Yaya Sanni, Bishwajit Ghose, Shah Vaibhav, Ekholuenetale Michael
School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tob Use Insights. 2017 Aug 14;10:1179173X17726297. doi: 10.1177/1179173X17726297. eCollection 2017.
Tobacco smoking is a growing concern for health care systems as it is projected to become the leading cause of death in the developing world. Knowledge of how smoking behavior differs across socioeconomic groups is crucial for designing effective preventive policies and alleviating the disparities. The aim of this study was to report the prevalence of (1) smoking status, (2) early smoking initiation, and (3) association with socioeconomic status (SES) of the 2 among Malawian men.
Cross-sectional data on 1693 men aged between 15 and 49 years were collected from the latest 2013-2014 Multiple Indicator Cluster Survey in Malawi. Educational qualification and wealth index quintile were used as the indicators of SES. Outcome variables were smoking status, first age of smoking being below 18 years, and ever using any form of smokeless tobacco products. Multiple logistic regression models were used to see the contribution of SES to smoking status and early smoking initiation.
Mean age of the sample population was 33.23 years (SD: 8.25). Prevalence of smoking, early initiation, and ever using any form of smokeless tobacco were, respectively, 46.6%, 33.7%, and 6%. Compared with men who had higher education, those who had no formal education, primary-level, and secondary-level qualification had, respectively, 21% (adjusted odds ratio [AOR] = 1.209; 95% confidence interval [CI] = 0.498-2.935), 40% (AOR = 1.4; 95% CI = 0.647-3.029), and 26% (AOR = 1.256; 95% CI = 0.593-2.661) higher odds of being a smoker. Those who had no formal education were 2.7 times (AOR = 2.734; 95% CI = 1.123-6.653) as likely to try smoking before reaching 18 years of age. Compared with the richest, those in the lowest wealth quintile had 32% lower odds (AOR = 0.676; 95% CI = 0.455-1.006) of early onset of smoking, 63% lower odds (AOR = 0.372; 95% CI = 0.201-0.690) of trying other tobacco products.
Addressing the socioeconomic disparities could play a vital role in delaying early onset and limiting overall consumption of tobacco. Ongoing health policy talks to reduce the prevalence of smoking should take into consideration improving educational and material well-being among men.
吸烟对医疗保健系统而言是一个日益令人担忧的问题，因为预计它将成为发展中世界的主要死因。了解吸烟行为在不同社会经济群体中的差异，对于制定有效的预防政策和缩小差距至关重要。本研究的目的是报告马拉维男性中（1）吸烟状况、（2）早期开始吸烟情况以及（3）这两者与社会经济地位（SES）的关联。
从马拉维最新的2013 - 2014年多指标类集调查中收集了1693名年龄在15至49岁之间男性的横断面数据。教育程度和财富指数五分位数被用作社会经济地位的指标。结果变量包括吸烟状况、首次吸烟年龄低于18岁以及曾经使用过任何形式的无烟烟草制品。使用多元逻辑回归模型来观察社会经济地位对吸烟状况和早期开始吸烟的影响。
样本人群的平均年龄为33.23岁（标准差：8.25）。吸烟、早期开始吸烟以及曾经使用过任何形式无烟烟草的患病率分别为46.6%、33.7%和6%。与受过高等教育的男性相比，未接受过正规教育、小学学历和初中学历的男性成为吸烟者的几率分别高出21%（调整后优势比[AOR] = 1.209；95%置信区间[CI] = 0.498 - 2.935）、40%（AOR = 1.4；95% CI = 0.647 - 3.029）和26%（AOR = 1.256；95% CI = 0.593 - 2.661）。未接受过正规教育的男性在18岁之前尝试吸烟的可能性是受过高等教育男性的2.7倍（AOR = 2.734；95% CI = 1.123 - 6.653）。与最富有的人相比，处于最低财富五分位数的人早期开始吸烟的几率低32%（AOR = 0.676；95% CI = 0.455 - 1.006），尝试其他烟草制品的几率低63%（AOR = 0.372；95% CI = 0.201 - 0.690）。
解决社会经济差距问题对于延缓吸烟的早期开始和限制烟草的总体消费可能起着至关重要的作用。正在进行的关于降低吸烟率的健康政策讨论应考虑改善男性的教育和物质福利。
