Association between tobacco control policies and current smoking across different occupational groups in the EU between 2009 and 2017

Abstract

BackgroundThis study investigated the cross-national and longitudinal associations between national tobacco control policies and current smoking in 28 European Union (EU) member states between 2009 and 2017. It also examined the interaction between tobacco control policies and occupational status.MethodsWe used data from four waves of Eurobarometer (2009, 2012, 2014 and 2017). The total sample size was 105 231 individuals aged ≥15 years. Tobacco Control Scale (TCS) scores (range 0 to 100) for years 2005, 2007, 2012 and 2014 measured the strength of country-level tobacco control policies. Logistic multilevel regression analyses with three levels (the individual, the country-year and the country) were performed with current smoker as the dependent variable.ResultsAcross the EU, average smoking prevalence fell from 29.4% (95% CI 28.5% to 30.2%) in 2009 to 26.3% (95% CI 25.4% to 27.1%) in 2017. We confirmed that cross-nationally, strong national tobacco control policies are significantly associated with a low probability of smoking. A one-point increase in TCS score was associated with lower odds of smoking (OR=0.990; 95% CI 0.983 to 0.998), but longitudinally (within-country) increases in TCS were not associated with current smoking (OR=0.999; 95% CI 0.994 to 1.005). Compared with those in manual occupations, the cross-national association was stronger in the upper occupational group (conditional OR for the interaction=0.985; 95% CI 0.978 to 0.992) and weaker in the economically inactive group (conditional OR for the interaction=1.009; 95% CI 1.005 to 1.013).ConclusionDifferences in tobacco control policies between countries were associated with the probability of smoking but the changes in TCS within countries over time were not. Differences between countries in tobacco control policies were found to be most strongly associated with the likelihood of smoking in the highest occupational groups and were found to have only a weak association with smoking among the economically inactive in this sample.

Smoking cessation counselling practices among health care providers dealing with cancer patients

“…Smoking cessation practices implemented in different countries across the globe vary in its type, reach, and effectiveness. For instance, in developed countries like United Kingdom, United States, Canada, and some EU countries smoking cessation practices include behavioural therapy such as counselling, pharmacotherapy such as nicotine replacement therapy, a combination of both, policy interventions such as restrictions on the sale, increases in taxes, mass media campaigns, and surveillance and evaluation 12‐17 . Effectiveness of the different smoking cessation practices implemented in developed countries has varied by the type of the specific practice implemented.…”

“…Effectiveness of the different smoking cessation practices implemented in developed countries has varied by the type of the specific practice implemented. For instance, while all of the implemented smoking cessation practices in the United Kingdom have been found to increase the population's quit attempt rates, nicotine replacement therapy, in particular, was found to increase the quit success rate among the population 12,13 …”

Smoking and inequalities in mortality in 11 European countries: a birth cohort analysis

“…Among all health risks, smoking is believed to be the greatest avoidable risk factor [2] and one of the leading contributors to inequalities in mortality [3][4][5][6]. In Europe, smoking prevalence has declined in many countries [7], partly as a result of tobacco control policies [8,9]. However, it has been less studied how changes in smoking behavior have influenced trends in educational inequalities in mortality.…”

“…Stockholm Centre for Health and Social Change, Södertörn University, Huddinge, Sweden. 9 Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia. 10 Agència de Salut Pública de Barcelona, Barcelona, Spain.…”

Smoking and Inequalities in Mortality in 11 European Countries: A Birth Cohort Analysis

“…Among all health risks, smoking is believed to be the greatest avoidable risk factor [2] and one of the leading contributors to inequalities in mortality [3][4][5][6]. In Europe, smoking prevalence has declined in many countries [7], partly as a result of tobacco control policies [8,9].…”