UK Centre for Tobacco Control Studies, University of Nottingham, Division of Epidemiology and Public Health, Clinical Sciences Building, Nottingham City Hospital, Nottingham NG5 1PB, UK.
BMC Public Health. 2013 Jun 5;13:546. doi: 10.1186/1471-2458-13-546.
Smoking prevalence is particularly high amongst more deprived social groups. This cross-sectional study uses the Mosaic classification to explore socioeconomic variations in the delivery and/or uptake of cessation interventions in UK primary care.
Data from 460,938 smokers registered in The Health Improvement Network between 2008 and 2010 were analysed. Logistic regression was used to calculate odds ratios for smokers having a record of receiving cessation advice or a prescription for a cessation medication during the study period by Townsend quintile and for each of the 11 Mosaic groups and 61 Mosaic types. Both of these measures are area-level indicators of deprivation. Profiles of Mosaic categories were used to suggest ways to target specific groups to increase the provision of cessation support.
Odds ratios for smokers having a record of advice or a prescription increased with increasing Townsend deprivation quintile. Similarly, smokers in more deprived Mosaic groups and types were more likely to have a documented cessation intervention. The odds of smokers receiving cessation advice if they have uncertain employment and live in social housing in deprived areas were 35% higher than the odds for successful professionals living in desirable areas (odds ratio (OR) 1.35, 95% confidence interval (CI) 1.20-1.52; absolute risks 57.2% and 50.1% respectively), and those in low-income families living in estate-based social housing were 50% more likely to receive a prescription than these successful professionals (OR 1.50, 95% CI 1.31-1.73; absolute risks 19.5% and 13% respectively). Smokers who did not receive interventions were generally well educated, financially successful, married with no children, read broadsheet newspapers and had broadband internet access.
Wide socioeconomic variations exist in the delivery and/or uptake of smoking cessation interventions in UK primary care, though encouragingly the direction of this variation may help to reduce smoking prevalence-related socioeconomic inequalities in health. Groups with particularly low intervention rates may be best targeted through broadsheet media, the internet and perhaps workplace-based interventions in order to increase the delivery and uptake of effective quit support.
吸烟率在较贫困的社会群体中尤其高。本横断面研究使用马赛克分类法来探讨英国初级保健中戒烟干预措施的提供和/或采用情况在社会经济方面的差异。
对 2008 年至 2010 年间在健康改善网络登记的 460938 名吸烟者的数据进行了分析。采用 logistic 回归计算了按汤森德五分位数和 11 个马赛克组和 61 个马赛克类型计算吸烟者在研究期间接受戒烟建议或戒烟药物处方记录的可能性比。这两个指标都是地区贫困程度的指标。马赛克类别的分布情况用于建议针对特定群体的方法，以增加戒烟支持的提供。
有记录的建议或处方的吸烟者的可能性比随着汤森德贫困五分位数的增加而增加。同样，在较贫困的马赛克组和类型中的吸烟者更有可能接受记录的戒烟干预措施。如果他们从事不稳定的工作且居住在贫困地区的社会住房中，吸烟者接受戒烟建议的可能性比成功专业人士居住在理想地区的可能性高 35%（比值比（OR）1.35，95%置信区间（CI）1.20-1.52；绝对风险分别为 57.2%和 50.1%），而那些在以庄园为基础的社会住房中低收入家庭的吸烟者获得处方的可能性比这些成功专业人士高 50%（OR 1.50，95%CI 1.31-1.73；绝对风险分别为 19.5%和 13%）。未接受干预的吸烟者通常受教育程度较高、经济上成功、已婚且没有子女、阅读大报和使用宽带互联网。
在英国初级保健中，戒烟干预措施的提供和/或采用存在广泛的社会经济差异，但令人鼓舞的是，这种差异的方向可能有助于减少与吸烟相关的健康方面的社会经济不平等。干预率特别低的群体可能通过大报媒体、互联网和可能的基于工作场所的干预措施来针对性地进行干预，以提高有效戒烟支持的提供和采用。
