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Alves J, Perelman J, Ramos E, Kunst AE. The emergence of socioeconomic inequalities in smoking during adolescence and early adulthood. BMC Public Health 2023; 23:1382. [PMID: 37464370 DOI: 10.1186/s12889-023-16182-w] [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: 01/26/2023] [Accepted: 06/23/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND While it is known that educational inequalities in smoking start during early and middle adolescence, it is unknown how they further develop until adulthood. The aim of this article is to map, in the Portuguese context, how educational inequalities in smoking emerge from pre-adolescence until young adulthood. METHODS This study used longitudinal data from the EPITeen Cohort, which recruited adolescents enrolled in schools in Porto, Portugal. We included the 1,038 participants followed at ages 13 (2003/2004), 17, 21, and 24 years. We computed the odds ratio (OR) for the prevalence of smoking states (never smoking, experimenter, less-than-daily, daily and former smoker) and the incidence of transitions between these states, as function of age and education, stratified by sex. We also added interaction terms between age and education. RESULTS Educational inequalities in daily smoking prevalence, with higher prevalence among those with lower educational level, emerged at 17 years old and persisted until higher ages. They were formed in a cumulative way by the increased risk of experimenting between 13 and 17 years, and increased risk of becoming daily smoker between 17 and 21 years. The incidence of smoking cessation was higher among the higher educated. Inequalities were formed similarly for women and men, but with lower level and showed no significance among women. CONCLUSIONS These results highlight that actions to prevent smoking should also take in account the potential impact in smoking inequalities, and should focus not only on middle adolescence but also on late adolescence and early adulthood.
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Affiliation(s)
- Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Avenida Padre Cruz, Lisbon, 1600-560, Portugal.
| | - Julian Perelman
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Avenida Padre Cruz, Lisbon, 1600-560, Portugal
| | - Elisabete Ramos
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto, 4200-319, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Rua das Taipas 135, Porto, 4050-091, Portugal
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
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2
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Ogbodo SC, Onyekwum CA. Social determinants of health, religiosity, and tobacco use in sub-Saharan Africa: evidence from the global adult tobacco surveys in seven countries. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01882-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
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3
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Penfornis KM, Gebhardt WA, Rippe RCA, Van Laar C, van den Putte B, Meijer E. My future-self has (not) quit smoking: An experimental study into the effect of a future-self intervention on smoking-related self-identity constructs. Soc Sci Med 2023; 320:115667. [PMID: 36641885 DOI: 10.1016/j.socscimed.2023.115667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 11/28/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Envisioning one's (non)smoking future may make (un)desired future identities more accessible, salient, and personally relevant and facilitate smoking cessation. The current study assessed whether a future-self intervention can weaken smoker self-identity and expected identity loss when quitting smoking, and strengthen quitter- and nonsmoker self-identity, while accounting for personal factors-socioeconomic position, nicotine dependence, consideration of future consequences, and clarity of the envisioned future-self. Additionally, it examined the association between smoking-related identity and quitting intention and behavior. METHODS This longitudinal online experimental study randomized 233 adult smokers to an intervention condition (where they completed mental imagery, visual, and verbal tasks about a future (non)smoking self), or to a passive control condition. Smoker-, quitter-, nonsmoker self-identity and identity loss were measured post-intervention and after one- and three-months. Quit intention and attempts were measured at baseline and after one month. RESULTS There was a consistent increase in non-smoker self-identity, and decrease in smoker self-identity and identity loss over a period of six months for all participants, but no significant difference in smoking-related identity between the intervention and control group. While personal factors did not moderate the effect of the intervention, we found that smoking-related identity constructs do vary with nicotine dependence, consideration of future consequences, and clarity of the envisioned future-self. Quitting behavior is primarily associated with non-smoker self-identity. CONCLUSIONS Although the future-self intervention did not significantly influence smoking-related identity or behavior, identity-in particular, non-smoker self-identity-is important to consider in smoking cessation interventions. More research is needed to find effective operationalizations for identity-based interventions in the context of smoking.
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Affiliation(s)
- Kristell M Penfornis
- Institute of Psychology, Unit Health-, Medical- and Neuropsychology, Leiden University, Leiden, the Netherlands; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Winifred A Gebhardt
- Institute of Psychology, Unit Health-, Medical- and Neuropsychology, Leiden University, Leiden, the Netherlands
| | - Ralph C A Rippe
- Centre for Child and Family Studies, Leiden University, Leiden, the Netherlands
| | - Colette Van Laar
- Social and Cultural Psychology, University of Leuven, Leuven, Belgium
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, the Netherlands
| | - Eline Meijer
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, the Netherlands
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4
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Kallio A, Suominen A, Tolvanen M, Rantavuori K, Jussila H, Karlsson L, Karlsson H, Lahti S. Concurrent changes in dental anxiety and smoking in parents of the FinnBrain Birth Cohort Study. Eur J Oral Sci 2023; 131:e12912. [PMID: 36599651 PMCID: PMC10107302 DOI: 10.1111/eos.12912] [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: 04/01/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
We evaluated associations between changes in dental anxiety and tobacco use, adjusted for general anxiety and depressive symptoms. The FinnBrain Birth Cohort Study data, collected at gestational weeks 14 and 34 and at 3 months postpartum, were used. Questionnaires included the Modified Dental Anxiety Scale (MDAS), the Edinburgh Postnatal Depression Scale (EPDS), and the anxiety subscale of the Symptom Checklist-90 (SCL). Smoking was categorized as "stable non-smoking", "started smoking", "quit smoking", and "stable smoking". Changes in smoking and dental anxiety were evaluated "during pregnancy" (i.e., from gestational week 14 to gestational week 34) in 2442 women and 1346 men and "after pregnancy" (i.e., from gestational week 34 to 3 months postpartum) in 2008 women and 1095 men. Changes were evaluated in three smoking categories (stable non-smoking, fluctuating, and stable smoking), using data from all three time-points (1979 women and 1049 men). Modeling used repeated measures analysis of covariance. Stable smoking mothers had statistically significantly higher levels of dental anxiety (mean MDAS 12.3-12.6) than non-smoking mothers (mean MDAS 10.1-10.7) or mothers who smoked at some point during pregnancy (mean MDAS 10.8-11.5). A similar tendency was observed in fathers. However, no systematic change in dental anxiety by changes in smoking habits was observed. Those smoking during pregnancy and with high dental anxiety may need special support for smoking cessation.
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Affiliation(s)
- Anu Kallio
- Department of Community Dentistry, University of Turku, Turku, Finland.,City of Turku, Welfare Services Division, Oral and Dental Health Care, Turku, Finland
| | - Auli Suominen
- Department of Community Dentistry, University of Turku, Turku, Finland
| | - Mimmi Tolvanen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Kari Rantavuori
- Department of Oral Development and Orthodontics, University of Turku, Turku, Finland.,Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Heidi Jussila
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
| | - Satu Lahti
- Department of Community Dentistry, University of Turku, Turku, Finland.,FinnBrain Birth Cohort Study, Department of Clinical Medicine, Brain and Mind Center, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland
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5
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Nguyen CV, Le TT, Nguyen NH, Hoang KT. Socioeconomic inequality in smoking: Evidence from a decomposition analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2022.101213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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6
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Wu H, Yang J, Wang H, Li L. Mendelian randomization to explore the direct or mediating associations between socioeconomic status and lung cancer. Front Oncol 2023; 13:1143059. [PMID: 37207156 PMCID: PMC10189779 DOI: 10.3389/fonc.2023.1143059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
Objective The purpose of this study was to verify whether there are direct or mediated causal associations between socioeconomic status and lung cancer. Methods Pooled statistics were obtained from corresponding genome-wide association studies. The inverse-variance weighted, weighted median, MR-Egger, MR-PRESSO and contamination-mixture methods were used as supplements to Mendelian randomization (MR) statistical analysis. Cochrane's Q value and the MR-Egger intercept were used for sensitivity analysis. Results In the univariate MR analysis, household income and education had protective effects on overall lung cancer (income: P = 5.46×10-4; education: P = 4.79×10-7) and squamous cell lung cancer (income: P = 2.67×10-3; education: P = 1.42×10-10). Smoking and BMI had adverse effects on overall lung cancer (smoking: P = 2.10×10-7; BMI: P = 5.67×10-4) and squamous cell lung cancer (smoking: P = 5.02×10-6; BMI: P = 2.03×10-7). Multivariate MR analysis found that smoking and education were independent risk factors for overall lung cancer (smoking: P = 1.96×10-7; education: P = 3.11×10-3), while smoking was an independent risk factor for squamous cell lung cancer (P = 2.35×10-6). Smoking, education, and household income mediate the effect of BMI on overall lung cancer (smoking 50.0%, education 49.2%, income 25.3%) and squamous cell lung cancer (smoking 34.8%, education 30.8%, income 21.2%). Smoking, education, and BMI mediate the effect of income on overall lung cancer (smoking 13.9%, education 54.8%, BMI 9.4%) and squamous cell lung cancer (smoking 12.6%, education 63.3%, BMI 11.6%). Smoking, BMI, and income mediate the effect of education on squamous cell lung cancer (smoking 24.0%, BMI 6.2%, income 19.4%). Conclusion Income, education, BMI, and smoking are causally associated with both overall lung cancer and squamous cell lung cancer. Smoking and education are independent association factors for overall lung cancer, while smoking is an independent association factor for squamous cell lung cancer. Smoking and education also play important mediating roles in overall lung cancer and squamous cell lung cancer. No causal relationship was found between multiple risk factors associated with socioeconomic status and lung adenocarcinoma.
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Affiliation(s)
- Hong Wu
- Department of Oncology, Binzhou Medical University Hospital, Binzhou, Shandong, China
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Jing Yang
- Department of Oncology, Binzhou Medical University Hospital, Binzhou, Shandong, China
| | - Hui Wang
- Department of Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Lei Li
- Department of Oncology, Binzhou Medical University Hospital, Binzhou, Shandong, China
- *Correspondence: Lei Li,
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7
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Carreras G, Lugo A, Stival C, Amerio A, Odone A, Pacifici R, Gallus S, Gorini G. Impact of COVID-19 lockdown on smoking consumption in a large representative sample of Italian adults. Tob Control 2022; 31:615-622. [PMID: 33782199 PMCID: PMC8008911 DOI: 10.1136/tobaccocontrol-2020-056440] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Italy is one of the first countries that imposed a nationwide stay-at-home order during the COVID-19 outbreak, inevitably resulting in changes in lifestyles and addictive behaviours. The aim of this work is to investigate the impact of lockdown restrictions on smoking habits using data collected within the Lost in Italy project. METHODS A web-based cross-sectional study was conducted on a representative sample of 6003 Italian adults aged 18-74 years. Study subjects were recruited from 27 April to 3 May 2020 and were asked to report changes in smoking habits before the lockdown and at the time of interview. RESULTS During the lockdown, 5.5% of the overall sample quit or reduced smoking, but 9.0% of the sample started, relapsed smoking or increased their smoking intensity. In total, the lockdown increased cigarette consumption by 9.1%. An improvement in smoking habits was associated with younger age, occasional smoking and unemployment, whereas a worsening was mainly associated with mental distress. In particular, an increase in cigarette consumption during lockdown was more frequently reported among those with worsening quality of life (OR: 2.05; 95% CI: 1.49 to 2.80), reduction in sleep quantity (OR: 2.29; 95% CI: 1.71 to 3.07) and increased anxiety (OR: 1.83; 95% CI: 1.38 to 2.43) and depressive symptoms (OR: 2.04; 95% CI: 1.54 to 2.71). CONCLUSIONS COVID-19 lockdown had a huge impact on smoking consumption of the Italian general population. The main concern is for smokers who increase their cigarette consumption due to an increased mental distress. Providing greater resources for cessation services capable of reducing mental health symptoms in smokers is urgently needed.
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Affiliation(s)
- Giulia Carreras
- Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Chiara Stival
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Andrea Amerio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA, USA
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Roma, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), Florence, Italy
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8
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Zijp A, van Deelen TRD, van den Putte B, Kunst AE, Kuipers MAG. Educational inequalities in exposure to tobacco promotion at the point of sale among adolescents in four Dutch cities. Health Place 2022; 76:102824. [PMID: 35660750 DOI: 10.1016/j.healthplace.2022.102824] [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] [Received: 02/03/2022] [Revised: 04/29/2022] [Accepted: 05/12/2022] [Indexed: 11/30/2022]
Abstract
This study aimed to assess educational differences in adolescents' exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08-1.98), especially around school (IRR:2.61,95%CI:1.50-4.55). These differences may contribute to socioeconomic inequalities in smoking.
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Affiliation(s)
- Anne Zijp
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands.
| | - Tessa R D van Deelen
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
| | - Bas van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Nieuwe Achtergracht 166, 1018, WV, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
| | - Mirte A G Kuipers
- Department of Public and Occupational Health, Amsterdam UMC-University of Amsterdam, Meibergdreef 15, 1105, AZ, Amsterdam, the Netherlands
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9
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Educational Gradients in Drinking Amount and Heavy Episodic Drinking among Working-Age Men and Women in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074371. [PMID: 35410052 PMCID: PMC8998990 DOI: 10.3390/ijerph19074371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 02/04/2023]
Abstract
Alcohol-related harm decreases as socioeconomic position increases, although sometimes the opposite happens with alcohol intake. The objective was to know the educational gradient in monthly measures of drinking amount and heavy episodic drinking (HED) among people aged 25−64 years in Spain from 1997−2017. Such gradient was characterized with the relative percent change (PC) in drinking measures per year of education from generalized linear regression models after adjusting for age, year, region, marital status and immigration status. Among men, the PCs were significantly positive (p < 0.05) for prevalence of <21 g alcohol/day (2.9%) and 1−3 HED days (1.4%), and they were negative for prevalences of 21−40 g/day (−1.1%), >40 g/day (−6.0%) and ≥4 HED days (−3.2%), while among women they ranged from 3.6% to 5.7%. The gradient in prevalences of >40 g/day (men) and >20 g/day (women) was greatly attenuated after additionally adjusting for HED, while that of ≥4 HED days was only slightly attenuated after additionally adjusting for drinking amount. Among women, the gradients, especially in HED measures, seem steeper in 2009−2017 than in 1997−2007. Educational inequality remained after additional adjustment for income and occupation, although it decreased among women. These results can guide preventive interventions and help explain socioeconomic inequalities in alcohol-related harm.
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Gagné T, Schoon I, Sacker A. Has the distribution of smoking across young adult transition milestones changed over the past 20 years? Evidence from the 1970 British Cohort Study (1996) and Next Steps (2015-16). SSM Popul Health 2021; 16:100941. [PMID: 34712769 PMCID: PMC8529167 DOI: 10.1016/j.ssmph.2021.100941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Transitions into work and family life during young adulthood exacerbate differences in the progression of smoking over the life-course. Few have considered how changes in smoking and the transition to adulthood in the past two decades have influenced these relationships over time. Methods We compared the distribution of smoking at ages 25–26 across transition milestones among 3764 men and 4568 women in the 1970 British Cohort study (1996) and 3426 men and 4281 women in the Next Steps study (2015–16). We regressed occasional and daily smoking status on educational attainment, economic activity, living arrangements, relationship status, and parenthood, adjusting for family background, socio-demographics, and smoking history. Results There were few differences in associations between the 1996 and 2015-16 samples. Young men and women were less likely to smoke if they had higher education, were homeowners, and cohabited with a partner. Women were less likely to smoke occasionally if they were full-time students, and men were less likely to smoke daily if they were employed full-time and not living with children. However, comparing associations in 2015–16 to 1996: 1) in men, higher education had a weaker negative association and living with a partner had a stronger negative association with daily smoking; 2) in women, independently renting had a weaker positive association with daily smoking. Conclusions Despite considerable changes in smoking and the transition to adulthood over the past two decades, the distribution of smoking at ages 25–26 across transition milestones has been relatively stable during this time period in Great Britain. Smoking at ages 25–26 was associated with economic activity, living arrangements, relationship status, and parenthood in 1996 and 2015–16. Differences in smoking across transition milestones differed by gender. Differences in smoking did not substantially change between 1996 and 2015–16.
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Affiliation(s)
- T Gagné
- Department of Epidemiology and Public Health, University College London, UK.,International Centre for Lifecourse Studies in Society and Health, UK
| | - I Schoon
- Institute of Education, University College London, UK
| | - A Sacker
- Department of Epidemiology and Public Health, University College London, UK.,International Centre for Lifecourse Studies in Society and Health, UK
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11
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García-Mayor J, Moreno-Llamas A, la Cruz-Sánchez ED. High educational attainment redresses the effect of occupational social class on health-related lifestyle: findings from four Spanish national health surveys. Ann Epidemiol 2021; 58:29-37. [PMID: 33640485 DOI: 10.1016/j.annepidem.2021.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/26/2020] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Social determinants as occupational social class or educational attainment might influence health outcomes. This phenomenon is known as the social gradient of health and is related to a skewed distribution of health behaviours that might explain differences in morbidity and mortality between social groups. But social class and educational attainment differ in their nature and might have distinct effects on health. Here we study the combined effect of educational attainment and occupational social class on health-related lifestyle. METHODS We retrieved data from four large-scale, national representative Spanish surveys (n = 67,171). A latent class regression analysis was run to identify clusters of health-related lifestyle behaviours. Clusters were made according to sociodemographic factors, including a combined analysis of education and occupational social class. RESULTS Higher educational attainment and occupational social class were associated with a healthier lifestyle for both sexes. The combined analysis of education and social class indicated that women with secondary education showed a high risk combination of unhealthy behaviours, as men with middle, primary or no education. CONCLUSIONS Regardless of social class, a higher educational attainment redresses the effect of occupational social class on health-related behaviours. Our results suggest that education likely plays a crucial role in population health outcomes through its effects on lifestyle.
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12
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Alali WQ, Longenecker JC, Alwotyan R, AlKandari H, Al-Mulla F, Al Duwairi Q. Prevalence of smoking in the Kuwaiti adult population in 2014: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10053-10067. [PMID: 33161520 PMCID: PMC7648895 DOI: 10.1007/s11356-020-11464-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/28/2020] [Indexed: 05/06/2023]
Abstract
The study objective was to assess tobacco smoking prevalence in Kuwaiti adults in relation to sociodemographic characteristics. A cross-sectional study survey was conducted in 2014 on 3917 Kuwaiti citizens (18-69 years) following the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) methodology. The study assessed prevalence of self-reported ever-smoking or currently smoking tobacco products and exposure to secondhand smoke in relation to demographic and smoking-related characteristics. The prevalence of "ever smoker" in men and women was 49.9% and 4.4%, respectively, whereas the prevalence of "current smoker" was 39.2% and 3.3%, respectively. Sex (adjusted OR [AOR], 19.2 [95% confidence interval (CI) 13.0-28.3], male versus female) was significantly associated with current smoking. Among daily smokers, 87.1% used manufactured cigarettes. The average daily number of manufactured cigarettes for men and women was 21.8 and 13.0, respectively. Mean age at smoking initiation was 17.5 years (95% CI 17.2-17.9). The prevalence of secondhand smoke at home and work was 38.6% and 29.9%, respectively. Half of Kuwaiti men have smoked at some point in their life with most of these being current smokers. Secondhand smoke is a common exposure at home and work, posing serious health risks to the population.
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Affiliation(s)
- Walid Q Alali
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kuwait University, Safat, Kuwait.
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait.
| | - Joseph C Longenecker
- Faculty of Medicine and Faculty of Public Health, Kuwait University, Safat, Kuwait
| | - Rehab Alwotyan
- Primary Health Care Department, Ministry of Health, Kuwait City, Kuwait
| | - Hessa AlKandari
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Pediatrics, Ministry of Health, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Qais Al Duwairi
- Department of Population Health, Dasman Diabetes Institute, Kuwait City, Kuwait
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13
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Prenatal Stress and Early Childhood Body Mass Index: A Path Analysis Approach. Matern Child Health J 2021; 25:439-449. [PMID: 33502673 DOI: 10.1007/s10995-020-03060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Stress experienced by mothers during the prenatal period can have negative impacts on offspring development. Elevated BMI in childhood in response to early stress experience is a particularly critical outcome of interest since high BMI in childhood is associated with diabetes, heart disease and stroke in later life. The primary objective of this study was to analyze pathways between prenatal stress and early childhood BMI at 54-months of age and to begin to explore ethnic variations in these pathways. METHODS This study used the Growing Up in New Zealand (GUiNZ) dataset, which is a longitudinal, representative birth cohort study that began with recruiting pregnant women in 2009 and 2010 in Auckland, New Zealand. Path analysis modeling was used to explore risk and protective pathways between prenatal maternal stress and early childhood body mass index (BMI) at 54-months of age and differences by ethnicity (n = 5510). RESULTS Prenatal stress was positively associated with early childhood BMI at 54-months and maternal nutrition behaviors and length of exclusive breastfeeding mediated this direct relationship (χ2 (1) = 0.83, p = 0.36; AIC = 50,496). Mediation and moderation paths varied by ethnicity. CONCLUSIONS FOR PRACTICE These findings contribute to the understanding of the intergenerational transmission of stress with respect to early childhood obesity. Reducing early stress exposure and/or addressing mediating and moderating factors linking stress experience with obesity development may prove to be more effective than attempting to alter health behaviors and trajectories in adulthood.
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Watanapongvanich S, Khan MSR, Putthinun P, Ono S, Kadoya Y. Financial Literacy, Financial Education, and Smoking Behavior: Evidence From Japan. Front Public Health 2021; 8:612976. [PMID: 33520921 PMCID: PMC7844398 DOI: 10.3389/fpubh.2020.612976] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/08/2020] [Indexed: 11/17/2022] Open
Abstract
In this study, we examine the relationship between financial literacy, financial education, and smoking behavior among the Japanese population. We hypothesize that financially literate and financially educated people, who have the ability to make more rational decisions, are less likely to smoke. Using the Preference Parameters Study of Osaka University, conducted in 2010 (N = 3,706), the probit regression results show that both financial literacy (with an emphasis on knowledge of investments) and financial education (with an emphasis on savings behavior) have a significant negative impact on smoking behavior. In addition, gender, age, education, marital status, household income and assets, risky behaviors, a myopic view of the future, risk preference, and level of happiness also significantly predict the likelihood of a person being a current smoker. This study provides empirical evidence that enhancing the rational decision-making ability of individuals through financial literacy and financial education may curtail smoking behavior.
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Mlinarić M, Günther S, Moor I, Winter K, Hoffmann L, Richter M. [The association between school tobacco policies and the perceived smoking prevalence of adolescents]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:91-101. [PMID: 33284361 PMCID: PMC7772164 DOI: 10.1007/s00103-020-03261-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the German context, there is hardly any quantitative data about the implementation of school tobacco polices that include the perspective of both teachers and students. The aim of the study is to investigate the associations between implemented school tobacco policies and the perceived prevalence of smoking at the level of school staff and adolescents. METHODS The repeated cross-sectional study (2013 and 2017) is based on pooled responses of 13- to 17-year-old adolescents (N = 2393) and school staff (N = 85) from 25 schools located in the West German metropolitan region of Hanover. In linear regression models, average marginal effects (AMEs) with 95% confidence intervals (CI95%) and robust standard errors for perceived tobacco prevalence are reported separately for school tobacco policies assessed by teachers and students (scale 0-6). All models were controlled for sociodemographic, school-, and smoking-specific covariates. RESULTS On average, adolescents perceive a smoking prevalence of 30% ([Formula: see text]; s: 24.0) for their school. A comprehensive school tobacco policy is consistently associated with lower school smoking prevalence both from the point of view of teachers (AME: -3.54 CI95% -6.49 to -0.58) and students (AME: -1.69 CI95% -2.52 to -0.86). The number of smoking friends (e.g., "most of them are smokers" +14%: AME: 14.13 CI95% 10.46 to 17.80) and the type of school are the most relevant determinants of a high school smoking prevalence. School types with a nonacademic track report a 15% (AME: 15.03 CI95% 10.13 to 19.93) higher prevalence compared to grammar schools. DISCUSSION Progressive school tobacco control policies should focus more on school types with nonacademic tracks, certain groups at risk, and those schools that do not strictly enforce school tobacco policies.
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Affiliation(s)
- Martin Mlinarić
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland.
| | - Sebastian Günther
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Irene Moor
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Kristina Winter
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Laura Hoffmann
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
| | - Matthias Richter
- Institut für Medizinische Soziologie, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Deutschland
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Tönnies T, Pohlabeln H, Eichler M, Zeeb H, Brand T. Relative and absolute socioeconomic inequality in smoking: time trends in Germany from 1995 to 2013. Ann Epidemiol 2020; 53:89-94.e2. [PMID: 32920099 DOI: 10.1016/j.annepidem.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/24/2020] [Accepted: 09/01/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE This study aimed to investigate time trends in relative and absolute socioeconomic inequality in smoking prevalence in Germany using several indicators for socioeconomic position. METHODS We conducted a repeated cross-sectional study using representative samples of the German population aged between 25 and 64 years in 1995, 1999, 2005, 2009, and 2013 (n = 857,264). Socioeconomic position was measured by indicators for income, education, and occupation. Relative and absolute socioeconomic inequalities were estimated with the regression-based relative index of inequality and the slope index of inequality, respectively. Trends in inequalities were estimated with interaction terms for time and relative index of inequality/slope index of inequality. RESULTS Highest and increasing smoking prevalence was observed among long-term unemployed and people with less than 60% of the median household income. Between 1995 and 2013, relative increases in inequalities in smoking prevalence ranged from 31% (95% confidence interval, 26%-36%; men, occupation) to 94% (95% confidence interval, 84%-104%; women, education). Absolute increases ranged from 6.2 (95% confidence interval, 4.7-7.6) percentage points (men, occupation) to 20.3 (95% confidence interval, 18.9-21.7) percentage points (women, education). CONCLUSIONS Relative and absolute socioeconomic inequalities in smoking prevalence increased in Germany between 1995 and 2013, with regard to income, education, and occupation, particularly among women.
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Affiliation(s)
- Thaddäus Tönnies
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
| | - Hermann Pohlabeln
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research, and Epidemiology-BIPS, Bremen, Germany
| | - Martin Eichler
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University of Mainz, Mainz, Germany; Department of Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany; Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Tilman Brand
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
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17
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Pereira AM. Smoking in Portugal: Where do we stand today? Rev Port Cardiol 2019; 38:595-597. [PMID: 31703972 DOI: 10.1016/j.repc.2019.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Ana Margarida Pereira
- CINTESIS, Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Portugal; Allergy Unit, CUF-Porto Instituto & Hospital, Porto, Portugal; MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
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Masud H, Oyebode O. Inequalities in smoking prevalence: a missed opportunity for tobacco control in Pakistan. J Public Health (Oxf) 2019; 40:271-278. [PMID: 28505324 DOI: 10.1093/pubmed/fdx044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/04/2017] [Indexed: 11/14/2022] Open
Abstract
Background Pakistan is one of the highest tobacco consuming countries in South Asia and consumption is increasing. To implement equity orientated tobacco control policies, the most vulnerable groups must be identified. We aimed to identify these groups using the Pakistan Demographic and Health Survey (PDHS) 2012-13. Methods Descriptive statistics, univariate and multivariate analyses were used to explore household and participant characteristics associated with smoking inside the home or tobacco smoking, respectively. Survey weights were used to give nationally representative findings. Results Data for 12 931 households, 3132 men and 13 538 women were examined. About 58.3% of surveyed households were smoke-free, 39.1% were exposed to indoor tobacco smoke every day, 2.6% less frequently. Significantly more rural households were exposed to indoor tobacco smoke than urban households (45.2% versus 34.9%). Of men, 28.3% reported smoking compared with 1.3% of women. Smoking prevalence was higher in older age groups. Increasing wealth was associated with lower smoking prevalence and indoor smoking. For men, but not women, increasing education was associated with reduced smoking. Conclusions Inequalities in smoking behaviour impose harm to those who can least afford the financial and health costs. Future tobacco control policies in Pakistan must be sensitive to gender, geography and socio-economic status.
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Affiliation(s)
- Haleema Masud
- Department of Public Health, Al-Shifa School of Public Health, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
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19
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Pereira AM. Smoking in Portugal: Where do we stand today? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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20
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Moor I, Kuipers MAG, Lorant V, Pförtner TK, Kinnunen JM, Rathmann K, Perelman J, Alves J, Robert PO, Rimpelä A, Kunst AE, Richter M. Inequalities in adolescent self-rated health and smoking in Europe: comparing different indicators of socioeconomic status. J Epidemiol Community Health 2019; 73:963-970. [DOI: 10.1136/jech-2018-211794] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 05/02/2019] [Accepted: 06/27/2019] [Indexed: 11/03/2022]
Abstract
BackgroundAlthough there is evidence for socioeconomic inequalities in health and health behaviour in adolescents, different indicators of socioeconomic status (SES) have rarely been compared within one data sample. We examined associations of five SES indicators with self-rated health (SRH) and smoking (ie, a leading cause of health inequalities) in Europe.MethodsData of adolescents aged 14–17 years old were obtained from the 2013 SILNE survey (smoking inequalities: learning from natural experiments), carried out in 50 schools in 6 European cities (N=10 900). Capturing subjective perceptions of relative SES and objective measures of education and wealth, we measured adolescents’ own SES (academic performance, pocket money), parental SES (parental educational level) and family SES (Family Affluence Scale, subjective social status (SSS)). Logistic regression models with SRH and smoking as dependent variables included all SES indicators, age and gender.ResultsCorrelations between SES indicators were weak to moderate. Low academic performance (OR=1.96, 95% CI 1.53 to 2.51) and low SSS (OR=2.75, 95% CI 2.12 to 3.55) were the strongest indicators of poor SRH after adjusting for other SES-indicators. Results for SSS were consistent across countries, while associations with academic performance varied. Low academic performance (OR=5.71, 95% CI 4.63 to 7.06) and more pocket money (OR=0.21, 95% CI 0.18 to 0.26) were most strongly associated with smoking in all countries.ConclusionsSocioeconomic inequalities in adolescent health were largest according to SES indicators more closely related to the adolescent’s education as well as the adolescent’s perception of relative family SES, rather than objective indicators of parental education and material family affluence. For future studies on adolescent health inequalities, consideration of adolescent-related SES indicators was recommended.
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21
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Gagné T, Quesnel-Vallée A, Frohlich KL. Considering the age-graded nature of associations between socioeconomic characteristics and smoking during the transition towards adulthood. Prev Med 2019; 123:262-269. [PMID: 30935999 DOI: 10.1016/j.ypmed.2019.03.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 03/21/2019] [Accepted: 03/28/2019] [Indexed: 11/25/2022]
Abstract
Young adulthood is a sensitive period characterized by the accumulation of resources and transitions in and out of education, employment, family, and housing arrangements. The association between these characteristics and smoking outcomes likely varies with age yet few studies address its dynamic age-graded nature. To explore this, we examined 2083 young adults ages 18-25 from the 2011-2012 cross-sectional sample of the Montreal-based Interdisciplinary Study of Inequalities in Smoking. We operationalized participants' socioeconomic characteristics using their resources (e.g., education, income, financial difficulties) and transition stages (i.e., studying, working full-time, living arrangements with parents and children, and being in a relationship). We examined differences in these characteristics' associations with occasional and daily smoking across two-year categories (18-19, 20-21, 22-23, and 24-25) using multinomial logistic regression models with age-based interaction terms. Findings highlighted four characteristics, i.e., educational attainment, personal income, student status, and relationship status, with significant differences in associations with smoking outcomes across age categories. Between the age groups of 18-19 and 24-25: 1) the negative association between low educational attainment and daily smoking increased; 2) the positive association between personal income and daily smoking decreased; 3) the negative association between student status and both outcomes decreased; 4) the negative association between relationship status and occasional smoking increased. Findings support that the associations between young adults' socioeconomic characteristics and smoking outcomes vary substantially during the second and third decades of life. Addressing this has critical implications for identifying vulnerable populations and developing appropriate age-based policies in this age group.
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Affiliation(s)
- Thierry Gagné
- Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), Canada; Département de Médecine Sociale et Préventive, École de Santé Publique de l'Université de Montréal (ESPUM), Canada.
| | - Amélie Quesnel-Vallée
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada; Department of Sociology, McGill University, Canada
| | - Katherine L Frohlich
- Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), Canada; Département de Médecine Sociale et Préventive, École de Santé Publique de l'Université de Montréal (ESPUM), Canada
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22
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Gagné T, Lee JGL, Steinmetz-Wood M, Frohlich KL. Methodological systematic review of studies on social inequalities in smoking among young adults: A field coming of age? Tob Control 2018; 28:566-573. [PMID: 30397029 DOI: 10.1136/tobaccocontrol-2018-054576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/15/2018] [Accepted: 10/22/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Socioeconomic circumstances are critically important to addressing smoking. In young adulthood (ages 18-25), dynamic transitions in education, employment, family and housing complicate the measurement of socioeconomic circumstances. To better understand approaches to capturing these circumstances, this methodological systematic review examined how socioeconomic characteristics used to identify social inequalities in smoking among young adults are measured. DATA SOURCES We searched PubMed/MEDLINE, Scopus, EMBASE, ERIC and Sociological Abstracts, and used three prior reviews. We updated the search in March 2018. STUDY SELECTION Two reviewers independently screened peer-reviewed records from OECD countries published in English, French, German or Spanish after 1995 whose samples covered at least 1 year between the ages of 18 and 25. We included 89 of 1320 records. DATA EXTRACTION One reviewer extracted study characteristics, indicators used to operationalise socioeconomic circumstances and each indicator's relation to results on smoking (ie, significance and direction). We found 39 indicators of socioeconomic circumstances related to six broad domains. These indicators were used in 425 results. DATA SYNTHESIS We descriptively analysed the extracted data using evidence tables. Educational attainment was most common. Evidence of inequalities varied by indicator used. For example, there was inconsistent evidence regarding the role of parental characteristics and transition stages and insufficient evidence regarding personal income on smoking. CONCLUSION Despite its importance, studies have disproportionally examined inequalities among young adults using traditional indicators. The mismatch between young adults' life transitions and measurement strategies may attenuate evidence of inequalities. We suggest strategies to improve future measurement.
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Affiliation(s)
- Thierry Gagné
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal (ESPUM), Montreal, Quebec, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Quebec, Canada
| | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, and Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Katherine L Frohlich
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal (ESPUM), Montreal, Quebec, Canada.,Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Quebec, Canada
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23
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Kardash EV, Ertuzun IA, Khakimova GR, Kolyadin AN, Tarasov SA, Wagner S, Andriambeloson E, Ivashkin VT, Epstein OI. Dose-Response Effect of Antibodies to S100 Protein and Cannabinoid Receptor Type 1 in Released-Active Form in the Light-Dark Test in Mice. Dose Response 2018; 16:1559325818779752. [PMID: 30013455 PMCID: PMC6043939 DOI: 10.1177/1559325818779752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022] Open
Abstract
Earlier studies have shown that combination of antibodies to S100 protein and to cannabinoid receptor type 1 in released-active form (Brizantin) may possess anxiolytic properties and decrease nicotine dependence. Released-active form of antibodies is a novel approach that permits to modify natural functions of the target molecule (antigen) under investigation. The aim of the present study was to evaluate the anxiolytic-like effect of Brizantin in the light-dark test in mice, according to its ability to influence the number of entries into the lit compartment and the total time spent there. Three doses of Brizantin (2.5, 5, and 10 mL/kg) were compared with diazepam (1 mg/kg), placebo, and vehicle control. Anxiolytic-like effect of the tested drug was shown to be dose dependent, with an increasing trend from 2.5 to 10 mL/kg. Brizantin in its highest dose significantly increased studied behavioral parameters, although its effect was less pronounced than that of the reference drug diazepam (1 mg/kg).
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Affiliation(s)
- Elena V Kardash
- Research Institute of General Pathology and Pathophysiology, Moscow, Russian Federation
| | - Irina A Ertuzun
- OOO "NPF "Materia Medica Holding", Moscow, Russian Federation
| | | | | | - Sergey A Tarasov
- Research Institute of General Pathology and Pathophysiology, Moscow, Russian Federation
| | | | | | - Vladimir T Ivashkin
- I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Oleg I Epstein
- Research Institute of General Pathology and Pathophysiology, Moscow, Russian Federation
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Si Y, Zhou Z, Su M, Wang X, Li D, Wang D, He S, Hong Z, Chen X. Socio-Economic Inequalities in Tobacco Consumption of the Older Adults in China: A Decomposition Method. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071466. [PMID: 29997376 PMCID: PMC6069145 DOI: 10.3390/ijerph15071466] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 12/03/2022]
Abstract
Background: In China, tobacco consumption is a leading risk factor for non-communicable diseases, and understanding the pattern of socio-economic inequalities of tobacco consumption will, thus, help to develop targeted policies of public health control. Methods: Data came from the China Health and Retirement Longitudinal Study in 2013, involving 17,663 respondents aged 45 and above. Tobacco use prevalence and tobacco use quantities were defined for further analysis. Using the concentration index (CI) and its decomposition, socio-economic inequalities of tobacco consumption grouped by gender were estimated. Results: The concentration index of tobacco use prevalence was 0.044 (men 0.041; women −0.039). The concentration index of tobacco use quantities among smokers was 0.039 (men 0.033; women 0.038). The majority of the inequality could be explained by educational attainment, age, area, and economic quantiles. Conclusions: Tobacco consumption was more common among richer compared to poorer people in China. Gender, educational attainments, age, areas, and economic quantiles were strong predictors of tobacco consumption in China. Public health policies need to be targeted towards men in higher economic quantiles with lower educational attainment, and divorced or widowed women, especially in urban areas of China.
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Affiliation(s)
- Yafei Si
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an 710049, China.
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an 710049, China.
| | - Min Su
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an 710049, China.
| | - Xiao Wang
- International Business School, Xi'an Jiaotong Liverpool University, Suzhou 215123, China.
| | - Dan Li
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an 710049, China.
| | - Dan Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an 710049, China.
| | - Shuyi He
- International Business School, Xi'an Jiaotong Liverpool University, Suzhou 215123, China.
| | - Zihan Hong
- International Business School, Xi'an Jiaotong Liverpool University, Suzhou 215123, China.
| | - Xi Chen
- Department of Health Policy and Management and Department of Economics, Yale University, 60 College Street Suite 301, New Haven, CT 06510, USA.
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Csémy L, Sovinová H, Dvořáková Z. Socioeconomic and gender inequalities in smoking. Findings from the Czech National Tobacco Surveys 2012-2015. Cent Eur J Public Health 2018; 26:28-33. [PMID: 29684294 DOI: 10.21101/cejph.a4923] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/20/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. METHODS The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories: low, lower-middle, upper-middle, and high. RESULTS In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. CONCLUSIONS Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.
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Affiliation(s)
- Ladislav Csémy
- National Institute of Public Health, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic
| | - Hana Sovinová
- National Institute of Public Health, Prague, Czech Republic
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26
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van den Brand FA, Nagelhout GE, Hummel K, Willemsen MC, McNeill A, van Schayck OCP. Does free or lower cost smoking cessation medication stimulate quitting? Findings from the International Tobacco Control (ITC) Netherlands and UK Surveys. Tob Control 2018; 28:s61-s67. [PMID: 29618494 DOI: 10.1136/tobaccocontrol-2017-054023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/25/2018] [Accepted: 03/07/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate whether mentioning free or lower cost smoking cessation medication as a trigger for thinking about quitting is related to higher medication use, more quit attempts and quit success, and whether these associations are modified by education and income. METHODS Data were derived from the 2013 and 2014 surveys of the International Tobacco Control Netherlands (n=1164) and UK (n=768) cohort. Logistic regression analyses were used to assess associations between mentioning in 2013 that free/lower cost smoking cessation medication was a trigger for thinking about quitting smoking and the use of medication, quit attempts and smoking cessation in 2014. RESULTS 37.0% of smokers in the UK and 24.9% of smokers in the Netherlands mentioned free/lower cost medication as a trigger for thinking about quitting. Smokers who mentioned this trigger were more likely to have used cessation medication during a quit attempt both in the UK (OR=4.19, p<0.001) and in the Netherlands (OR=2.14, p=0.033). The association between mentioning free/lower cost medication as a trigger for thinking about quitting and actual quit attempts was significant in the UK (OR=1.45, p=0.030), but not in the Netherlands (OR=1.10, p=0.587). There was no significant association with quit success. Associations did not differ across income and education groups. CONCLUSION Free/lower cost smoking cessation medication may increase the use of cessation medication and stimulate quit attempts among smokers with low, moderate and high education and income.
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Affiliation(s)
- Floor A van den Brand
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Gera E Nagelhout
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands.,Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.,IVO Addiction Research Institute, The Hague, The Netherlands
| | - Karin Hummel
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.,Netherlands Expertise Center for Tobacco Control (NET), Trimbos Institute, Utrecht, The Netherlands
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Onno C P van Schayck
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
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Meijer E, Van den Putte B, Gebhardt WA, Van Laar C, Bakk Z, Dijkstra A, Fong GT, West R, Willemsen MC. A longitudinal study into the reciprocal effects of identities and smoking behaviour: Findings from the ITC Netherlands Survey. Soc Sci Med 2018; 200:249-257. [PMID: 29321102 DOI: 10.1016/j.socscimed.2017.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although it has been found that identity constructs related to smoking are associated with changes in smoking behaviour, the direction of causal associations is as yet unclear. This study aims to clarify the nature and direction of these associations. METHODS In this longitudinal study we examined the reciprocal relations between identity constructs (i.e., smoker self-identity, quitter self-identity and smoker group-identity), intention to quit and smoking and quitting behaviour among a sample of 1036 smokers and ex-smokers, using cross-lagged structural equation modelling. Moreover, we tested whether these relations differed by socio-economic status (SES). RESULTS Identity and smoking behaviour were reciprocally related in that in intention to quit and smoking behaviour consistently predicted identity change, and identity predicted (changes in) intentions to quit and smoking behaviour. Behaviour appears more important for identity change than identity for behaviour change. Furthermore, quitter self-identity appears more important than smoker self- and group-identity. Relationships did not differ significantly between SES-groups. The findings were replicated using a cross-validation sample. CONCLUSION Results imply that changing smoking behaviour may be a vehicle to change smoking-related identity. Moreover, strengthening identification with quitting is more crucial for quit success than decreasing smoker identities. The finding that behaviour may be more important for identity than vice versa, if replicated, may call for additions to identity theories.
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Affiliation(s)
- E Meijer
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - B Van den Putte
- University of Amsterdam, Amsterdam School of Communication Research, Amsterdam, The Netherlands; Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands
| | - W A Gebhardt
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands.
| | - C Van Laar
- Social and Cultural Psychology, University of Leuven, Leuven, Belgium.
| | - Z Bakk
- Section of Methodology and Statistics, Department of Psychology, Leiden University, Leiden, The Netherlands
| | - A Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, The Netherlands
| | - G T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Canada
| | - R West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - M C Willemsen
- Department of Health Promotion, CAPHRI, Maastricht University, Maastricht, The Netherlands; Dutch Alliance for a Smoke Free Society, The Hague, The Netherlands
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Guo C, Tomson G, Keller C, Söderqvist F. Prevalence and correlates of positive mental health in Chinese adolescents. BMC Public Health 2018; 18:263. [PMID: 29454315 PMCID: PMC5816379 DOI: 10.1186/s12889-018-5133-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies investigating the prevalence of positive mental health and its correlates are still scarce compared to the studies on mental disorders, although there is growing interest of assessing positive mental health in adolescents. So far, no other study examining the prevalence and determinants of positive mental health in Chinese adolescents has been found. The purpose of this study was to assess the prevalence and correlates of positive mental health in Chinese adolescents. METHODS This cross-sectional study used a questionnaire including Mental Health Continuum-Short Form (MHC-SF) and items regarding multiple aspects of adolescent life. The sample involved a total of 5399 students from grade 8 and 10 in Weifang, China. Multivariate Logistic regression analyses were performed to evaluate the associations between potential indicators regarding socio-economic situations, life style, social support and school life and positive mental health and calculate odds ratios and 95% confidence intervals. RESULTS More than half (57.4%) of the participants were diagnosed as flourishing. The correlated factors of positive mental health in regression models included gender, perceived family economy, the occurrence of sibling(s), satisfaction of self-appearance, physical activity, sleep quality, stress, social trust, desire to learn, support from teachers and parents as well as whether being bullied at school (OR ranging from 1.23 to 2.75). The Hosmer-Lemeshow p-value for the final regression model (0.45) indicated adequate model fit. CONCLUSION This study gives the first overview on prevalence and correlates of positive mental health in Chinese adolescents. The prevalence of positive mental health in Chinese adolescents is higher than reported in most of the previous studies also using MHC-SF. Our findings suggest that adolescents with advantageous socio-economic situations, life style, social support and school life are experiencing better positive mental health than others.
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Affiliation(s)
- Cheng Guo
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Tomson
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Christina Keller
- International Business School, Jönköping University, Jönköping, Sweden
| | - Fredrik Söderqvist
- Center for Clinical Research, Uppsala University, Västerås Hospital, Västerås, Sweden
- Competence Center for Health, Region of Västmanland, Västerås Hospital, Västerås, Sweden
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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: 63] [Impact Index Per Article: 10.5] [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.
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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
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30
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Alvarez-Galvez J, Gomez-Baya D. Socioeconomic Context as a Moderator in the Relationship between Body Mass Index and Depression in Europe. Appl Psychol Health Well Being 2017; 9:410-428. [PMID: 29171197 DOI: 10.1111/aphw.12104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Obesity and depression are two major health issues in contemporary societies. This study aims to address two fundamental questions: (1) what is the impact of macro-level adverse socioeconomic circumstances on depression? and (2) how do macro-level variations in the socioeconomic context affect the relationship between body mass index (BMI) and depression? METHODS Data from the 7th round of the European Social Survey were used, collected from a sample size of 37,623 participants and aggregated around a total of 20 countries. A random intercept multilevel model was constructed to study the variations in the relationship between depression and BMI. The contextual effect of risk of poverty, unemployment rate, and gross domestic product per capita were studied at the country level. RESULTS First, both unemployment and poverty risk were found to be positively associated with depressive disorders. Second, the results show that a higher risk of poverty at the macro level may increase the effect of BMI on depression in European countries. CONCLUSION The present study provides new evidence suggesting that the obesity-depression relationship will be, on average, stronger in countries with poor socioeconomic conditions. Therefore, adverse socioeconomic contextual conditions may increase depression associated with obesity.
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Tchicaya A, Lorentz N, Demarest S. Income-related inequality in smoking cessation among adult patients with cardiovascular disease: a 5-year follow-up of an angiography intervention in Luxembourg. BMC Cardiovasc Disord 2017; 17:107. [PMID: 28476143 PMCID: PMC5420161 DOI: 10.1186/s12872-017-0541-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 04/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking contributes to cardiovascular diseases (CVD), a leading cause of death and a large source of healthcare costs in Western countries. We examined the association between income and smoking cessation among smokers who underwent coronary angiography at the National Institute for Cardiac Surgery and Interventional Cardiology in Luxembourg. METHODS Data were derived from a follow-up study conducted in 2013/2014 among 4391 patients (of which 1001 patients were smokers) at the time of coronary angiography in 2008/2009. Four logistic regression models were applied. In three models, the predictor was income and the covariates were sex, age, nationality, marital status, diagnosis, body mass, physical activity, and awareness of tobacco as a cardiovascular (CV) risk factor. In the other model, the predictor was an interaction term composed of income and awareness of tobacco as a CV risk factor; the other variables were covariates. RESULTS Among patients who were current smokers at baseline, 43.2% were current smokers at follow-up and 56.8% had quit smoking. In the multivariate logistic models, quitting smoking was associated with income even after controlling for socio-demographic, diagnostic, and behavioural risk factors. In the full model, the odds of quitting smoking among patients in the two highest income categories remained significant when compared to patients in the lowest income category: odds ratio (OR) = 2.8; 95% confidence interval (CI), 1.3-6.1 and OR = 2.8; 95% CI, 1.2-6.5, respectively. In the full model with an interaction term, quitting smoking was only associated with income when patients knew tobacco was a CV risk factor. The odds of smoking cessation were 5.62 (95% CI: 2.13-14.86) and 3.65 (95% CI: 1.51-8.86) times for patients with annual incomes of 36,000-53,999€ and ≥54,000€, respectively), compared to those for patients with an annual income of <36,000€. CONCLUSIONS This study highlights the influence of income on behaviours regarding CVD risk factors after a major CVD event. Patients in the highest income groups were more likely to quit smoking, although only when they were aware of tobacco as a CV risk factor. Therefore, intervention strategies targeting lower income groups should be implemented in major health facilities.
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Affiliation(s)
- Anastase Tchicaya
- Luxembourg Institute of Socio-Economic Research (LISER), Living Conditions Department/Health Research Team, Esch-sur-Alzette, Luxembourg.
| | - Nathalie Lorentz
- Luxembourg Institute of Socio-Economic Research (LISER), Living Conditions Department/Health Research Team, Esch-sur-Alzette, Luxembourg
| | - Stefaan Demarest
- Scientific Institute of Public Health WIV-ISP, DO Santé publique et surveillance, Brussels, Belgium
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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.
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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.
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Yu XQ, Luo Q, Kahn C, Cahill C, Weber M, Grogan P, Jemal A, O'Connell DL. Widening socioeconomic disparity in lung cancer incidence among men in New South Wales, Australia, 1987-2011. Chin J Cancer Res 2017; 29:395-401. [PMID: 29142458 DOI: 10.21147/j.issn.1000-9604.2017.05.03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective We assessed the trends in lung cancer incidence over a 25-year period by socioeconomic groups for men in New South Wales (NSW), Australia. Methods Men diagnosed with lung cancer between 1987 and 2011 were divided into five quintiles according to an Index of Education and Occupation (IEO). We assessed relative socioeconomic differences over time by calculating age-standardized incidence ratios (SIRs) by 5-year period of diagnosis, and estimated absolute differences by comparing the observed and expected numbers of cases using the highest IEO quintile as the reference. Results Lung cancer incidence for men decreased from 1987 to 2011 for all IEO quintiles, with a greater rate of decline for men living in the highest IEO areas. Thus, the relative disparity increased significantly over the 25-year period (P=0.0006). For example, the SIR for the lowest IEO quintile increased from 1.28 during 1987-1991 to 1.74 during 2007-2011. Absolute differences also increased with the proportion of " potentially preventable" cases doubling from 14.5% in 1987-1991 to 30.2% in 2007-2011. Conclusions Despite the overall decline in lung cancer incidence among men in NSW over the past 25 years, there was a significant increase in disparity across socioeconomic areas in both relative and absolute terms.
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Affiliation(s)
- Xue Qin Yu
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Qingwei Luo
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Clare Kahn
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Camilla Cahill
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Marianne Weber
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Paul Grogan
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia
| | - Ahmedin Jemal
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney NSW 1340, Australia.,Sydney School of Public Health, University of Sydney, Sydney NSW 2006, Australia.,Sanofi Australia, Sydney NSW 2113, Australia
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Crammond BR, Carey G. What do we mean by ‘structure’ when we talk about structural influences on the social determinants of health inequalities? SOCIAL THEORY & HEALTH 2016. [DOI: 10.1057/s41285-016-0020-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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35
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Lee JE, Park EC, Chun SY, Park HK, Kim TH. Socio-demographic and clinical factors contributing to smoking cessation among men: a four-year follow up study of the Korean Health Panel Survey. BMC Public Health 2016; 16:908. [PMID: 27581873 PMCID: PMC5006525 DOI: 10.1186/s12889-016-3583-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/24/2016] [Indexed: 12/02/2022] Open
Abstract
Background To examine factors contributing to smoking cessation among male smokers, we looked at how socio-demographic and clinical characteristics influence stopping smoking with passage of time. Methods Data from the Korea Health Panel during 2009–2012 were used. In 2009 a total of 2,941 smokers were followed up until 2012. Statistical analysis using a generalized linear mixed model was performed for all smokers, and a subgroup analysis was also performed to determine whether individual characteristics influence smoking cessation differently based on health condition. Results Male smokers who have married or graduated college or above were more likely to succeed in smoking cessation. Those with chronic disease(s) were also more likely to quit smoking than those without. Among those without chronic disease, higher education showed significant association with smoking cessation, however, being married or ever married showed significant association with smoking cessation among those with chronic disease. Conclusions The finding that higher education helped smokers without chronic disease succeed in smoking cessation suggests that a smoking cessation campaign should focus on those with lower education. In addition, quit smoking programs may be particularly helpful for male smokers with chronic disease(s) who have never married.
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Affiliation(s)
- Joo Eun Lee
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Sung Youn Chun
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hye Ki Park
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. .,Department of Hospital Administration, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro,Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Socio-economic status in relation to smoking: The role of (expected and desired) social support and quitter identity. Soc Sci Med 2016; 162:41-9. [DOI: 10.1016/j.socscimed.2016.06.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 06/02/2016] [Accepted: 06/13/2016] [Indexed: 11/19/2022]
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Korinek K, Loebach P, Trinh HN. Military service and smoking in a cohort of northern Vietnamese older adults. Int J Public Health 2016; 62:43-51. [PMID: 27321700 DOI: 10.1007/s00038-016-0841-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 03/06/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Wide-ranging scholarship demonstrates war's impacts on US veterans' health. We ask whether, among Vietnamese men of a certain age, wartime experiences contributed to initiating smoking, and thus shaped one behavioral pathway linking war exposure and older adult health. METHODS We analyze the Vietnam Health and Aging Pilot Study (VHAPS), a survey of adults ages 55 and older (N = 405) conducted in one commune of northern Vietnam. We implement Cox discrete-time proportional hazards models to discern the effects of military service upon the initiation of smoking. RESULTS Military service results in a heightened risk of initiating smoking within this cohort (HR 2.13, [CI 1.36, 3.35]). Smoking initiation is also significantly gendered and age graded. Socioeconomic position and social capital variables in the models are statistically insignificant. CONCLUSIONS This study finds that, among older northern Vietnamese men whose early adulthood coincided with mass mobilization in the Vietnam War, involvement in formal military service significantly increased the risk of initiating smoking. Military-induced smoking emerges where tobacco products were not provided by the military institution, but where social availability of tobacco was widespread.
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Affiliation(s)
- Kim Korinek
- Department of Sociology, University of Utah, 380 S. 1530 E., Room 301, Salt Lake City, UT, 84112, USA.
| | - Peter Loebach
- Department of Sociology and Anthropology, Weber State University, Social Science Building, Room 114, Ogden, UT, USA
| | - Ha Ngoc Trinh
- Department of Sociology, University of Utah, 380 S. 1530 E., Room 301, Salt Lake City, UT, 84112, USA
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Hajizadeh M, Nandi A. The socioeconomic gradient of secondhand smoke exposure in children: evidence from 26 low-income and middle-income countries. Tob Control 2016; 25:e146-e155. [DOI: 10.1136/tobaccocontrol-2015-052828] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/01/2016] [Accepted: 04/28/2016] [Indexed: 11/03/2022]
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Benson FE, Nagelhout GE, Nierkens V, Willemsen MC, Stronks K. Inequalities in the Impact of National Reimbursement of Smoking Cessation Pharmacotherapy and the Influence of Injunctive Norms: An Explorative Study. Subst Abuse 2016; 10:45-53. [PMID: 27257383 PMCID: PMC4880292 DOI: 10.4137/sart.s32225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 09/27/2015] [Accepted: 09/29/2015] [Indexed: 12/02/2022]
Abstract
In 2011, the Dutch government reimbursed smoking cessation pharmacotherapy with behavioral therapy for quitting smokers. We investigate whether inequalities in the use of pharmacotherapy change and, if not, whether this is due to a relatively positive injunctive norm in lower socioeconomic status (SES) groups. A total of 75,415 participants aged ≥15 years from the Dutch Continuous Survey of Smoking Habits, 2009–2012, were considered with the following measures: SES (education/income), injunctive norm (mostly acceptable/neutral/mostly unacceptable), period (2011/all other years), and pharmacotherapy use (yes/no). The proportion of low SES smokers compared with high SES smokers making quit attempts with pharmacotherapy did not differ significantly. The injunctive norm of low SES smokers differed significantly from high SES smokers and nonsmokers of all SES levels. Low income smokers with mostly acceptable injunctive norms were significantly less likely to make quit attempts using pharmacotherapy than those with a neutral or less accepting injunctive norm. The significantly lower use of pharmacotherapy in quit attempts in low income smokers with a positive injunctive norm toward smoking may partly underlie the lack of uptake of reimbursed pharmacotherapy in low SES smokers.
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Affiliation(s)
- Fiona E Benson
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Gera E Nagelhout
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Vera Nierkens
- Department of Public Health and Primary Care, LUMC, Leiden, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.; Dutch Alliance for a Smokefree Society, The Hague, The Netherlands
| | - Karien Stronks
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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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.
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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
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Pohjola V, Rekola A, Kunttu K, Virtanen JI. Association between dental fear and oral health habits and treatment need among University students in Finland: a national study. BMC Oral Health 2016; 16:26. [PMID: 26922793 PMCID: PMC4769491 DOI: 10.1186/s12903-016-0179-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 02/12/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND First-year university students are in a new, independent life situation, which may affect health behaviour, including oral health habits. The aim of this study was to evaluate the association between dental fear and oral health habits, while considering the simultaneous effects of attitude toward food and treatment need at dental check-ups. METHODS The data (n = 8514) for this national cross-sectional study were collected from health registers of Finnish Student Health Service. As part of health examination all first-year university students in Finland were sent an electronic questionnaire asking about general, psychological and oral health, and health habits. Dental fear was measured by the question: "How afraid are you of visiting a dentist?" (reply alternatives: "Not at all", "Somewhat" and "Very"). Chi-square tests and Multiple logistic regression analyses were used to determine the associations between dental fear and oral health habits (tooth brushing, tobacco use, frequency of eating and drinking, eating habits and interval between dental check-ups) as well as attitude to food and treatment need at dental check-ups while controlling for age, gender, general mood and feelings in social situations. RESULTS Of the oral health habits, tooth brushing and tobacco use were associated with dental fear. Those who brushed their teeth once a day or less often or used tobacco regularly were more likely to have high dental fear than those who brushed their teeth twice a day or more often or used tobacco occasionally or not at all. Students who reported not having a normal attitude to food were more likely to have high dental fear than were those reporting normal attitude to food, but the frequency of eating and drinking was not associated with dental fear. Students who reported needing treatment frequently or at every dental check-up were more likely to have high dental fear than those who reported rarely or never needing treatment. CONCLUSION Those students with high dental fear seem to be at risk of having poor oral health habits and abnormal attitude to food, which may increase the risk of deterioration of oral health and the need for treatment. Dental teams should make efforts in helping fearful patients to find motivation for good oral health habits.
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Affiliation(s)
- Vesa Pohjola
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
| | - Aino Rekola
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | | | - Jorma I Virtanen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland. .,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
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Lahelma E, Pietiläinen O, Ferrie J, Kivimäki M, Lahti J, Marmot M, Rahkonen O, Sekine M, Shipley M, Tatsuse T, Lallukka T. Changes Over Time in Absolute and Relative Socioeconomic Differences in Smoking: A Comparison of Cohort Studies From Britain, Finland, and Japan. Nicotine Tob Res 2016; 18:1697-704. [PMID: 26764256 DOI: 10.1093/ntr/ntw004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 01/05/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Socioeconomic differences in smoking over time and across national contexts are poorly understood. We assessed the magnitude of relative and absolute social class differences in smoking in cohorts from Britain, Finland, and Japan over 5-7 years. METHODS The British Whitehall II study (n = 4350), Finnish Helsinki Health Study (n = 6328), and Japanese Civil Servants Study (n = 1993) all included employed men and women aged 35-68 at baseline in 1997-2002. Follow-up was in 2003-2007 (mean follow-up 5.1, 6.5, and 3.6 years, respectively). Occupational social class (managers, professionals and clerical employees) was measured at baseline. Current smoking and covariates (age, marital status, body mass index, and self-rated health) were measured at baseline and follow-up. We assessed relative social class differences using the Relative Index of Inequality and absolute differences using the Slope Index of Inequality. RESULTS Social class differences in smoking were found in Britain and Finland, but not in Japan. Age-adjusted relative differences at baseline ranged from Relative Index of Inequality 3.08 (95% confidence interval 1.99-4.78) among Finnish men to 2.32 (1.24-4.32) among British women, with differences at follow-up greater by 8%-58%. Absolute differences remained stable and varied from Slope Index of Inequality 0.27 (0.15-0.40) among Finnish men to 0.10 (0.03-0.16) among British women. Further adjustment for covariates had modest effects on inequality indices. CONCLUSIONS Large social class differences in smoking persisted among British and Finnish men and women, with widening tendencies in relative differences over time. No differences could be confirmed among Japanese men or women. IMPLICATIONS Changes over time in social class differences in smoking are poorly understood across countries. Our study focused on employees from Britain, Finland and Japan, and found relative and absolute and class differences among British and Finnish men and women. Key covariates had modest effects on the differences. Relative differences tended to widen over the 4- to 7-year follow-up, whereas absolute differences remained stable. In contrast, class differences in smoking among Japanese men or women were not found. Britain and Finland are at the late stage of the smoking epidemic model, whereas Japan may not follow the same model.
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Affiliation(s)
- Eero Lahelma
- Department of Public Health, University of Helsinki, Helsinki, Finland;
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jane Ferrie
- Department of Epidemiology and Public Health, University College London, London, UK; School of Community and Social Medicine, University of Bristol, Bristol, UK
| | - Mika Kivimäki
- Department of Public Health, University of Helsinki, Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, UK; Centre of Expertise for Development of Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Michikazu Sekine
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan
| | - Martin Shipley
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Takashi Tatsuse
- Department of Epidemiology and Health Policy, University of Toyama, Toyama, Japan
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland; Centre of Expertise for Development of Work and Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
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Wang Q, Shen JJ, Cochran C. Unemployment Rate, Smoking in China: Are They Related? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13010113. [PMID: 26761019 PMCID: PMC4730504 DOI: 10.3390/ijerph13010113] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 12/29/2015] [Accepted: 01/06/2016] [Indexed: 12/13/2022]
Abstract
Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. Results: A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent for those who smoked including a 2.9% increase for those who smoked 1–10 cigarettes per day; a 2.8% increase for those who smoked 11–20 cigarettes per day; and a 3.4% increase for those who smoked 20 cigarettes or more per day. The effects were stronger for those who were employed. Non-drinkers were more likely to engage in smoking with increased unemployment rate. 2SLS estimation revealed the same association. Conclusions: The unemployment rate was positively associated with smoking behavior. Smoking control and intervention strategies should focus on both the individual′s characteristics and the physical environment in which unemployment rate tend to rise.
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Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin 124221, China.
| | - Jay J Shen
- School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89103, USA.
| | - Chris Cochran
- Department of Health Care Administration, University of Nevada Las Vegas, Las Vegas, NV 89103, USA.
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Effectiveness of video- versus text-based computer-tailored smoking cessation interventions among smokers after one year. Prev Med 2016; 82:42-50. [PMID: 26577867 DOI: 10.1016/j.ypmed.2015.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 10/23/2015] [Accepted: 11/04/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND In western countries, smoking prevalence rates are high among smokers unmotivated to quit and those with a lower socioeconomic status (LSES). Multiple computer tailoring and the use of audio-visual aids may improve such interventions and increase cessation in LSES smokers. This study assessed the 12-month effectiveness of a video- and text-based computer-tailored intervention. METHODS A randomized controlled trial in the Netherlands was used in which smokers were allocated to the video-based condition (VC) (N=670), the text-based condition (TC) (N=708) or the control condition (CC) (brief generic text advice) (N=721). After 12months, self-reported prolonged abstinence was assessed and biochemically verified in respondents indicating to have quit smoking. Three analysis strategies were used to assess the effects: (1) multiple imputation (MI); (2) intention-to-treat (ITT); (3) complete case analysis (CC). RESULTS VC was more effective in prolonged abstinence compared to CC (odds ratio (OR)=1.90, p=.005) and the text-based condition (OR=1.71, p=.01). VC was furthermore more effective than TC. No differences were found for SES and motivational levels. Results were similar when using ITT and CC. For our secondary outcome seven-day point prevalence abstinence; however, neither VC (OR=1.17, p=.34) or TC (OR=0.91, p=.52) outperformed the CC. CONCLUSION The video-based computer-tailored intervention was effective in obtaining substantial long-term abstinence compared to the text-based version and a brief generic text advice.
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Hansen K, Lindström M, Rosvall M. Age at smoking initiation and self-rated health among second grade high school boys and girls in Scania, Sweden, a cross-sectional study. BMC Public Health 2015; 15:1143. [PMID: 26581335 PMCID: PMC4652342 DOI: 10.1186/s12889-015-2457-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 10/26/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Smoking is usually initiated early in life and most adult regular smokers have started smoking before 18 years of age. A younger age at smoking initiation is associated with risk taking behaviours and worse health outcomes regarding psychological and somatic conditions, suggested to be caused by exposure during critical developmental periods. The present study aims to investigate self-rated health among second grade high school boys and girls related to age at smoking initiation (<14 years of age and ≥ 14 years of age) among current and former smokers, compared to never smokers. METHODS Data was derived from the Scania public health survey among children and adolescents in 2012. The study was cross-sectional with retrospective information about first time cigarette smoking experiences among 3245 boys and 3434 girls in second grade of high school. Self-rated health was assessed with the question "How do you rate your general health". Associations of age at smoking initiation, current smoking status and poor self-rated health were investigated with logistic regression models. RESULTS Crude odds ratios of poor self-rated health were increased for all smoking groups compared to never smokers. Former smoking boys and currently smoking girls with early smoking initiation had the highest odds ratios of poor self-rated health, with odds ratios (OR) 2.4 (95 % confidence interval (CI): 1.5-3.7) and OR 2.9 (95 % CI: 2.3-3.6), respectively. After adjustments for sociodemographic factors, health-related behaviours, psychosocial factors, weight and functional disabilities, the results were attenuated, but remained statistically significant regarding former and current smoking boys with early smoking initiation, OR 2.0 (95 % CI: 1.1-3.7) and OR 1.7 (95 % CI: 1.1-2.4) and for current smoking girls with early and later smoking initiation, OR 2.1 (95 % CI: 1.5-2.8) and OR 1.5 (95 % CI: 1.1-2.0). CONCLUSION Boys and girls in second grade of high school with early smoking initiation reported poorer self-rated health than later initiators and never smokers. Poorer self-rated health persisted also after smoking cessation among early initiating boys. Further studies are needed to understand the adverse health effects associated with timing of smoking initiation.
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Affiliation(s)
- Kristina Hansen
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
| | - Martin Lindström
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
| | - Maria Rosvall
- Department of Clinical Sciences, Social Medicine and Health Policy, CRC, Scania University Hospital, Lund University, Jan Waldenströms gata 35, SE-205 02, Malmö, Sweden.
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Xu X, Gong T, Zhang Y, Wu C, Xie YJ, Wang HH, Zhu R, Li W, An L, Zhao Y. Evaluation of anti-smoking television advertising on tobacco control among urban community population in Chongqing, China. Tob Induc Dis 2015; 13:31. [PMID: 26339225 PMCID: PMC4558728 DOI: 10.1186/s12971-015-0057-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 08/26/2015] [Indexed: 11/17/2022] Open
Abstract
Background China is the largest producer and consumer of tobacco in the world. Considering the constantly growing urban proportion, persuasive tobacco control measures are important in urban communities. Television, as one of the most pervasive mass media, can be used for this purpose. Methods The anti-smoking advertisement was carried out in five different time slots per day from 15 May to 15 June in 2011 across 12 channels of Chongqing TV. A cross-sectional study was conducted in the main municipal areas of Chongqing. A questionnaire was administered in late June to 1,342 native residents aged 18–45, who were selected via street intercept survey. Results Respondents who recognized the advertisement (32.77 %) were more likely to know or believe that smoking cigarettes caused impotence than those who did not recognize the advertisement (26.11 %). According to 25.5 % of smokers, the anti-smoking TV advertising made them consider quitting smoking. However, females (51.7 %) were less likely to be affected by the advertisement to stop and think about quitting smoking compared to males (65.6 %) (OR = 0.517, 95 % CI [0.281–0.950]). In addition, respondents aged 26–35 years (67.4 %) were more likely to try to persuade others to quit smoking than those aged 18–25 years (36.3 %) (OR = 0.457, 95 % CI [0.215–0.974]). Furthermore, non-smokers (87.4 %) were more likely to find the advertisement relevant than smokers (74.8 %) (OR = 2.34, 95 % CI [1.19–4.61]). Conclusions This study showed that this advertisement did not show significant differences on smoking-related knowledge and attitude between non-smokers who had seen the ad and those who had not. Thus, this form may not be the right tool to facilitate change in non-smokers. The ad should instead be focused on the smoking population. Gender, smoking status, and age influenced the effect of anti-smoking TV advertising on the general population in China.
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Affiliation(s)
- Xianglong Xu
- School of Public Health and Management, Chongqing Medical University, No. 1, Yixueyuan Road, Yuanjiagang, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Tao Gong
- School of Public Health and Management, Chongqing Medical University, No. 1, Yixueyuan Road, Yuanjiagang, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Yong Zhang
- School of Public Health and Management, Chongqing Medical University, No. 1, Yixueyuan Road, Yuanjiagang, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Chengbin Wu
- Chongqing Health Education Institute, Chongqing, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR Hong Kong
| | - Harry Hx Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080 P.R. China ; General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX UK
| | - Runzhi Zhu
- School of Public Health and Management, Chongqing Medical University, No. 1, Yixueyuan Road, Yuanjiagang, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
| | - Wentao Li
- School of Nursing, Dalian University, Liaoning, China
| | - Libin An
- School of Nursing, Dalian University, Liaoning, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, No. 1, Yixueyuan Road, Yuanjiagang, Chongqing, 400016 China ; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016 China ; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016 China
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Smoking Cessation and Socioeconomic Status: An Update of Existing Evidence from a National Evaluation of English Stop Smoking Services. BIOMED RESEARCH INTERNATIONAL 2015; 2015:274056. [PMID: 26273602 PMCID: PMC4529910 DOI: 10.1155/2015/274056] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 04/24/2015] [Accepted: 05/03/2015] [Indexed: 11/17/2022]
Abstract
Smokers from lower socioeconomic groups are less likely to be successful in stopping smoking than more affluent smokers, even after accessing cessation programmes. Data were analysed from 3057 clients of nine services. Routine monitoring data were expanded with CO validated smoking status at 52-week follow-up. Backwards logistic regression modelling was used to consider which factors were most important in explaining the relationship between SES and quitting. The odds ratio of stopping smoking among more affluent clients, compared with more disadvantaged clients, after taking into account design variables only, was 1.85 (95% CI 1.44 to 2.37) which declined to 1.44 (1.11 to 1.87) when all controls were included. The factors that explained more than 10% of the decline in the odds ratio were age, proportion of friends and family who smoked, nicotine dependence, and taking varenicline. A range of factors contribute to lower cessation rates for disadvantaged smokers. Some of these can be modified by improved smoking cessation service provision, but others require contributions from wider efforts to improve material, human, and social capital.
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Howdon D, Jones AM. A discrete latent factor model for smoking, cancer and mortality. ECONOMICS AND HUMAN BIOLOGY 2015; 18:57-73. [PMID: 25898078 DOI: 10.1016/j.ehb.2015.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 02/18/2015] [Accepted: 03/23/2015] [Indexed: 06/04/2023]
Abstract
This paper investigates the relationship between smoking and ill-health, with a focus on the onset of cancer. A discrete latent factor model for smoking and health outcomes, allowing for these to be commonly affected by unobserved factors, is jointly estimated, using the British Health and Lifestyle Survey (HALS) dataset. Post-estimation predictions suggest the reduction in time-to-cancer to be 5.7 years for those with an exposure of 30 pack-years, compared to never-smokers. Estimation of posterior probabilities for class membership shows that individuals in certain classes exhibit similar observables but highly divergent health outcomes, suggesting that unobserved factors influence outcomes. The use of a joint model changes the results substantially. The results show that failure to account for unobserved heterogeneity leads to differences in survival times between those with different smoking exposures to be overestimated by more than 50% (males, with 30 pack-years of exposure).
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Affiliation(s)
- Daniel Howdon
- Department for Economics and Related Studies, University of York, Heslington, York YO10 5DD, UK; Centre for Health Economics, University of York, Heslington, York YO10 5DD, UK; School of Slavonic & East European Studies, University College London, 16 Taviton Street, WC1H 0BW, UK
| | - Andrew M Jones
- Department for Economics and Related Studies, University of York, Heslington, York YO10 5DD, UK; Centre for Health Economics, Monash University, Clayton, Victoria 3800, Australia.
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Meijer E, Gebhardt WA, Dijkstra A, Willemsen MC, Van Laar C. Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban. Psychol Health 2015; 30:1387-409. [PMID: 25959600 DOI: 10.1080/08870446.2015.1049603] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We examined how 'smoker' and 'non-smoker' self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e., the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban. DESIGN Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers. MAIN OUTCOME MEASURES Intention to quit, quit attempts and 'rejecting', 'victimizing', 'socially conscious smoking' and 'active quitting' responses to the smoking ban. RESULTS Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES. CONCLUSION Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.
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Affiliation(s)
- Eline Meijer
- a Health, Medical and Neuropsychology , Leiden University , Leiden , The Netherlands
| | - Winifred A Gebhardt
- a Health, Medical and Neuropsychology , Leiden University , Leiden , The Netherlands
| | - Arie Dijkstra
- b Department of Social Psychology , University of Groningen , Groningen , The Netherlands
| | - Marc C Willemsen
- c Department of Health Promotion , CAPHRI, Maastricht University , Maastricht , The Netherlands.,d Alliantie Nederland Rookvrij , The Hague , The Netherlands
| | - Colette Van Laar
- e Social and Cultural Psychology , University of Leuven , Leuven , Belgium
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50
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Zhuang YL, Gamst AC, Cummins SE, Wolfson T, Zhu SH. Comparison of smoking cessation between education groups: findings from 2 US National Surveys over 2 decades. Am J Public Health 2015; 105:373-9. [PMID: 25521868 DOI: 10.2105/ajph.2014.302222] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined smoking cessation rate by education and determined how much of the difference can be attributed to the rate of quit attempts and how much to the success of these attempts. METHODS We analyzed data from the National Health Interview Survey (NHIS, 1991-2010) and the Tobacco Use Supplement to the Current Population Survey (TUS-CPS, 1992-2011). Smokers (≥ 25 years) were divided into lower- and higher-education groups (≤ 12 years and >12 years). RESULTS A significant difference in cessation rate between the lower- and the higher-education groups persisted over the last 2 decades. On average, the annual cessation rate for the former was about two thirds that of the latter (3.5% vs 5.2%; P<.001, for both NHIS and TUS-CPS). About half the difference in cessation rate can be attributed to the difference in quit attempt rate and half to the difference in success rate. CONCLUSIONS Smokers in the lower-education group have consistently lagged behind their higher-education counterparts in quitting. In addition to the usual concern about improving their success in quitting, tobacco control programs need to find ways to increase quit attempts in this group.
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Affiliation(s)
- Yue-Lin Zhuang
- Yue-Lin Zhuang and Tanya Wolfson are with the Cancer Center, University of California, San Diego, La Jolla. Shu-Hong Zhu, Anthony C. Gamst, and Sharon E. Cummins are with the Department of Family and Preventive Medicine, University of California, San Diego
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