Smoking is a significant risk factor for several diseases. Social inequalities have been

described for both tobacco consumption and, though to a lesser extend, for tobacco cessation.

Previous works had shown that less affluent classes are more prone to smoke and less to quit

smoking. These results have been observed for both men and women, in several European

countries.1, 2

Aims

This study aims to describe socio-demographic factors associated with tobacco consumption

and cessation in Portugal.

Socio-demographic factors associated with tobacco

consumption and cessation in Portugal

Andreia Leite1, Ausenda Machado 1, Carlos Matias Dias1

1. Departamento de Epidemiologia (Department of Epidemiology), Instituto Nacional de Saúde Dr. Ricardo Jorge (National Institute of Health Doutor. Ricardo Jorge, INSA), Lisbon, Portugal

European Congress of Epidemiology – August 12-13, 2013 – Aarhus, Denmark

Introduction

Unfavourable socio-demographic characteristics are associated with higher prevalence of being a

current smoker and lower of being an ex-smoker. Different and further cessation measures are

needed in these less prone to quit group of individuals, namely men from Azores, divorced,

unemployed and with lower secondary education. In women divorced, unemployed and those with

higher and pos-secondaire should be targeted.

Conclusion

Data from the 2005/2006 Portuguese National Health Interview Survey was analyzed. A

multinomial log-linear model was fitted considering 3 groups of reported tobacco consumption:

• Present smokers – Those who have claimed to smoke during the last 15 days;

• Former smokers – Those who have reported to smoke but not in the last 15 days;

• Never smokers – Those who have claimed never had smoke.

Data was analyzed with the R software version 2.15.3 (package nnet).3, 4 Analysis was run

separately for men and women and adjusted for age. Relative Risk Ratios (RRR) were obtained:

• Present smokers to never smokers;

• Former smokers to present smokers.

Divorced

Single

Widowed

Unemployed

Domestic tasks

Others

Retired

Employed

None

Primary

Lower secondaire

Higher secondaire

Pos-secondaire

0 0.5 1.0 1.5 2.0 2.5

Marital status

(Ref. Married)

Results

Methods

Figure 1. Relative risk ratio of being a former smoker comparatively to present smokers in each of the response categories of

socio-demographic covariates. Ref. is the reference class for a given covariate.

Divorced

Single

Widowed

Unemployed

Domestic tasks

Others

Retired

Employed

None

Primary

Lower secondaire

Higher secondaire

Pos-secondaire

0 1.0 2.0 3.0 4.0 6.0 5.0

Marital status

(Ref. Married)

Figure 2. Relative risk ratio of being a present smokers comparatively to never smokers in each of the response categories of

socio-demographic covariates. Ref. is the reference class for a given covariate.

Bibliography 1. Semyonov L, Iarocci G, Boccia A, La Torre G. Socioeconomic differences in tobacco smoking in Italy: is there an interaction between variables? ScientificWorldJournal. 2012;2012:286472.

2. Laaksonen M, Rahkonen O, Karvonen S, Lahelma E. Socioeconomic status and smoking: analysing inequalities with multiple indicators. Eur J Public Health. 2005;15(3):262-9.

3. R Development Core Team (2011). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-

project.org/.

4. Venables, W. N. & Ripley, B. D. (2002) Modern Applied Statistics with S. Fourth Edition. Springer, New York. ISBN 0-387-95457-0.

Analysis from RRR of former smokers comparatively to present smokers and of present smokers

comparatively to never smokers shows that classes of higher tobacco consumption are, in general,

those of lower cessation. For men this classes are divorcees, unemployed, men with lower

secondary education and from Azores [respectively RRR (95% Confidence Intervals (95CI)): 0.50

(0.41, 0.61) and 2.01 (1.64, 2.46); RRR (95CI): 0.16 (0.13, 0.20) and 6.29 (5.00, 7.91); RRR (95CI):

0.65 (0.56, 0.77) and 1.53 (1.30, 1.79); RRR (95CI) 0.53 (0.46, 0.61) and 1.89 (1.64, 2.18) ].

For women higher RRR of smoking were, in general, those of lower RRR of stop smoking.

Exceptions were found in the non-unemployed women and those with less that upper secondary.

For region Madeira had a lower RRR of stop smoking and Lisbon had the higher RRR of smoking

[RRR (IC95): 0.40 (0.27, 0.58) and 2.11 (1.74, 2.57), respectively]. Divorced and unemployed had

the lowest prevalence of cessation and the highest of smoking [RRR (IC95): 0.54 (0.41, 0.69) and

3.21 (2.69, 3.84), RRR (IC95): 0.83 (0.51, 1.38) and 4.23 (3.20, 5.58)].

1.88

1.33

2.11

1.00

1.10

1.00 – 1.22

1.23 – 1.44

1.45 – 1.67

1.68 – 1.89

1.90 – 2.11

0.77

0.76

0.88

1.00

1.03

0.40 – 0.53

0.54 – 0.65

0.66 – 0.78

0.79 – 0.90

0.91 – 1.03

1.00 – 1.18

1.19 – 1.36

1.37 – 1.53

1.54 – 1.71

1.72 – 1.89

1.79

1.67

1.37

1.00

1.18

0.53 – 0.62

0.63 – 0.72

0.73 – 0.81

0.82 – 0.91

0.92 – 1.00

0.60

0.56

0.73

1.00

0.84

Education

(Ref. Higher)

Professional situation

(Ref. Student)

Professional

situation

(Ref. Student)

Education

(Ref. Higher)

Male Female Male Female

Figure 3. Relative risk ratio of being a former smoker comparatively to present smokers for region. Maps in blue represent men

and maps in rose refer to women.

Figure 4. Relative risk ratio of being a present smoker comparatively to never smokers for region. Maps in blue represent men

and maps in rose refer to women.

0.53

0.81 0.40

0.60

1.24

1.89

1.08

1.38