Evaluating the Health Effects of Social Interventions, MRC/CSO Social and Public Health Sciences Unit, 4 Lilybank Gardens, Glasgow G128RZ, UK.
J Epidemiol Community Health. 2013 Apr;67(4):299-304. doi: 10.1136/jech-2012-201828. Epub 2012 Dec 4.
People living in areas of multiple deprivation are more likely to smoke and less likely to quit smoking. This study examines the effect on smoking and intention to quit smoking for those who have experienced housing improvements (HI) in deprived areas of Glasgow, UK, and investigates whether such effects can be explained by improved mental health.
Quasi-experimental, 2-year longitudinal study, comparing residents' smoking and intention to quit smoking for HI group (n=545) with non-HI group (n=517), adjusting for baseline (2006) sociodemographic factors and smoking status. SF-12 mental health scores were used to assess mental health, along with self-reported experience of, and General Practitioner (GP) consultations for, anxiety and depression in the last 12 months.
There was no relationship between smoking and HI, adjusting for baseline rates (OR=0.97, 95% CI 0.57 to 1.67, p=0.918). We found an association between intention to quit and HI, which remained significant after adjusting for sociodemographics and previous intention to quit (OR 2.16, 95% CI 1.12 to 4.16, p=0.022). We found no consistent evidence that this association was attenuated by improvement in our three mental health measures.
Providing residents in disadvantaged areas with better housing may prompt them to consider quitting smoking. However, few people actually quit, indicating that residential improvements or changes to the physical environment may not be sufficient drivers of personal behavioural change. It would make sense to link health services to housing regeneration projects to support changes in health behaviours at a time when environmental change appears to make behavioural change more likely.
生活在多重贫困地区的人更有可能吸烟,而戒烟的可能性较小。本研究考察了在英国格拉斯哥贫困地区经历住房改善(HI)的人对吸烟和戒烟意愿的影响,并探讨了这些影响是否可以通过改善心理健康来解释。
采用准实验、2 年纵向研究,比较了 HI 组(n=545)和非 HI 组(n=517)居民的吸烟和戒烟意愿,调整了基线(2006 年)社会人口因素和吸烟状况。使用 SF-12 心理健康评分来评估心理健康,以及自我报告的过去 12 个月的焦虑和抑郁经历以及全科医生(GP)咨询情况。
在调整基线率后,吸烟与 HI 之间没有关系(OR=0.97,95%CI 0.57 至 1.67,p=0.918)。我们发现戒烟意愿与 HI 之间存在关联,在调整社会人口统计学因素和之前的戒烟意愿后,这一关联仍然显著(OR 2.16,95%CI 1.12 至 4.16,p=0.022)。我们没有发现一致的证据表明,这一关联可以通过改善我们的三种心理健康测量来减弱。
为处于不利地位的地区的居民提供更好的住房可能会促使他们考虑戒烟。然而,很少有人真正戒烟,这表明住房改善或物理环境的变化可能不足以推动个人行为改变。在环境变化似乎更有可能导致行为改变的时候,将健康服务与住房再生项目联系起来,以支持健康行为的改变,这是有意义的。