Factors associated with self-assessed increase in tobacco consumption among over-indebted individuals in Germany: a cross-sectional study

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 The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14).ConclusionsThe study identifies over-indebted individuals and particularly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.

Family Hardships and Serum Cotinine in Children With Asthma

“…As a result, it is not surprising that most smoking cessation interventions have been largely ineffective for adults who experience hardships. 22,[37][38][39][40] Additionally, a recent study has noted that maternal smokers reporting more smoke-related child sick visits, greater perceived life stress, and less social support were more likely to report significant depressive symptoms than mothers with fewer clinic visits, less stress, and greater social support. 41 Stress, depression, and hardships may affect child exposure levels and health, and depression may be another area for intervention.…”

The Legacy of Economic Recession in Terms of Over-Indebtedness: A Framework and Review of the Evidence

“…Over-indebtedness may be associated with not being able to consume health-enhancing food and services, to access healthcare and to fully participate in social life (Goode, 2012b; see also Münster et al, 2009;Averett and Smith, 2014). A cross-sectional survey among clients of officially approved debt and insolvency counselling centres in Germany identified over-indebted individuals, and particularly over-indebted men, as a high-risk group of smokers (Rueger et al, 2013). Studies from Finland showed that over-indebtedness was also associated with the incidence of chronic disease, including severe depression, in a follow-up setting (Blomgren et al, 2016(Blomgren et al, , 2017.…”

Over-indebtedness and health in Switzerland: A cross-sectional study comparing over-indebted individuals and the general population

“…People with serious debt problems and in severe economic difficulties experience psychological distress [ 13 ], poor self-reported health [ 14 ], mental ill health or mental disorders and particularly depression [ 2 , 3 , 7 , 8 , 15 – 19 ], sleep problems [ 20 , 21 ], chronic diseases such as hypertension or diabetes [ 2 , 7 ], overweight and obesity [ 4 ] and back pain or pain in general [ 5 , 22 ]. Over-indebted individuals also show higher risks of self-destructive behaviors such as suicidal behavior [ 8 , 19 ], smoking [ 6 , 23 ], alcohol and drug abuse [ 18 , 19 ] or problem gambling [ 18 , 24 ].…”