National Centre for Education and Training on Addiction, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.
Nicotine Tob Res. 2021 Nov 5;23(12):2047-2055. doi: 10.1093/ntr/ntab126.
Australian workers' daily tobacco smoking over time was examined by industry and occupation, to identify factors associated with high and/or low prevalence.
Secondary analyses of 2007, 2010, 2013, and 2016 National Drug Strategy Household Surveys were undertaken (pooled n = 49 395). Frequency analyses informed subsequent modeling of select industries and occupations. Four logistic regression models estimated adjusted effects of demographics on daily smoking in industries with high (≥20%) and low (≤15%) daily smoking prevalence and occupations with high (≥20%) and low-moderate (<20%) daily smoking prevalence.
The sample comprised 55.7% men, 34.1% 25-39-year-olds, 31.4% New South Wales residents, 70.1% metropolitan residents, 66.9% high socioeconomic status workers, and 70.6% with low psychological distress. Daily smoking prevalence differed by industry and occupation in 2007, generally decreasing between 2007 and 2016. In high prevalence industries, daily smoking was associated with male gender and age (25-39-year-olds) and in low prevalence industries with males and nonmetropolitan workers. In high prevalence occupations, daily smoking was associated with males, female nonmetropolitan workers, and age 25-39 years and in low-moderate prevalence occupations with nonmetropolitan workers and negatively associated with females aged 14-24 years. In all models, increased odds of daily smoking were associated with low socioeconomic status and very high psychological distress.
Low socioeconomic status and very high psychological distress were risk factors for daily smoking regardless of industry, occupation, or high preexisting smoking prevalence. Targeted, as well as universal, interventions are required for workplaces and workers with greatest smoking vulnerability and least smoking cessation progress.
Specific strategies are warranted for identified industries, occupations, and subgroups with increased odds of daily tobacco smoking. Industries and occupations with low-moderate smoking prevalence may confer workers some protection but are not without risk; some subgroups in these settings (eg, nonmetropolitan areas) had elevated daily smoking risk. Hence, the following are supported: (1) universal interventions directed at low socioeconomic workers and workers with very high psychological distress regardless of workplace; (2) interventions targeted at high prevalence industries; (3) cessation efforts targeted for young workers in high prevalence industries and occupations; and (4) focused interventions addressing specific needs of nonmetropolitan at-risk workers in low prevalence industries.
本研究通过行业和职业分析,考察了澳大利亚工人吸烟率随时间的变化,以确定与高(≥20%)和低(≤15%)吸烟率相关的因素。
对 2007、2010、2013 和 2016 年国家药物策略家庭调查的二次分析(合并 n=49395)。频率分析为随后选择行业和职业的建模提供了信息。使用四个逻辑回归模型估计了高(≥20%)和低(≤15%)吸烟率行业以及高(≥20%)和低中度(<20%)吸烟率职业中人口统计学因素对每日吸烟的调整影响。
样本由 55.7%的男性、34.1%的 25-39 岁人群、31.4%的新南威尔士州居民、70.1%的大都市居民、66.9%的高社会经济地位工人和 70.6%的低心理困扰工人组成。2007 年,不同行业和职业的吸烟率存在差异,且普遍呈下降趋势。在高吸烟率行业,吸烟与男性性别和年龄(25-39 岁)相关,而在低吸烟率行业,吸烟与男性和非大都市工人相关。在高吸烟率职业中,吸烟与男性、女性非大都市工人和 25-39 岁年龄相关,而在低中度吸烟率职业中,吸烟与非大都市工人相关,与 14-24 岁女性呈负相关。在所有模型中,较低的社会经济地位和极高的心理困扰都与每日吸烟的几率增加有关。
无论行业、职业或高吸烟率,低社会经济地位和极高的心理困扰都是每日吸烟的风险因素。针对最易吸烟和戒烟进展最慢的工作场所和工人,需要采取有针对性和普遍性的干预措施。
对于具有较高每日吸烟几率的特定行业、职业和亚组,需要制定具体的策略。低吸烟率和中等吸烟率的行业和职业可能会给工人带来一些保护,但并非没有风险;这些环境中的某些亚组(例如非大都市地区)存在较高的每日吸烟风险。因此,以下措施得到支持:(1)针对低社会经济地位和高心理困扰的工人,无论工作场所如何,都要采取普遍性的干预措施;(2)针对高吸烟率行业的干预措施;(3)针对高吸烟率行业和职业的年轻工人的戒烟努力;(4)针对低吸烟率行业中处于高风险的非大都市工人的重点干预措施。