Department of Behavioural Science and Health, University College London, London, UK.
SPECTRUM Consortium, Edinburgh, UK.
BMC Med. 2024 Apr 18;22(1):99. doi: 10.1186/s12916-024-03311-4.
Tobacco smoking affects women's fertility and is associated with substantial risks of adverse pregnancy outcomes. This study explored trends by socioeconomic position in patterns of smoking, use of non-combustible nicotine products, and quitting activity among women of reproductive age in England.
Data come from a nationally representative monthly cross-sectional survey. Between October 2013 and October 2023, 197,266 adults (≥ 18 years) were surveyed, of whom 44,052 were women of reproductive age (18-45 years). Main outcome measures were current smoking, vaping, and use of nicotine replacement therapy (NRT), heated tobacco products (HTPs), and nicotine pouches; mainly/exclusively smoking hand-rolled cigarettes and level of dependence among current smokers; past-year quit attempts among past-year smokers; and success of quit attempts among those who tried to quit. We modelled time trends in these outcomes, overall and by occupational social grade (ABC1 = more advantaged/C2DE = less advantaged).
Smoking prevalence among women of reproductive age fell from 28.7% [95%CI = 26.3-31.2%] to 22.4% [19.6-25.5%] in social grades C2DE but there was an uncertain increase from 11.7% [10.2-13.5%] to 14.9% [13.4-16.6%] in ABC1. By contrast, among all adults and among men of the same age, smoking prevalence remained relatively stable in ABC1. Vaping prevalence among women of reproductive age more than tripled, from 5.1% [4.3-6.0%] to 19.7% [18.0-21.5%], with the absolute increase more pronounced among those in social grades C2DE (reaching 26.7%; 23.3-30.3%); these changes were larger than those observed among all adults but similar to those among men of the same age. The proportion of smokers mainly/exclusively smoking hand-rolled cigarettes increased from 40.5% [36.3-44.9%] to 61.4% [56.5-66.1%] among women of reproductive age; smaller increases were observed among all adults and among men of the same age. Patterns on other outcomes were largely similar between groups.
Among women of reproductive age, there appears to have been a rise in smoking prevalence in the more advantaged social grades over the past decade. Across social grades, there have been substantial increases in the proportion of women of reproductive age who vape and shifts from use of manufactured to hand-rolled cigarettes among those who smoke. These changes have been more pronounced than those observed in the general adult population over the same period.
吸烟会影响女性的生育能力，并与不良妊娠结局的大量风险相关。本研究探讨了在英国，处于生育年龄的女性中，按社会经济地位划分的吸烟、使用非燃烧尼古丁产品和戒烟活动的模式趋势。
数据来自全国代表性的月度横断面调查。2013 年 10 月至 2023 年 10 月期间，对 197266 名成年人（≥18 岁）进行了调查，其中 44052 名为生育年龄的女性（18-45 岁）。主要结局指标是当前吸烟、蒸气吸烟和尼古丁替代疗法（NRT）、加热烟草产品（HTPs）和尼古丁袋的使用情况；当前吸烟者中主要/仅吸手工卷烟的比例和依赖性水平；过去一年中过去吸烟者的戒烟尝试次数；以及尝试戒烟者的戒烟成功率。我们对这些结果进行了时间趋势建模，总体上和按职业社会等级（ABC1=更有利/C2DE=较不利）进行了建模。
处于生育年龄的女性吸烟率从 28.7%[95%置信区间=26.3-31.2%]下降到 22.4%[19.6-25.5%]在 C2DE 社会等级，但在 ABC1 中从 11.7%[10.2-13.5%]不确定增加到 14.9%[13.4-16.6%]。相比之下，在 ABC1 中，所有成年人和同龄男性的吸烟率仍然相对稳定。处于生育年龄的女性蒸气吸烟率增加了两倍多，从 5.1%[4.3-6.0%]增加到 19.7%[18.0-21.5%]，在 C2DE 社会等级中绝对增加更为明显（达到 26.7%；23.3-30.3%）；这些变化大于所有成年人中观察到的变化，但与同龄男性相似。主要/仅吸手工卷烟的吸烟者比例从 40.5%[36.3-44.9%]增加到 61.4%[56.5-66.1%]在生育年龄的女性中；所有成年人和同龄男性中观察到的增幅较小。其他结果的模式在不同群体之间基本相似。
在过去十年中，处于生育年龄的女性中，社会地位较高的女性吸烟率似乎有所上升。在所有社会阶层中，处于生育年龄的女性蒸气吸烟的比例大幅增加，而那些吸烟的女性则从使用制造的香烟转向手工卷烟。这些变化在同一时期比一般成年人群体中观察到的更为明显。
