Socio-demographic factors associated with tobacco consumption and cessation in Portugal

Background: Smoking is a significant risk factor for several diseases. Social inequalities have been described for tobacco consumption and though to a lesser extend for tobacco cessation. Objectives: Describe sociodemographic factors associated with tobacco consumption and cessation. Methods: Data from the 2005/2006 Portuguese National Health Interview Survey was analysed. A multinomial log-linear model was fitted considering 3 groups: present smokers, former smokers and never smokers. Relative Risk Ratios (RRR) were obtained. Men and women were analysed separately. RRR adjusted for age and comparatively with reference categories (Centre for regions, married for marital status, student for professional situation and higher education for education) are presented. RRR of present smokers compare to never smokers and RRR of former smokers to present smokers. Results: Men from groups that have higher RRR of present smoking also have lower RRR of stopping. The lowest risk of cessation and higher of consumption was observed in Azores [RRR (95 % Confidence Interval (CI 95)) 0.53 (0.46, 0.61) and 1.89 (1.64, 2.18), respectively]. Divorcees, unemployed, and men with lower secondary education all had lower risk of cessation and higher of consumption, [respectively RRR (IC 95): 0.50 (0.41, 0.61) and 2.01 (1.64, 2.46); RRR (IC 95): 0.16 (0.13, 0.20) and 6.29 (5.00, 7.91); RRR (IC 95): 0.65 (0.56, 0.77) and 1.53 (1.30, 1.79)]. Similar results were observed in women (higher RRR of smoking and lower RRR of stop). Exceptions were found in the non-unemployed women and those with less that upper secondary. Taking region into consideration women in Madeira had a lower RRR of stop smoking and in Lisbon they had the higher risk of smoking [RRR (IC 95) 0.40 (0.27, 0.58) and 2.11 (1.74, 2.57), respectively]. The same was observed for divorced women [RRR (IC 95) 0.54 (0.41, 0.69) and 3.21 (2.69, 3.84), respectively]. Unemployed had the lower risk of quitting smoking and the highest of smoking [RRR (IC 95) 0.83 (0.51, 1.38) and 4.23 (3.20, 5.58), respectively], while the other groups had highest RRR of stop smoking and smoking, comparatively with reference group. Less educated women (lower secondary or less) had lower risk of cessation but also lower risk of smoking. Conclusions: Unfavourable sociodemographic characteristics are associated with higher risks of being a current smoker and lower risks of being an ex-smoker. Different/further cessation measures are needed in these less prone to quit group of individuals, namely men from Azores, divorced, unemployed and with lower secondary education and for divorced and unemployed women