Department of Behavioural Science and Health, University College London, London, UK.
SPECTRUM Research Consortium, Edinburgh, UK.
Nicotine Tob Res. 2022 Mar 26;24(5):690-698. doi: 10.1093/ntr/ntab211.
Smoking among those who live with children is an important influence on smoking initiation among children. This study assessed socioeconomic inequalities in smoking and quitting-related outcomes among all adults with and without children in the household.
Monthly repeat cross-sectional household survey of adults (16+) from 2013-2019 in England (N = 138 583). We assessed the association between cigarette smoking and quitting-related outcomes and having children in the household, and whether these relationships were moderated by occupational social grade (categories AB-E from most to least advantaged). Trends in smoking prevalence among adults with and without children in the household were explored.
In adjusted analysis, the association of having children in the household with smoking prevalence depended on social grade: smoking prevalence was between 0.71 (95% confidence interval 0.66-0.77) and 0.93 (0.88-0.98) times lower among social grades AB-D with children in the household relative to those without. Conversely, it was 1.11 (1.05-1.16) times higher among social grade E. Yearly prevalence declined similarly among those with and without children (both prevalence ratio: 0.98, 95% confidence interval 0.97-0.99). Motivation to stop smoking was higher among those with children than those without, but lower among disadvantaged than more advantaged groups. Social grades D-E had greater heavy smoking, but higher prevalence of past-month quit attempts.
Among the most disadvantaged social grade in England, smoking prevalence was higher in those with children in the household than without. To attenuate future smoking-related inequalities, there is an urgent need to target support and address barriers to quitting and promote longer-term quit success.
In the most disadvantaged occupational social grade, having children in the household was associated with higher smoking prevalence compared with not having children. This contrasts with all other social grades in which there was lower comparative smoking prevalence among those with than without children in the household. Without attention this disparity could exacerbate existing and future health inequalities related to smoking.
与孩子一起生活的人中吸烟是儿童吸烟的一个重要影响因素。本研究评估了家庭中有和没有孩子的所有成年人的吸烟和戒烟相关结果的社会经济不平等。
这是一项 2013-2019 年在英格兰进行的家庭中成年人（16 岁及以上）每月重复横断面调查（N=138583）。我们评估了家庭中有孩子与吸烟和戒烟相关结果之间的关联，以及这些关系是否受职业社会等级（从最有利到最不利的 AB-E 类别）的调节。探讨了家庭中有和没有孩子的成年人吸烟率的趋势。
在调整分析中，家庭中有孩子与吸烟率的关联取决于社会等级：家庭中有孩子的成年人吸烟率比家庭中没有孩子的成年人低 0.71（95%置信区间 0.66-0.77）到 0.93（0.88-0.98）倍。相反，社会等级 E 的吸烟率则高 1.11（1.05-1.16）倍。有和没有孩子的成年人的吸烟率都以相似的速度下降（两者的流行率比值：0.98，95%置信区间 0.97-0.99）。有孩子的成年人戒烟动机高于没有孩子的成年人，但劣势群体的戒烟动机低于优势群体。社会等级 D-E 的重度吸烟者较多，但过去一个月尝试戒烟的比例较高。
在英国最劣势的社会等级中，家庭中有孩子的成年人的吸烟率高于没有孩子的成年人。为了减轻未来与吸烟有关的不平等，迫切需要针对支持和解决戒烟障碍，并促进长期戒烟成功。
在最劣势的职业社会等级中，家庭中有孩子与家庭中没有孩子相比，吸烟率更高。这与其他所有社会等级形成对比，在这些社会等级中，家庭中有孩子的成年人的吸烟率低于家庭中没有孩子的成年人。如果不加以关注，这种差距可能会加剧与吸烟有关的现有和未来健康不平等。
