Gender, Tobacco Control Policies, and Persistent Smoking Among Older Adults: A Longitudinal Analysis of 11 European Countries.
Gender, Tobacco Control Policies, and Persistent Smoking Among Older Adults: A Longitudinal Analysis of 11 European Countries.
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性别、烟草控制政策和老年人持续吸烟：11 个欧洲国家的纵向分析。
DOI：
10.1093/ntr/ntac023
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Park,Soojin
中科院分区：
文献类型：
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作者：
Gao,Manjing;Lee,Chioun;Park,Soojin
当一个人出现可能由吸烟引起的健康状况时，对持续吸烟的社会人口学和宏观水平预测因素知之甚少。目的和方法我们调查了性别、教育和烟草控制政策（tcp）对欧洲老年人持续吸烟的影响。调查对象（年龄50岁以上）均有吸烟史，且至少有一种与吸烟相关的健康状况。调查对象来自2004年至2013年欧洲健康、老龄化和退休调查（SHARE）和英国老龄化纵向研究（ELSA）的四次调查。我们拟合了具有双向固定效应（国家和年份）的性别特定逻辑回归模型，并测试了性别、教育和tcp之间的相互作用项。结果尽管女性吸烟的可能性低于男性，但她们更有可能持续吸烟。教育程度和一般控烟计划对持续吸烟的影响仅在女性中显著。与受教育程度低的女性相比，受教育程度中等的女性(优势比[OR] = .63；82)和高等教育(OR = 0.57；不太可能成为长期吸烟者。tcp与女性持续吸烟风险降低相关（OR = 0.70; 0.51 -）。95)而且受教育程度越低，这种联系就越强。结论老年妇女，尤其是受教育程度较低的妇女易受持续吸烟的影响。tcp可能对减少老年妇女持续吸烟有效，对受教育程度较低的妇女效果更大。未来的研究需要了解解释性别对tcp反应差异的机制。持续吸烟是一种特别有害的吸烟行为，因为它与更大的合并症和死亡风险有关。通过采用多层次健康社会决定因素的框架，本研究调查了欧洲国家老年人持续吸烟的行为。妇女，特别是受教育程度低的妇女容易受到持续吸烟的影响。此外，总体而言，tcp仅与老年妇女持续吸烟的减少显著相关，而对于受教育程度较低的妇女，这种负相关关系更强，这表明对tcp的反应存在性别和社会经济差异。
IntroductionLittle is known about sociodemographic and macro-level predictors of persistent smoking when one has developed a health condition that is likely caused by smoking.Aims and MethodsWe investigate the impact of gender, education, and tobacco control policies (TCPs) on persistent smoking among older Europeans. Respondents (aged 50 +) with a smoking history and at least one smoking-related health condition were pooled from the Survey of Health, Aging and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) from four waves from 2004 to 2013. We fitted gender-specific logistic regression models with two-way fixed effects (country and year) and tested interaction terms between gender, education, and TCPs.ResultsAlthough women are less likely to smoke than men, they were more likely to smoke persistently. The effects of education and general TCPs on persistent smoking were significant for women only. Compared to women with low levels of education, those with moderate education (odds ratio [OR] = .63; .49–.82) and high education (OR = .57; .34–.98) are less likely to be persistent smokers. TCPs are associated with a reduced risk of women’s persistent smoking (OR = .70; .51–.95) and the association is stronger for those having less education.ConclusionsOlder women, particularly those with low levels of education, are vulnerable to persistent smoking. TCPs might be effective in reducing persistent smoking for older women, with greater effects for less-educated women. Future studies are needed to understand mechanisms that explain gender differences in responsiveness to TCPs.ImplicationsPersistent smoking is a particularly harmful smoking behavior as it is associated with greater risks of comorbidity and mortality. By employing the framework of the multilevel social determinants of health, this study examined the behavior of persistent smoking among older adults in European countries. Women, especially women with low levels of education are vulnerable to persistent smoking. Moreover, TCPs, in general, are significantly related to a reduction in persistent smoking among older women only and the negative association is stronger for those having less education, indicating gender and socioeconomic differences in responsiveness to TCPs.