Influence of Occupational Background on Smoking Prevalence as a Health Inequality Among Employees of Medium- and Small-Sized Companies in Japan

Takako Fujita,Akira Babazono,Yumi Harano,Peng Jiang

doi:10.1089/pop.2019.0021

Abstract

Tobacco smoking is a major public health problem. In addition, the influence of socioeconomic status on health inequalities has received great attention worldwide. The authors used insurance data of beneficiaries employed in medium- and small-sized Japanese companies to investigate the influence of occupational background on smoking prevalence as a health inequality among workers in Japan. Participants were aged 35–74 years and underwent health examinations in 2015. Smoking prevalence was estimated for each occupational group according to sex, age, and income. Logistic regression analysis was used to assess the association between smoking status and occupational groups. A total of 385,945 participants were included. Overall smoking prevalence was 36.3%, higher than average in Japan. Smoking prevalence was lowest among workers in the education and learning support category; all other occupational groups had significantly high prevalence, with the highest for transport and postal services (odds ratio 2.69, 95% confidence interval 2.53–2.86). There were few differences in smoking prevalence at higher income levels among female participants, but differences were remarkably significant at lower income levels. For health inequalities related to smoking, occupational background was associated with smoking prevalence. In particular, there was high smoking prevalence in workplaces not covered by smoke-free policies. These results also demonstrated differences between the sexes; smoking prevalence among female workers with lower income levels was strongly associated with occupational background whereas there were no large differences among male workers by income. These findings suggest that the government should encourage companies to adopt smoke-free policies in the workplace.

Highlights

Tobacco smoking is a major public health problem worldwide
For health inequalities related to smoking, occupational background was associated with smoking prevalence
These results demonstrated differences between the sexes; smoking prevalence among female workers with lower income levels was strongly associated with occupational background whereas there were no large differences among male workers by income

Summary

Introduction

Tobacco smoking is a major public health problem worldwide. Tobacco users as well as nonusers are at risk of tobacco-related illnesses. Age-adjusted smoking prevalence in 2015 was estimated at 34.1% for males and 6.4% for females globally[1]; in Japan, this prevalence was 31.4% for males and 8.3% for females.[2] In high-income countries, smoking prevalence declined to 23.1% in 2015.3 it is a highincome country, the prevalence of smoking in Japan is higher than in other developed countries, despite an annual decline. According to the National Health and Nutrition Survey Japan in 2017, the proportion of smokers who wanted to quit smoking was 28.9% (26.1% for male smokers and 39.0% for females).[2] In the workplace, 39.6% of workers reported that they were exposed to secondhand smoke at work.[2] promoting smoke-free workplace policies is important to support smoking cessation among smokers, to provide a clean air working environment, and to protect all workers from secondhand smoke

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Conclusion