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 and quitting in Canada by demographic and socioeconomic characteristics and province.BC British Columbia; PEI Prince Edward Island.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3585192&req=5

pone-0057646-g003: Adjusted prevalence of current smoking and quitting in Canada by demographic and socioeconomic characteristics and province.BC British Columbia; PEI Prince Edward Island.

Mentions: A strong and graded association was observed between education and current smoking, with the odds of smoking being 3.92 (95% CI: 2.78–5.52) times higher among those who had not completed secondary school compared to those who had completed university (Table 2). There was no evidence of an interaction in this association by sex (P = 0.24). Current smoking was higher among those working manual occupations (OR 2.05; 95% CI: 1.49–2.83) and in sales or service occupations (OR 1.68; 95% CI: 1.25–2.25) compared to those in professional specialties with no indication of interaction by sex (P = 0.43). The adjusted prevalence of current smoking across all of the study variables and for men and women is presented in Figure 3A. We observed substantial variation in prevalence according to education; overall the prevalence varied from 11.0% among individuals who had completed university to 32.8% among those with less than high school education, corresponding to a difference of 21.8% (95% CI: 16.4–27.3). Large variation in the prevalence of current smoking was also observed by occupation group with a difference of 10.1% (95% CI: 4.2–16.3) between those in professional specialties (14.6%) and those in manual occupations (24.7%).


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 and quitting in Canada by demographic and socioeconomic characteristics and province.BC British Columbia; PEI Prince Edward Island.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057646-g003: Adjusted prevalence of current smoking and quitting in Canada by demographic and socioeconomic characteristics and province.BC British Columbia; PEI Prince Edward Island.
Mentions: A strong and graded association was observed between education and current smoking, with the odds of smoking being 3.92 (95% CI: 2.78–5.52) times higher among those who had not completed secondary school compared to those who had completed university (Table 2). There was no evidence of an interaction in this association by sex (P = 0.24). Current smoking was higher among those working manual occupations (OR 2.05; 95% CI: 1.49–2.83) and in sales or service occupations (OR 1.68; 95% CI: 1.25–2.25) compared to those in professional specialties with no indication of interaction by sex (P = 0.43). The adjusted prevalence of current smoking across all of the study variables and for men and women is presented in Figure 3A. We observed substantial variation in prevalence according to education; overall the prevalence varied from 11.0% among individuals who had completed university to 32.8% among those with less than high school education, corresponding to a difference of 21.8% (95% CI: 16.4–27.3). Large variation in the prevalence of current smoking was also observed by occupation group with a difference of 10.1% (95% CI: 4.2–16.3) between those in professional specialties (14.6%) and those in manual occupations (24.7%).

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