Widening inequalities in smoking initiation and cessation patterns: A cohort and gender analysis in France
Widening inequalities in smoking initiation and cessation patterns: A cohort and gender analysis in France
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DOI：
10.1016/j.drugalcdep.2011.02.004
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发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
Peretti-Watel, P.
中科院分区：
文献类型：
--
作者：
Legleye, S.;Khlat, M.;Peretti-Watel, P.
目的：本研究根据性别和出生队列调查了法国在开始吸烟和戒烟方面教育不平等的演变。方法：我们使用了 2005 年全国范围内的调查，调查对象包括 25,239 名 18-75 岁的受试者。定义了三个队列组（出生于 1930-1945 年、1946-1965 年或 1966-1987 年）。我们通过时间离散逻辑回归比较了他们 40 岁之前的吸烟史。使用比值比和相对不平等指数（RII）量化开始和戒烟的教育差异，并使用比值比（性别比）量化性别差距。结果：对于开始吸烟，在最年长的队列中，男性没有出现教育梯度，但女性存在正梯度（RII = 0.19）；在中间队列中，男性出现负梯度（RII = 1.55），而女性出现正梯度（RII = 0.74）：在最年轻的队列中，男性负梯度加强（RII = 2.72），而女性出现负梯度（RII = 1.86）。性别比例从最年长的队列（3.23）缩小到最年轻的队列（1.09），并且随着每个队列中教育水平的提高而减小。在戒烟方面，两性的教育梯度均为负值，最年轻人群中的差距更大，性别比低于1反映了女性更显着的戒烟动态。结论：女性在烟草流行中处于起步阶段比男性早，戒烟阶段晚，社会不平等正在扩大。我们相信，除非在预防活动中考虑性别和吸烟的心理社会方面，否则吸烟率不会减少。 (C) 2011 Elsevier Ireland Ltd. 保留所有权利。
Aims: This study investigates the evolution of educational inequalities in smoking initiation and cessation in France according to gender and birth cohort.Methods: We used a 2005 nationwide survey comprising 25,239 subjects aged 18-75 years. Three cohort groups were defined (born 1930-1945, 1946-1965 or 1966-1987). We compared their smoking histories until age 40 years with time-discrete logistic regressions. Educational differences in initiation and cessation were quantified using odds ratios and relative indices of inequality (RII), and the gender gap using odds ratios (gender ratios).Results: For smoking initiation, in the oldest cohorts, no educational gradient appeared in men, but there was a positive gradient in women (RII = 0.19); ill the middle cohorts, a negative gradient emerged in men (RII = 1.55), while the positive gradient reduced in women (RII = 0.74): in the youngest cohorts, there was a strengthening of the negative gradient in men (RII = 2.72), and the emergence of a negative gradient for women (RII = 1.86). The gender ratio narrowed from the oldest cohorts (3.23) to the youngest (1.09), and diminished with increasing educational level within each cohort. For smoking cessation, the educational gradients were negative in both genders, with wider gaps in the youngest cohorts, and gender ratios below 1 reflecting more marked cessation dynamics in women.Conclusion: Women are at an earlier stage in the tobacco epidemic than men for initiation and at a later stage for cessation and social inequalities are widening. We believe that they will not decrease unless gender and the psycho-social aspects of smoking are considered in prevention campaigns. (C) 2011 Elsevier Ireland Ltd. All rights reserved.