Hanafin Joan, Sunday Salome, Clancy Luke
TobaccoFree Research Institute Ireland, TU Dublin, Dublin, Ireland.
Dept Sociology, Faculty of Arts Humanities and Social Sciences, University of Limerick, Limerick, Ireland.
Tob Use Insights. 2024 Sep 16;17:1179173X241283744. doi: 10.1177/1179173X241283744. eCollection 2024.
Ireland's Smoking Ban reduced health inequalities known to be associated with smoking but some groups may not have benefitted. Mental ill-health and smoking are known to be associated with health inequalities. Whether similar patterns exist for e-cigarette use is less clear, as few data exist. To examine: (1) self-reported doctor-diagnosed mental ill-health in Irish 20-year-olds; (2) smoking, e-cigarette, and dual use in those with and without mental ill-health; and (3) protective and risk factors for smoking and e-cigarette use in these groups. We use cross-sectional data from 20 year-olds in Wave 4 of Child Cohort. They were asked to self-report mental ill-health which had been diagnosed by a clinician, and their smoking and e-cigarette use. All analyses were performed using SPSS v27. 19.4% (n = 1008) of the total sample (n = 4729) reported a mental ill-health diagnosis. Comparing those with and without, those with mental ill-health had significantly higher prevalence of current smoking (47%, n = 419 vs 36%, n = 1361; OR 1.57, CI: 1.36, 1.82), e-cigarette use (17%, n = 152 vs 13%, n = 485; OR 1.40, CI:1.15, 1.70), and dual use (12%, n = 109 vs 9%, n = 328; OR 1.46, CI:1.16, 1.84). Risk factors for smoking and e-cigarette use were, earlier smoking initiation, peers or primary caregivers who smoked, being in paid employment, one-parent family background, and social media use. Being female was protective. Most risk factors were significantly higher in young adults with mental ill-health but, after adjusting for these variables, respondents with mental ill-health still have significantly higher adjusted higher odds of smoking (aOR 1.28, CI:1.05, 1.56). Inequalities in smoking and e-cigarette use in young adults with mental ill-health are evident 20 years after Ireland's National Smoking Ban. Despite extensive Tobacco Control interventions in the past 20 years, there is still need in Ireland for new targeted interventions to reduce health inequalities for left-behind young smokers with mental ill-health.
爱尔兰的禁烟令减少了已知与吸烟相关的健康不平等现象，但一些群体可能并未从中受益。精神健康不佳与吸烟已知与健康不平等有关。电子烟使用是否存在类似模式尚不清楚，因为相关数据很少。本研究旨在：（1）调查爱尔兰20岁人群中自我报告的经医生诊断的精神健康不佳情况；（2）对比有和没有精神健康问题的人群的吸烟、使用电子烟及双重使用情况；（3）研究这些群体中吸烟和使用电子烟的保护因素及风险因素。我们使用了儿童队列第4波中20岁人群的横断面数据。他们被要求自我报告经临床医生诊断的精神健康不佳情况以及他们的吸烟和电子烟使用情况。所有分析均使用SPSS v27进行。在总样本（n = 4729）中，19.4%（n = 1008）报告有精神健康不佳诊断。对比有和没有精神健康问题的人群，有精神健康问题的人群当前吸烟率（47%，n = 419 vs 36%，n = 1361；OR 1.57，CI：1.36，1.82）、使用电子烟率（17%，n = 152 vs 13%，n = 485；OR 1.40，CI：1.15，1.70）和双重使用率（12%，n = 109 vs 9%，n = 328；OR 1.46，CI：1.16，1.84）显著更高。吸烟和使用电子烟的风险因素包括：更早开始吸烟、有吸烟的同龄人或主要照顾者、有带薪工作、单亲家庭背景以及使用社交媒体。女性具有保护作用。大多数风险因素在有精神健康问题的年轻人中显著更高，但在对这些变量进行调整后，有精神健康问题的受访者吸烟的调整后更高几率仍然显著（aOR 1.28，CI：1.05，1.56）。在爱尔兰实施全国禁烟令20年后，有精神健康问题的年轻人在吸烟和使用电子烟方面的不平等现象依然明显。尽管在过去20年里进行了广泛的烟草控制干预措施，但爱尔兰仍需要新的针对性干预措施，以减少有精神健康问题的留守年轻吸烟者的健康不平等现象。
