Rathmann Katharina, Pförtner Timo-Kolja, Elgar Frank J, Hurrelmann Klaus, Richter Matthias
Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany.
Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Faculty of Human Sciences and the Faculty of Medicine, University of Cologne, Cologne, Germany.
Nicotine Tob Res. 2017 Nov 1;19(11):1284-1291. doi: 10.1093/ntr/ntw298.
Conflicting evidence has been reported on smoking behavior among adults during times of economic downturn. No study has yet investigated young people's smoking and inequalities in smoking during economic recessions. This study examines the association between country-level youth unemployment due to the economic recession and adolescent smoking and smoking inequalities in Europe.
The WHO collaborative "Health Behaviour in School-aged Children" study in 2009/2010 included 15-year-old adolescents from 24 European countries (N = 43 093). Socioeconomic position (SEP) was measured by the Family Affluence Scale. Logistic multilevel models were conducted. The absolute rate of youth unemployment in 2010 (during the recession) and the relative change rate in youth unemployment (2005/2006-2009/2010) were regressed on smoking and SEP inequalities in smoking in 2010, respectively.
Youth unemployment rates were not significantly associated with overall smoking in adolescents. A higher absolute youth unemployment rate in 2010 related to lower likelihoods of smoking among middle (OR: 0.99; 95% CI: 0.98-0.99) and low affluent adolescents (OR: 0.99; 95% CI: 0.98-0.99) compared to high affluent adolescents. In contrast, an increase in youth unemployment (2005/2006-2009/2010) was not associated with overall likelihoods of smoking and inequalities in smoking.
Our findings indicate that an increase in youth unemployment was not related to smoking and smoking inequalities. However, higher absolute levels of youth unemployment are related to lower likelihoods of smoking in lower SEP adolescents. Thus, smoking among vulnerable groups is more linked to the overall insecure circumstances and the affordability of cigarettes rather than to the economic recession itself.
Economic recessions have often led to increases in adult and youth unemployment rates. Conflicting evidence has been reported on smoking behavior among adults during times of economic downturn. This study examines for the first time the impact of the economic recession on young people's smoking and socioeconomic inequalities in smoking. Findings highlight that rather than an increase in youth unemployment, the overall country-level youth unemployment rate is related to young people's tobacco use and particularly to lower odds in smoking among less affluent adolescents across Europe, a finding which is likely to be linked to the affordability of tobacco use.
关于经济衰退时期成年人的吸烟行为，已有相互矛盾的证据报道。尚无研究调查经济衰退期间年轻人的吸烟情况及吸烟方面的不平等现象。本研究考察欧洲因经济衰退导致的国家层面青年失业率与青少年吸烟及吸烟不平等之间的关联。
2009/2010年世界卫生组织合作开展的“学龄儿童健康行为”研究纳入了来自24个欧洲国家的15岁青少年（N = 43093）。社会经济地位（SEP）通过家庭富裕量表进行衡量。采用逻辑多水平模型。分别将2010年（衰退期间）青年失业率的绝对比率以及青年失业率的相对变化率（2005/2006 - 2009/2010）对2010年的吸烟情况及吸烟方面的SEP不平等进行回归分析。
青年失业率与青少年总体吸烟情况无显著关联。与高富裕程度的青少年相比，2010年较高的青年失业率绝对值与中等富裕程度（比值比：0.99；95%置信区间：0.98 - 0.99）和低富裕程度青少年（比值比：0.99；95%置信区间：0.98 - 0.99）吸烟可能性较低相关。相比之下，青年失业率的增加（2005/2006 - 2009/2010）与总体吸烟可能性及吸烟不平等无关。
我们的研究结果表明，青年失业率的增加与吸烟及吸烟不平等无关。然而，较高的青年失业率绝对值与社会经济地位较低的青少年吸烟可能性较低相关。因此，弱势群体中的吸烟行为更多地与总体不安全状况及香烟的可负担性相关，而非与经济衰退本身相关。
经济衰退常常导致成年人及青年失业率上升。关于经济衰退时期成年人的吸烟行为，已有相互矛盾的证据报道。本研究首次考察了经济衰退对年轻人吸烟及吸烟社会经济不平等的影响。研究结果表明，与青年失业率的增加相比，国家层面的青年总体失业率与年轻人的烟草使用相关，尤其与欧洲较不富裕青少年吸烟几率较低相关，这一发现可能与烟草使用的可负担性有关。
