Abstract
BackgroundSome previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults.MethodsThis study was based on the Korean Community Health Survey (KCHS) performed in South Korea, between September and November 2009. In total, 222,242 subjects (103,124 men and 119,118 women) were included in the analysis. Information on smoking status was collected using a standardized questionnaire. Income status was determined by monthly household income. Household income was categorized as: <1 million won; <2 million won; <3 million won; and ≥3 million won. Area-level income categorized as quartiles. Data were analyzed using multilevel regression models. The analysis was conducted separately urban and rural, by sex.ResultsThe lowest household income group had a higher risk of smoking than the highest household income group in both urban and rural areas for both men and women after adjusting for individual characteristics (urban men: odds ration [OR], 1.44; 95% confidence interval [CI], 1.36–1.53; rural men: OR, 1.33; 95% CI, 1.25–1.42; urban women: OR, 2.38; 95% CI, 2.06–2.76; rural women: OR, 1.51; 95% CI, 1.25–1.83). In men, the lowest area-level income group had a higher risk for smoking than the highest area-level income group in urban areas after adjusting for individual characteristics and household income (OR, 1.17; 95% CI, 1.02–1.33). In women, the lowest area-level income group had a lower risk for smoking than the highest area-level income group in rural areas after adjusting for individual characteristics and household income (OR, 0.52; 95% CI, 0.39–0.70). However, no association was observed between area-level income and smoking in rural areas for men or in urban areas for women.ConclusionsThe results showed that smoking is strongly associated with household income status in both men and women, and area-level income is partly associated with smoking. Effects of area-level income on smoking differed by sex and region. These findings suggest that area characteristics have contextual effects on health related behavior independent of individual characteristics.
Highlights
Some previous studies have suggested that area-level characteristics have effects on smoking
Age-adjusted prevalence of smoking Table 2 showed that the lowest household income group had higher age-adjusted prevalence of smoking than the highest household income group in both urban and rural areas for men and women
The lowest household income group had a higher risk of smoking than did the highest household income group in both urban and rural areas after adjusting for individual characteristics
Summary
Some previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults. Smoking is an important issue in public health. As it is a major risk factor for cardiovascular disease and is a common cause of death [1,2,3]. The prevalence of smoking has decreased, the prevalence of smoking in Korea is still higher than in other OECD countries [5]. According to the Korea National Health and Nutrition Examination Survey (KNHANES), the prevalence of smoking in men decreased from 66.3% to 45.7% during 1998–2007, whereas the prevalence of smoking in women increased from 6.5% to 7.4% during 1998–2008. The smoking rate in men has not decreased since 2008 [6]
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