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Socioeconomic, health-related disadvantages associated with increased smoking prevalence

Six different socioeconomic and health-related disadvantages were associated with greater odds of smoking initiation and lower odds of smoking cessation, according to a study published in JAMA Internal Medicine.

“Results of this study demonstrate that recent disparities in the prevalence of smoking among U.S. adults who were 25 years or older are disproportionately accounted for by populations facing multiple forms of socioeconomic and health-related disadvantage,” Adam M. Leventhal, PhD, of the department of preventive medicine at Keck School of Medicine, University of Southern California, and colleagues wrote. “In addition, this study demonstrates that the magnitude of disparities in current smoking associated with cumulative disadvantage has widened from 2008 to 2017.”

To investigate disparities in smoking prevalence associated with socioeconomic and health-related disadvantages, researchers used data from 278,048 National Health Interview Survey respondents (mean age, 51.9 years; 55.7% women).

Participants were classified as being “never smokers,” which included those who reported smoking fewer than 100 cigarettes throughout their lifetime; “former smokers,” which included those who reported smoking 100 cigarettes or more in their lifetime and who now do not smoke at all; or “current smokers,” which included those who smoked more than 100 cigarettes in their lifetime and continue smoking on some days or every day.

Researchers considered six forms of disadvantage including current unemployment, poverty, low education, disability, serious psychological distress and heavy drinking.

Odds ratios regarding the association of smoking status with the disadvantage variables were then estimated.

 

Six different socioeconomic and health-related disadvantages were associated with greater odds of smoking initiation and lower odds of smoking cessation.

Source: Adobe Stock

Researchers found that, when compared with populations without disadvantages, current smoking prevalence was successively higher with each disadvantage (one disadvantage, 21.4% vs. 13.8%; two disadvantages, 26.6% vs. 13.8%; three disadvantages, 35.1% vs. 13.8%; four disadvantages, 45.7% vs. 13.8%; five or six disadvantages, 58.2% vs. 13.8%). When looking at current smokers compared with never smokers, the adjusted ORs were 2.34 (95% CI, 2.27-2.43) for one disadvantage; 3.55 (95% CI, 3.39-3.72) for two disadvantages; 5.05 (95% CI, 5.05-5.66) for three disadvantages; 8.59 (95% CI, 7.91-9.34) for four disadvantages; and 14.7 (95% CI, 12.30-17.5) for five or six disadvantages.

Researchers noted that although the odds ratios were lower in current vs. former smokers and former vs. never smokers, they still showed successively greater associations with increasing cumulative disadvantage.

In a press release, Leventhal said, “Until we can do something about the life circumstances that drive disadvantaged populations to smoke, encouraging them to quit may be an uphill battle.” – by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.