Social determinants of smoking in low- and middle-income countries: results from the World Health Survey.
Social determinants of smoking in low- and middle-income countries: results from the World Health Survey.
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DOI：
10.1371/journal.pone.0020331
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Chatterji S
中科院分区：
文献类型：
--
作者：
Hosseinpoor AR;Parker LA;Tursan d'Espaignet E;Chatterji S
吸烟是导致过早死亡和残疾的主要原因，世界上80%以上的吸烟者生活在低收入或中等收入国家。本研究的目的是评估低收入和中等收入国家目前吸烟的人口和社会经济决定因素。我们使用来自48个低收入和中等收入国家的世界健康调查数据，探讨人口和社会经济因素对受访者当前吸烟状况的影响。这些调查的数据提供了213，807名18岁或以上受访者的信息，这些受访者根据性别和国家收入分组分为4个汇总数据集。在每个汇总数据集中计算当前吸烟者的总体比例以及每个相关人口统计学和社会经济学决定因素的比例，并使用多变量logistic回归评估当前吸烟与这些决定因素之间的关联。吸烟的几率在所有人口统计学或社会经济群体中并不相等。在研究的四个数据集中，一些因素相当稳定：例如，如果受教育程度很低或没有受教育，无论是男性还是女性，或者生活在低收入或中等收入国家，个人更有可能吸烟。然而，其他因素，特别是年龄和财富，对吸烟的影响因性别或国家收入水平而异。虽然低收入国家组中处于最低财富五分之一的妇女吸烟的可能性是最高财富五分之一的妇女的两倍，但在中等收入国家组中，这种联系并不存在。关于吸烟在低收入或中等收入国家中分布情况的信息将使决策者能够调整未来的政策，并以最脆弱的人口为目标。
Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries. We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants. The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group. Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations.
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