |
Collapse
|
49
|
Turrell G, Hewitt BA, Miller SA. The influence of neighbourhood disadvantage on smoking cessation and its contribution to inequalities in smoking status. Drug Alcohol Rev 2012; 31:645-52. [PMID: 22507105 DOI: 10.1111/j.1465-3362.2012.00452.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Individual smokers from disadvantaged backgrounds are less likely to quit, which contributes to widening inequalities in smoking. Residents of disadvantaged neighbourhoods are more likely to smoke, and neighbourhood inequalities in smoking may also be widening because of neighbourhood differences in rates of cessation. This study examined the association between neighbourhood disadvantage and smoking cessation and its relationship with neighbourhood inequalities in smoking. DESIGN AND METHODS A multilevel longitudinal study of mid-aged (40-67 years) residents (n = 6915) of Brisbane, Australia, who lived in the same neighbourhoods (n = 200) in 2007 and 2009. Neighbourhood inequalities in cessation and smoking were analysed using multilevel logistic regression and Markov chain Monte Carlo simulation. RESULTS After adjustment for individual-level socioeconomic factors, the probability of quitting smoking between 2007 and 2009 was lower for residents of disadvantaged neighbourhoods (9.0-12.8%) than their counterparts in more advantaged neighbourhoods (20.7-22.5%). These inequalities in cessation manifested in widening inequalities in smoking: in 2007 the between-neighbourhood variance in rates of smoking was 0.242 (P ≤ 0.001) and in 2009 it was 0.260 (P ≤ 0.001). In 2007, residents of the most disadvantaged neighbourhoods were 88% (OR 1.88, 95% credible intervals (CrI) 1.41-2.49) more likely to smoke than residents in the least disadvantaged neighbourhoods: the corresponding difference in 2009 was 98% (OR 1.98, 95% CrI 1.48-2.66). CONCLUSION Fundamentally, social and economic inequalities at the neighbourhood and individual levels cause smoking and cessation inequalities. Reducing these inequalities will require comprehensive, well-funded and targeted tobacco control efforts and equity-based policies that address the social and economic determinants of smoking.
Collapse
Affiliation(s)
- Gavin Turrell
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia.
| | | | | |
Collapse
|
50
|
Kim YN, Cho YG, Kim CH, Kang JH, Park HA, Kim KW, Hur YI, Lee SH, Na YM, Park NY. Socioeconomic Indicators Associated with Initiation and Cessation of Smoking among Women in Seoul. Korean J Fam Med 2012; 33:1-8. [PMID: 22745882 PMCID: PMC3383246 DOI: 10.4082/kjfm.2012.33.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 01/12/2012] [Indexed: 11/30/2022] Open
Abstract
Background While smoking prevalence in Korean men has been decreasing, it is increasing in Korean women. Little is known about women's smoking inequalities in Korea. This study was conducted to investigate the association of socioeconomic indicators with the initiation and cessation of smoking among Korean women. Methods This was a cross-sectional study on 9,089 women aged 25-64 years from the 2008 Seoul Community Health Survey. The data on smoking and socioeconomic status were obtained through face-to-face interviews. Smoking initiation rate was defined as the proportion of the individuals who had started smoking at least one cigarette among all subjects. Smoking cessation rate was calculated by dividing the number of individuals who had quit smoking by the number of ever smokers. Education level, total family income and occupation were investigated as socioeconomic indicators. Results Education level was significantly associated with both initiation and cessation of smoking. Lower educated women had a higher likelihood of smoking initiation (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.17 to 2.51) but lower likelihood of smoking cessation (OR, 0.38; 95% CI, 0.22 to 0.66) than higher educated women. Smoking initiation rate was higher in manual workers (OR, 1.65; 95% CI, 1.20 to 2.27) than in non-manual workers. However, there were no significant differences of both initiation and cessation of smoking according to total household income. Conclusion This study shows that there are smoking inequalities among Korean women. It is thought that education level and occupation are important determinants of women's smoking status.
Collapse
Affiliation(s)
- Yu-Na Kim
- Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | |
Collapse
|