Harman Juliet, Graham Hilary, Francis Brian, Inskip Hazel M
Centre for Applied Statistics, Department of Mathematics and Statistics, Lancaster University, Lancaster LA1 4YF, UK.
Soc Sci Med. 2006 Dec;63(11):2791-800. doi: 10.1016/j.socscimed.2006.07.021. Epub 2006 Sep 7.
Marked and increasing socioeconomic gradients in cigarette smoking are well established. Tracking these differentials among women requires appropriate measures of their socioeconomic position (SEP) which are equivalent across older and younger age groups. This study examines socioeconomic gradients in cigarette smoking by age among women aged 20-34, using a standard indicator of SEP (age left full-time education) and alternative indicators which take account of changes in women's educational levels across age cohorts. The study is based on a large cross-sectional British data set (n = 12,398), the Southampton Women's Survey, conducted 1998-2002. Poisson log-linear regression with adjusted variance was used to predict smoking status (ever smoked > or =1 cigarette a day for 1 year, currently smoking > or =1 cigarette a day, and ex-smoker - ever-smoker not currently smoking > or =1 cigarette a day) in models which controlled for SEP, age and year of interview. Socioeconomic gradients in ever-smoking were marked but stable across age groups. With quitting more prevalent in the higher than lower socioeconomic groups, gradients in current smoking steepened across age groups, with significant age/SEP interactions. The socioeconomic patterning of ever, ex and current smoking was similar using both the standard and alternative measures of education, but interactions were less pronounced with the alternative measures. Socioeconomic indicators which take account of the recent and rapid increase in women's educational participation rates may provide a more reliable indication of age-related differentials in smoking status than standard measures. Nonetheless, both conventional and alternative measures point to stable socioeconomic differentials in rates of ever-smoking and widening differentials in current smoking across age groups. Our study confirms that addressing the link between socioeconomic disadvantage and tobacco use remains a major challenge for the tobacco control community.
吸烟方面显著且不断扩大的社会经济梯度已得到充分证实。要追踪女性之间的这些差异，需要有适用于各个年龄组的社会经济地位（SEP）衡量指标。本研究使用SEP的标准指标（完成全日制教育时的年龄）以及考虑到不同年龄队列女性教育水平变化的替代指标，来考察20至34岁女性中吸烟的社会经济梯度。该研究基于1998年至2002年进行的一项大型英国横断面数据集（n = 12398）——南安普顿女性调查。在控制了SEP、年龄和访谈年份的模型中，采用调整方差的泊松对数线性回归来预测吸烟状况（曾经每天吸烟≥1支持续1年、目前每天吸烟≥1支以及已戒烟——曾经吸烟但目前每天吸烟<1支）。曾经吸烟的社会经济梯度在各年龄组中显著但稳定。由于较高社会经济群体中戒烟更为普遍，各年龄组当前吸烟的梯度变得更陡，存在显著的年龄/SEP交互作用。使用教育的标准指标和替代指标时，曾经吸烟、已戒烟和当前吸烟的社会经济模式相似，但替代指标的交互作用不太明显。考虑到女性教育参与率近期快速增长的社会经济指标，可能比标准指标更可靠地反映吸烟状况的年龄相关差异。尽管如此，传统指标和替代指标均表明，曾经吸烟率的社会经济差异稳定，而各年龄组当前吸烟的差异在扩大。我们的研究证实，解决社会经济劣势与烟草使用之间的联系仍是烟草控制界面临的一项重大挑战。
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