Socio-economic inequalities in smoking prevalence and involuntary exposure to tobacco smoke in Argentina: Analysis of three cross-sectional nationally representative surveys in 2005, 2009 and 2013

PLoS One. 2019 Jun 7;14(6):e0217845. doi: 10.1371/journal.pone.0217845. eCollection 2019.

Abstract

Background: Understanding patterns of socio-economic inequalities in tobacco consumption is key to design targeted public health policies for tobacco control. This study examines socio-economic inequalities in smoking and involuntary exposure to tobacco smoke between 2005 and 2013.

Methods: Data were derived from the Argentine National Risk Factors Surveys, conducted in 2005, 2009, and 2013. Two inequality measures were calculated: the age-adjusted prevalence ratio (PR) and the disparity index (DI). Educational level, household income per consumer unit and employment status were used as proxies for socio-economic status (SES). Generalized linear models were used in the analysis.

Results: Prevalence of smoking decreased from 29.7% to 25.1% between 2005 and 2013, mainly in women (p<0.001). Despite the overall prevalence reduction, socio-economic inequalities in smoking persisted. For both men and women, the DI was moderately high for smoking (14.47%-33.06%) across the three surveys. In men, the PR indicated a higher smoking prevalence for lower educational levels and lower household income throughout the analyzed period. In women, unlike previous years, the 2013 survey showed disparity related to unemployment. Involuntary exposure to tobacco smoke in 2013 was associated with educational level and household income, with lower involuntary exposure among those with higher SES.

Conclusions: While overall smoking rates have decreased in Argentina, socio-economic disparities related to tobacco smoking persist. Comprehensive tobacco control programs targeted to address these inequalities are essential in developing strategies to reduce health disparities in tobacco-related diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Argentina / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities
  • Health Surveys / statistics & numerical data
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Income / statistics & numerical data
  • Male
  • Middle Aged
  • Nicotiana / adverse effects*
  • Prevalence
  • Sex Factors
  • Social Class
  • Tobacco Smoke Pollution / statistics & numerical data*
  • Tobacco Smoking / epidemiology*
  • Tobacco Use / adverse effects
  • Tobacco Use / epidemiology
  • Young Adult

Substances

  • Tobacco Smoke Pollution

Grants and funding

This research was funded by the Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina and Universidad San Ignacio de Loyola, Lima, Peru. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.