Co-variation in dimensions of smoking behaviour: A multivariate analysis of individuals and communities in Canada |
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| Affiliation: | 1. Harvard Center for Population and Development Studies, Harvard University, 9 Bow Street, Cambridge, Massachusetts, 02138, USA;2. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA;3. Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada;4. The George Institute for Global Health, University of Sydney, New South Wales, Australia;5. Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada;6. Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada;1. Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland;2. Department of Health Sciences, University of Tampere, Finland;3. Centre of Expertise for Work Organisations, Finnish Institute of Occupational Health, Helsinki, Finland;4. Creating Solutions, Statistics and Health Economics Team, Finnish Institute of Occupational Health, Helsinki, Finland;5. Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, Helsinki, Finland |
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| Abstract: | We evaluated the effects of socioeconomic status on the prevalence of current smoking, number of cigarettes smoked per day and pack-years, and the extent to which prevalence and consumption co-vary across communities, health regions, and provinces in Canada between 2001 and 2010. Current smoking, cigarettes per day, and pack-years were considered as outcomes within individuals using a multilevel analytical framework. Markers of SES were education, income, and occupation. Residual covariance estimated at the different levels of geography was used to determine if areas high in current smoking were also high on levels of consumption. A strong inverse gradient was found between education and current smoking and level of consumption with large variation found in levels of consumption between individual smokers. The co-variation between current smoking and level of consumption was positive and statistically significant at the level of communities and health regions. Our findings suggest that novel policy efforts may be needed to encourage smoking prevention/cessation among certain population groups and in places with high levels of smoking prevalence and tobacco use intensity. |
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| Keywords: | Tobacco Smoking/prevention & control Health behaviour Geographic variation Social environment Canada |
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