Villalbí Joan R, Daban Ferran, Pasarín M Isabel, Rodríguez-Sanz Maica, Borrell Carme
Agència de Salut Pública de Barcelona, Barcelona, Spain.
Aten Primaria. 2008 Feb;40(2):87-92. doi: 10.1157/13116155.
To analyse the joint role of social class and primary health care in giving up smoking.
Cross-sectional study.
Barcelona (Catalonia, Spain), 2000-2001.
A sample of the resident non-institutionalized population, restricted to people aged 15-50 who have a habitual primary care source (n=4178).
These were obtained from the Barcelona Health Interview Survey. Independent variables include sex, social class and usual source of primary health care. Dependent variables are having ever been a smoker, having quit, and being a current smoker. Age-adjusted proportions were calculated (95% CI).
Social class shows that more manual workers have been smokers. Men smoked more than women. Overall quitting is similar in both sexes. Quitting showed a social gradient in men. Measurement of source of care showed quitting was higher among users of private clinics, but CI overlapped. On stratifying the source of primary care by social class, an effect seemed to emerge for men, but the CI overlapped. Prevalence at the time of the survey was higher for men; a class gradient in current prevalence emerged for men, but was less visible for women, where CI overlapped.
Social class is a powerful determinant of smoking. Men in low-classed jobs are at greater risk of starting to smoke, are less likely to give up, and smoke more. The proportion of quitting seems lower in of public clinics users. Health advice is efficacious, but in population terms other factors seem to have greater influence.
分析社会阶层和初级卫生保健在戒烟方面的共同作用。
横断面研究。
2000 - 2001年,巴塞罗那(西班牙加泰罗尼亚)。
常住非机构化人口样本,限于年龄在15 - 50岁且有固定初级保健机构的人群(n = 4178)。
数据来自巴塞罗那健康访谈调查。自变量包括性别、社会阶层和初级卫生保健的常用机构。因变量为曾经吸烟、已戒烟和目前仍在吸烟。计算年龄调整比例(95%置信区间)。
社会阶层显示,体力劳动者中吸烟的人更多。男性吸烟多于女性。总体戒烟情况在两性中相似。男性的戒烟情况呈现社会梯度。对保健机构的调查显示,私人诊所使用者的戒烟率较高,但置信区间有重叠。按社会阶层对初级保健机构进行分层时,男性似乎出现了一种效应,但置信区间有重叠。调查时男性的患病率较高;男性当前患病率存在阶层梯度,但女性不太明显,置信区间有重叠。
社会阶层是吸烟的一个重要决定因素。从事低阶层工作的男性开始吸烟的风险更高,戒烟的可能性更小,且吸烟量更大。公立诊所使用者的戒烟比例似乎较低。健康建议是有效的,但从总体人群来看,其他因素似乎有更大影响。