Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries

Sreeramareddy, Chandrashekhar T; Harper, Sam; Ernstsen, Linda

doi:10.1136/tobaccocontrol-2016-053266

Cited by 59 publications

(54 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is consistent with previous findings indicating that low-income individuals experience increased PAH exposures related to poor air quality, which in turn is likely influenced by home location (i.e., proximity to industry or heavy traffic), and levels of environmental tobacco smoke [55]. It is important to note that smoking status may also be driving this relationship; higher smoking rates having been previously noted in low-income individuals relative to higher socioeconomic status individuals [56][57][58][59]. Indeed, careful scrutiny of the analysed data revealed nearly three times the number of non-smokers in households with incomes ≥$80,000 a year compared to those with incomes <$35,000 a year.…”

Section: Effects Of Demographic and Lifestyle Factorssupporting

confidence: 91%

The influence of demographic and lifestyle factors on urinary levels of PAH metabolites—empirical analyses of Cycle 2 (2009–2011) CHMS data

Keir

Cakmak

Blais

et al. 2020

J Expo Sci Environ Epidemiol

View full text Add to dashboard Cite

Polycyclic aromatic hydrocarbons (PAHs) are a group of compounds formed during the incomplete combustion of organic matter. Several are mutagenic carcinogens; the magnitude of exposure can be assessed by examining urinary levels of PAH metabolites. Data from biomonitoring studies that record urinary PAH metabolite levels, as well as demographic and lifestyle information, can be used to investigate relationships between PAH exposure and variables, such as smoking status, workplace smoking restrictions, age, sex, household income, home age, and occupation. This study analysed creatinineadjusted urinary PAH metabolite concentrations and questionnaire data from~1200 individuals aged 16 years and older surveyed in Cycle 2 of the Canadian Health Measures Survey (CHMS). Statistical analyses revealed that smoking status, age, and sex are associated with urinary concentrations of a pyrene metabolite (1-OHP), phenanthrene metabolites (ΣOH-Phen), fluorene metabolites (ΣOH-Flu) and naphthalene metabolites (ΣOH-Nap). More specifically, smoking status, age and sex can collectively account for 30, 24, 52, and 34% of the observed variations in 1-OHP, ΣOH-Phen, ΣOH-Flu and ΣOH-Nap metabolites, respectively (p < 0.001). Analyses of non-smokers revealed weak but significant effects of age, sex, home age, and occupation on urinary levels of selected PAH metabolites (i.e., <7% of observed variation, p < 0.05). The unexplained variation in PAH metabolite levels is most likely related to diet, which was not examined. Although the results revealed significant relationships between urinary PAH metabolite levels and several lifestyle and/or demographic variables, robust examinations of selected effects (e.g., sex, home age, occupation) will require datasets that are balanced with respect to the other highlighted variables. The results can be used to identify remedial measures to reduce exposure and concomitant risk, and/or design follow-up studies to test hypotheses regarding the causes of exposure differences empirically related to sex, age, home age, and occupation.

show abstract

Section: Effects Of Demographic and Lifestyle Factorssupporting

confidence: 91%

The influence of demographic and lifestyle factors on urinary levels of PAH metabolites—empirical analyses of Cycle 2 (2009–2011) CHMS data

Keir

Cakmak

Blais

et al. 2020

J Expo Sci Environ Epidemiol

View full text Add to dashboard Cite

show abstract

“…Education is presumed to be an important determinant of an individual's tobacco-use behavior. The prevalence of tobacco use is inversely associated with an individual's level of education in LMICs (Bosdriesz, Mehmedovic, Witvliet, & Kunst, 2014;Palipudi et al, 2012;Sreeramareddy, Harper, & Ernstsen, 2018). This pattern is also evident in the findings of GATS and household income and expenditure survey of Pakistan in 2014.…”

Section: Study Purposementioning

confidence: 72%

Tobacco control and household tobacco consumption: A tale of two educational groups

2020

View full text Add to dashboard Cite

Since the ratification of the World Health Organization Framework Convention on Tobacco Control in 2004, Pakistan has made modest but continued progress in implementing various tobacco control measures. By 2014, substantial progress was achieved in areas of monitoring, mass media antitobacco campaigns, and advertising bans. However, the findings from the 2014 Global Adult Tobacco Survey of Pakistan show significant differences in antitobacco campaign exposure among individuals of different educational attainment. Given this large variation in noticing antitobacco information, this paper analyzes how heterogeneity in treatment exposure may differentially impact tobacco‐use prevalence across household groups. Household‐level tobacco‐use prevalence in 2014 was, respectively, 56% and 48% for the low‐ and high‐education households. The gap in tobacco‐use prevalence between the two educational groups further widens post 2014. We find that, on average, individuals with higher than primary education are 14 percentage points and 6 percentage points more likely to notice anticigarette and antismokeless tobacco information in 2014, respectively. Subsequently, in 2016, high‐education households experienced a 3.6 percentage point higher reduction in tobacco‐use prevalence compared to the low‐education households. These findings motivate policies to enhance the outreach of tobacco control measures across different educational groups.

show abstract

“…This pattern of inequality in smoking has been extensively identified by studies in low-and middle-income countries, which have shown sociodemographic gradients in tobacco use. [25][26][27] For example, older smokers are more likely to quit 26,27 and education is inversely associated with smoking in multiple settings. 27 Evidence suggests that increasing tobacco price has the greatest potential to reduce socioeconomic disparities in smoking.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Socio-demographic inequalities in cigarette smoking in Indonesia, 2007 to 2014

Amalia

Cadogan

Prabandari

et al. 2019

Preventive Medicine

View full text Add to dashboard Cite

The prevalence of smoking in Indonesia is one of the highest in the world. Since 2007, some tobacco control policies have been implemented by the Indonesian government. However, evidence on the effectiveness of such policies at reducing tobacco use in Indonesia is scarcely available. Using both cross-sectional and longitudinal analysis of individual and household data from two waves of the Indonesia Family Life Survey (IFLS), this study explored changes in smoking patterns among Indonesian adults between 2007 and 2014 controlling for sociodemographic factors. Overall, there was no statistically significant change in the prevalence of smoking between 2007 and 2014. However, cigarettes became more affordable. Smokers in 2014 consumed more cigarettes (β: 0.95; 0.73, 1.17) and spent more money on cigarettes (β: IDR 2,775; IDR 1,124, IDR 4,426) compared to those in 2007. Males, individuals <55 years old and those with lower levels of education had a higher likelihood of being smokers in 2014. Respondents with lower education levels and those under 26 years of age had higher odds of initiating smoking during the study period. Similarly, smoking cessation between 2007 and 2014 was more likely among respondents with higher levels of education and aged above 40 years. In conclusion, the implementation of tobacco control measures does not appear to have had a positive impact on smoking behaviours among adults in Indonesia between 2007 and 2014. Instead, cigarette consumption increased differentially across socio-demographic groups. Hence, tailored tobacco control interventions targeting the most socially disadvantaged population may be necessary in Indonesia.

show abstract

Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries

Abstract: Our results confirm that socioeconomic inequalities tobacco use exist in LMIC, varied widely between the countries and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socioeconomic inequalities in health in LMIC.

Cited by 59 publications

References 41 publications

The influence of demographic and lifestyle factors on urinary levels of PAH metabolites—empirical analyses of Cycle 2 (2009–2011) CHMS data

The influence of demographic and lifestyle factors on urinary levels of PAH metabolites—empirical analyses of Cycle 2 (2009–2011) CHMS data

Tobacco control and household tobacco consumption: A tale of two educational groups

Socio-demographic inequalities in cigarette smoking in Indonesia, 2007 to 2014

Contact Info

Product

Resources

About