Beard Emma, Shahab Lion, Brown Jamie, Cox Sharon
Research Department of Behavioural Science and Health, University College London, London, UK.
Department of Epidemiology and Public Health, University College London, UK.
Addiction. 2025 Aug;120(8):1582-1600. doi: 10.1111/add.70071. Epub 2025 May 2.
Sampling frames used by population surveys may result in an underestimation of smoking prevalence as those not residing in households, also known as the 'hidden population', are not sampled. This includes people living in care and residential homes, populations experiencing homelessness, as well as those who have an "absent or "temporary" household status (e.g. bed and breakfasts, unsupported temporary accommodation, and those in prison). This study estimated the impact of including these populations on smoking prevalence in the UK.
Data from UK government reports and published studies were used to derive estimates of the size of the hidden populations and rates of smoking within these populations. The impact of including the 'hidden population' on overall smoking prevalence in the UK was estimated, along with a correction factor to account for their exclusion.
The hidden population over the age of 18 was estimated to be around 1.9 million with a smoking prevalence of between 58% and 66%. Accounting for this hidden population in smoking prevalence surveys may inflate estimates by a correction factor of 1.12 to 1.14. This means smoking prevalence in 2022 would increase from a reported 12.9% to an adjusted range of 14.5-14.8%.
The absence of the 'hidden population' from smoking prevalence surveys leads to underestimation of smoking rates in the UK. Based on the estimated correction factor, and assuming smoking continues to decline at current rates, achieving the UK government's target of <5% by 2030 would be substantially delayed.
人口调查所使用的抽样框架可能会低估吸烟率，因为未居住在家庭中的人群（即所谓的“隐藏人群”）未被纳入抽样范围。这包括住在护理院和养老院的人、无家可归者，以及那些处于“无家”或“临时”家庭状态的人（例如提供住宿和早餐的旅馆、无资助的临时住所中的人以及监狱中的人）。本研究估计了将这些人群纳入调查对英国吸烟率的影响。
利用英国政府报告和已发表研究中的数据，得出隐藏人群规模的估计值以及这些人群中的吸烟率。估计了将“隐藏人群”纳入调查对英国总体吸烟率的影响，并计算了一个校正因子以考虑对他们的排除。
估计18岁以上的隐藏人群约为190万，吸烟率在58%至66%之间。在吸烟率调查中考虑这一隐藏人群可能会使估计值因校正因子1.12至1.14而升高。这意味着2022年的吸烟率将从报告的12.9%升至调整后的14.5%至14.8%。
吸烟率调查中未纳入“隐藏人群”导致英国吸烟率被低估。基于估计的校正因子，并假设吸烟率继续以当前速度下降，英国政府到2030年将吸烟率降至<5%的目标将大幅推迟。
