Limits...
Socioeconomic and geographic patterning of smoking behaviour in Canada: a cross-sectional multilevel analysis.

Corsi DJ, Lear SA, Chow CK, Subramanian SV, Boyle MH, Teo KK - PLoS ONE (2013)

Bottom Line: Current smoking decreased and quitting increased with increasing SES.Current prevention and cessation policies have not been successful in improving the situation for all areas and groups.Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful.

View Article: PubMed Central - PubMed

Affiliation: Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, United States of America. djcorsi@hsph.harvard.edu

ABSTRACT

Objective: To describe the socioeconomic and geographic distribution of smoking behaviour in Canada among 19,383 individuals (51% women) aged 15-85 years.

Methods: Current smoking and quitting were modeled using standard and multilevel logistic regression. Markers of socioeconomic status (SES) were education and occupation. Geography was defined by Canadian Provinces.

Results: The adjusted prevalence of current smoking was 20.2% (95% confidence interval [CI]: 18.8-21.7) and 63.7% (95% CI: 61.1-66.3) of ever smokers had quit. Current smoking decreased and quitting increased with increasing SES. The adjusted prevalence of current smoking was 32.8% (95% CI: 28.4-37.5) among the least educated compared to 11.0% (95% CI: 8.9-13.4) for the highest educated. Among the least educated, 53.0% (95% CI: 46.8-59.2) had quit, rising to 68.7% (95% CI: 62.7-74.1) for the most educated. There was substantial variation in current smoking and quitting at the provincial level; current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia, and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island. Nationally, increasing education and occupation level were inversely associated with current smoking (odds ratio [OR] 0.64, 95% CI: 0.60-0.68 for education; OR 0.82, 95% CI: 0.77-0.87 for occupation) and positively associated with quitting (OR 1.27, 95% CI: 1.16-1.40 for education; OR 1.20, 95% CI: 1.12-1.27 for occupation). These associations were consistent in direction across provinces although with some variability in magnitude.

Conclusion: Our findings indicate that socioeconomic inequalities in smoking have persisted in Canada; current smoking was less likely and quitting was more likely among the better off groups and in certain provinces. Current prevention and cessation policies have not been successful in improving the situation for all areas and groups. Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful.

Show MeSH

Related in: MedlinePlus

Adjusted prevalence of current smoking in Canadian provinces for men (left) and women (right) aged 15 years and above, Canadian Tobacco Use Monitoring Survey 2010.Darker colours indicate higher prevalence. Estimates adjusted for age, sex, marital status, occupation, education. Province name abbreviations: Alta. Alberta; B.C. British Columbia; Man. Manitoba; N.B. New Brunswick; N.L. Newfoundland; N.S. Nova Scotia; O.N. Ontario; P.E.I. Prince Edward Island; Que. Quebec; Sask. Saskatchewan; data not available for Yukon Territory (Y.T.), Northwest Territories (N.W.T), or Nunavut (Nvt.).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3585192&req=5

pone-0057646-g001: Adjusted prevalence of current smoking in Canadian provinces for men (left) and women (right) aged 15 years and above, Canadian Tobacco Use Monitoring Survey 2010.Darker colours indicate higher prevalence. Estimates adjusted for age, sex, marital status, occupation, education. Province name abbreviations: Alta. Alberta; B.C. British Columbia; Man. Manitoba; N.B. New Brunswick; N.L. Newfoundland; N.S. Nova Scotia; O.N. Ontario; P.E.I. Prince Edward Island; Que. Quebec; Sask. Saskatchewan; data not available for Yukon Territory (Y.T.), Northwest Territories (N.W.T), or Nunavut (Nvt.).

Mentions: In the 2010 CTUMS, the prevalence (adjusted for age, sex, marital status, occupation, education, and province) for current smoking among Canadians 15 years of age and older was 20.2% (95% confidence interval [CI]: 18.8–21.7) and 63.7% (95% CI: 61.1–66.3) for quitting. At the provincial level, current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia (Figure 1), and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island (Figure 2). Odds ratios and 95% confidence intervals for current smoking and quitting from the mutually adjusted logistic regression models are presented in Table 2. The relationship between current regular smoking and age was strongly non-linear and this was emphasized by the statistical significance of the quadratic and cubic terms (P<0.001). This relationship had an inverse-U shape with a peak smoking prevalence found between the ages of 35 and 40 years. The prevalence increased rapidly at younger ages; it was 8.6% at age 15 and 27.8% at age 30, equivalent to a 3.3-fold increase (95% CI: 2.0–5.5).


Socioeconomic and geographic patterning of smoking behaviour in Canada: a cross-sectional multilevel analysis.

Corsi DJ, Lear SA, Chow CK, Subramanian SV, Boyle MH, Teo KK - PLoS ONE (2013)

Adjusted prevalence of current smoking in Canadian provinces for men (left) and women (right) aged 15 years and above, Canadian Tobacco Use Monitoring Survey 2010.Darker colours indicate higher prevalence. Estimates adjusted for age, sex, marital status, occupation, education. Province name abbreviations: Alta. Alberta; B.C. British Columbia; Man. Manitoba; N.B. New Brunswick; N.L. Newfoundland; N.S. Nova Scotia; O.N. Ontario; P.E.I. Prince Edward Island; Que. Quebec; Sask. Saskatchewan; data not available for Yukon Territory (Y.T.), Northwest Territories (N.W.T), or Nunavut (Nvt.).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585192&req=5

pone-0057646-g001: Adjusted prevalence of current smoking in Canadian provinces for men (left) and women (right) aged 15 years and above, Canadian Tobacco Use Monitoring Survey 2010.Darker colours indicate higher prevalence. Estimates adjusted for age, sex, marital status, occupation, education. Province name abbreviations: Alta. Alberta; B.C. British Columbia; Man. Manitoba; N.B. New Brunswick; N.L. Newfoundland; N.S. Nova Scotia; O.N. Ontario; P.E.I. Prince Edward Island; Que. Quebec; Sask. Saskatchewan; data not available for Yukon Territory (Y.T.), Northwest Territories (N.W.T), or Nunavut (Nvt.).
Mentions: In the 2010 CTUMS, the prevalence (adjusted for age, sex, marital status, occupation, education, and province) for current smoking among Canadians 15 years of age and older was 20.2% (95% confidence interval [CI]: 18.8–21.7) and 63.7% (95% CI: 61.1–66.3) for quitting. At the provincial level, current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia (Figure 1), and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island (Figure 2). Odds ratios and 95% confidence intervals for current smoking and quitting from the mutually adjusted logistic regression models are presented in Table 2. The relationship between current regular smoking and age was strongly non-linear and this was emphasized by the statistical significance of the quadratic and cubic terms (P<0.001). This relationship had an inverse-U shape with a peak smoking prevalence found between the ages of 35 and 40 years. The prevalence increased rapidly at younger ages; it was 8.6% at age 15 and 27.8% at age 30, equivalent to a 3.3-fold increase (95% CI: 2.0–5.5).

Bottom Line: Current smoking decreased and quitting increased with increasing SES.Current prevention and cessation policies have not been successful in improving the situation for all areas and groups.Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful.

View Article: PubMed Central - PubMed

Affiliation: Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, United States of America. djcorsi@hsph.harvard.edu

ABSTRACT

Objective: To describe the socioeconomic and geographic distribution of smoking behaviour in Canada among 19,383 individuals (51% women) aged 15-85 years.

Methods: Current smoking and quitting were modeled using standard and multilevel logistic regression. Markers of socioeconomic status (SES) were education and occupation. Geography was defined by Canadian Provinces.

Results: The adjusted prevalence of current smoking was 20.2% (95% confidence interval [CI]: 18.8-21.7) and 63.7% (95% CI: 61.1-66.3) of ever smokers had quit. Current smoking decreased and quitting increased with increasing SES. The adjusted prevalence of current smoking was 32.8% (95% CI: 28.4-37.5) among the least educated compared to 11.0% (95% CI: 8.9-13.4) for the highest educated. Among the least educated, 53.0% (95% CI: 46.8-59.2) had quit, rising to 68.7% (95% CI: 62.7-74.1) for the most educated. There was substantial variation in current smoking and quitting at the provincial level; current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia, and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island. Nationally, increasing education and occupation level were inversely associated with current smoking (odds ratio [OR] 0.64, 95% CI: 0.60-0.68 for education; OR 0.82, 95% CI: 0.77-0.87 for occupation) and positively associated with quitting (OR 1.27, 95% CI: 1.16-1.40 for education; OR 1.20, 95% CI: 1.12-1.27 for occupation). These associations were consistent in direction across provinces although with some variability in magnitude.

Conclusion: Our findings indicate that socioeconomic inequalities in smoking have persisted in Canada; current smoking was less likely and quitting was more likely among the better off groups and in certain provinces. Current prevention and cessation policies have not been successful in improving the situation for all areas and groups. Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful.

Show MeSH
Related in: MedlinePlus