Abstract
AimsTo examine smoking prevalence, motivation and attempts to stop smoking, markers of cigarette addiction and success in quit attempts of people living in social housing in England compared with other housing tenures.Design and settingA large cross‐sectional survey of a representative sample of the English population conducted between January 2015 and October 2017.ParticipantsA total of 57 522 adults (aged ≥ 16 years).MeasurementsMain outcomes were smoking status, number of cigarettes per day, time to first cigarette, exposure to smoking by others, motivation to stop smoking, past‐year quit attempts and use of cessation support. Covariates were age, sex, social grade, region and survey year.FindingsAdults in social housing had twice the odds of being smokers than those living in other housing types [odds ratio (OR) = 2.09, 95% confidence interval (CI) = 1.98–2.22, P < 0.001]. Smokers in social housing consumed more cigarettes daily (adjusted mean difference = 1.09 cigarettes, 95% CI = 0.72–1.46, P < 0.001) and were more likely to smoke within 30 minutes of waking (OR = 1.63, 95% CI = 1.48–1.79, P < 0.001) than smokers living in other housing types. Prevalence of high motivation to stop smoking was similar across housing types (OR = 1.04, 95% CI = 0.91–1.19, P = 0.553). The prevalence of quit attempts and use of cessation support within the past year were greater in social compared with other housing (OR = 1.14, 95% CI = 1.03–1.26, P = 0.011; OR = 1.30, 95% CI = 1.09–1.54, P = 0.003), but success in quitting was much lower (OR = 0.57, 95% CI = 0.45–0.72, P < 0.001).ConclusionsIn England, living in social housing is a major independent risk factor for smoking. These easily identifiable hot‐spots consist of smokers who are at least as motivated to stop as other smokers, but find it more difficult.
Highlights
Smoking increases the risk of a range of diseases and is a leading preventable cause of early death and disability in every world region, with approximately one in seven adults smoking every day [1,2,3,4]
Social housing residents had almost three times the odds of being a smoker compared with other housing residents (OR = 2.80, 95% confidence interval (CI) = 2.66, 2.95, P < 0.001; see Table 2) and twice the odds after adjusting for potential confounders (OR = 2.09, 95% CI = 1.98, 2.22, P < 0.001)
Social housing residents were more likely to report a quit attempt in the past year (OR = 1.14, 95% CI= 1.03, 1.26, P = 0.011) and the use of cessation support (OR = 1.30, 95% CI = 1.09, 1.54, P = 0.003)
Summary
Smoking increases the risk of a range of diseases and is a leading preventable cause of early death and disability in every world region, with approximately one in seven adults smoking every day [1,2,3,4]. The need to address this increasing disparity has been recognized in many countries [10,11]. High smoking prevalence among people living in social housing could be an important focus. In 2016, the UK Office of National Statistics reported that 33% of those who lived in social housing were cigarette smokers compared with approximately 10% of those who owned their home [13]. It is not clear to what extent this high smoking rate stemmed from other factors; nor is it clear how far it reflects lower motivation to quit among smokers, greater difficulty quitting or both. This study examined adjusted smoking prevalence, and smoking and quitting characteristics of people living in social housing compared with other housing tenures
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