Abstract
BackgroundOver-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. Nonetheless, few studies have explored smoking among over-indebted individuals.MethodsA cross-sectional survey (n=949) on retrospectively assessed changes in tobacco consumption was carried out in 2006 and 2007 among clients of 84 officially approved debt and insolvency counselling centres in Germany (response rate 39.7%). Logistic regressions were performed to explore factors associated with reports of increased smoking after onset of over-indebtedness.Results63% of all respondents stated daily or occasional tobacco consumption. Almost one fifth reported an increase in smoking after becoming over-indebted. Females were less likely to report increased smoking than men (aOR 0.66, 95% CI 0.44-0.99) whereas respondents who had been over-indebted for more than 10 years were more likely to report increased smoking than those who had been over-indebted for less than five years (aOR 1.66; 95%-CI 1.00-2.76). The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14).ConclusionsThe study identifies over-indebted individuals and particularly over-indebted men as a high-risk group of smokers. Low levels of social embeddedness/support were associated with a further increase in smoking after becoming over-indebted. Given recent increases of over-indebtedness, the findings highlight the need to develop appropriate public health policies.
Highlights
Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems
The study at hand adds to this area of research and examines smoking in overindebted individuals in Germany and factors associated with changes in tobacco consumption in times of over-indebtedness
Men were significantly more likely to smoke (67.7%) than women (59.3%, χ2=7.142, df=1, p=.008). 168 participants (17.7%) reported to be ex-smokers. 74.7% (n=572) of all current and former smokers answered the question regarding a possible change in tobacco consumption after onset of overindebtedness. 39.0% of this subpopulation (n=223, 23.5% of the entire study sample) reported to smoke less, 30.4% (n=174, 18.3% of the entire study sample) reported no changes in tobacco consumption, and 30.6% (n=175, 18.4% of the entire study sample) reported increased smoking
Summary
Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. The current financial and economic crisis has resulted in several European countries having stagnating economic growth, increasing unemployment rates and marked reductions in public welfare spending. Given that research shows that loss of employment and low income are major drivers of over-indebtedness [4], it can be assumed that the current crisis will lead to an increase in over-indebtedness. Over-indebtedness of individuals or Research in high-income countries has further suggested an association between financial difficulties and smoking cessation, with those experiencing financial stress being less likely to make quit attempts or successfully quit smoking [17,18,19,20]. The study at hand adds to this area of research and examines smoking in overindebted individuals in Germany and factors associated with changes in tobacco consumption in times of over-indebtedness
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