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. 2008 Feb;40(2):87-92.
doi: 10.1157/13116155.

[Quitting and prevalence of smoking: gender, social class, and primary health care]

[Article in Spanish]
Joan R Villalbí  1 , Ferran Daban, M Isabel Pasarín, Maica Rodríguez-Sanz, Carme Borrell
Affiliations

[Quitting and prevalence of smoking: gender, social class, and primary health care]

[Article in Spanish]
Joan R Villalbí et al. Aten Primaria. 2008 Feb.

Abstract
in English, Spanish

Objective: To analyse the joint role of social class and primary health care in giving up smoking.

Design: Cross-sectional study.

Setting: Barcelona (Catalonia, Spain), 2000-2001.

Participants: A sample of the resident non-institutionalized population, restricted to people aged 15-50 who have a habitual primary care source (n=4178).

Main measurements: These were obtained from the Barcelona Health Interview Survey. Independent variables include sex, social class and usual source of primary health care. Dependent variables are having ever been a smoker, having quit, and being a current smoker. Age-adjusted proportions were calculated (95% CI).

Results: Social class shows that more manual workers have been smokers. Men smoked more than women. Overall quitting is similar in both sexes. Quitting showed a social gradient in men. Measurement of source of care showed quitting was higher among users of private clinics, but CI overlapped. On stratifying the source of primary care by social class, an effect seemed to emerge for men, but the CI overlapped. Prevalence at the time of the survey was higher for men; a class gradient in current prevalence emerged for men, but was less visible for women, where CI overlapped.

Conclusions: Social class is a powerful determinant of smoking. Men in low-classed jobs are at greater risk of starting to smoke, are less likely to give up, and smoke more. The proportion of quitting seems lower in of public clinics users. Health advice is efficacious, but in population terms other factors seem to have greater influence.

Objetivo: Valorar el papel conjunto de la clase social y la fuente de atención primaria de salud sobre la cesación.

Diseño: Estudio transversal.

Emplazamiento: Barcelona (Cataluña, España), 2000-2001.

Participantes: Muestra de población residente no institucionalizada, con restricción a personas de 15-50 años que identifican una fuente habitual de atención primaria (n = 4.178).

Mediciones principales: Obtenidas en la Encuesta de Salud. Las variables independientes son el sexo, la clase social y la fuente habitual de atención primaria de salud. Las variables dependientes son haber sido alguna vez fumador, haber dejado de fumar y fumar actualmente. Se estiman proporciones e intervalos de confianza (IC) del 95% ajustando por edad.

Resultados: Por clase social se ve que más trabajadores manuales han sido fumadores. Por sexo se aprecia que más varones han fumado. La cesación general es similar en ambos sexos. El abandono muestra un gradiente social en varones. Por fuente de atención, la cesación parece mayor en usuarios de consultas privadas, pero los IC se solapan. Estratificando la fuente de atención primaria por clase social, aparece un efecto en varones pero los IC se solapan. La prevalencia en el momento de la encuesta es mayor para varones; parece emerger un gradiente por clase en varones, menor para mujeres donde los IC se solapan.

Conclusiones: La clase social es un poderoso determinante del tabaquismo. Los varones de categoría ocupacional baja tienen mayor riesgo de empezar a fumar, menos probabilidades de dejarlo, y una mayor prevalencia. La proporción de cesaciones parece menor en usuarios de la red pública. La intervención sanitaria es eficaz, pero en términos poblacionales otros factores parecen tener mayor influencia.

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References

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