Year: 2020
Type: dissertation
Study design: Observational Study
Abstract: Smoking causes premature mortality and smoking is unevenly distributed across population groups, creating inequalities in health. The lower socioeconomic groups smoke more than the higher socioeconomic groups but the differences in snus use are largely unknown. Detecting the associations and changes in the use of tobacco is essential for targeting and implementing policies to reduce inequalities in health. Another pivotal factor in the success of policymaking is the attitudes of the population towards tobacco control. The current investigation aimed to improve and elaborate the knowledge of socioeconomic differences in tobacco use and factors contributing to the association in the Finnish population. The specific aims of this study were to shed light on the changes in tobacco use and its determinants between socioeconomic groups, to examine the predictors of smoking cessation and to investigate the societal support for tobacco control in the Finnish population. For addressing these issues, several population-based surveys were utilised spanning from the year 1978 to 2017. The number of respondents varied from 945 to 384,379. The main statistical methods in the study included different regression models. Throughout the study, education was used as the indicator for socioeconomic position. The results showed that smoking has declined substantially during the last decades, yet a significant proportion of the adult population still smokes. The less educated smoke more than the highly educated, and the differences between the groups have increased. Among adolescents, a parallel association between socioeconomic position and smoking was observed. Smoking declined in all socioeconomic groups, yet differences between these groups partially increased. Use of snus increased among boys and socioeconomic differences in boys’ snus use were parallel as with smoking but less pronounced. Strong evidence pertaining to widening socioeconomic differences in adolescent snus use was observed. Among the general adult population, higher socioeconomic position was longitudinally associated with smoking cessation, more strongly among men than among women, however. High support for strict tobacco control policies was observed among the Finnish population. Smoking status and demographic variables were strongly associated with acceptance of these policies, non-smokers and women being more supportive than smokers and men. Generally, education was not associated with acceptance of tobacco control. Finnish health policy aims at reducing inequalities in health, and tobacco control policies can be viewed as one of the means to reach this objective. Finnish tobacco control policy has been successful in many respects, for example in decreasing smoking and preventing adolescent smoking initiation. The results from this study indicate that even though smoking has decreased among all socioeconomic groups, tobacco control policies have not been able to eliminate altogether the socioeconomic differences in tobacco use. Thus, future tobacco control policy actions should concentrate on reducing observed differences in tobacco use by socioeconomic groups, in addition to further reducing the overall prevalence.
Source: Työväentutkimus Vuosikirja
Author: Ruokolainen, Otto
Institution: University of Helsinki
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3119356522