Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan
Abstract
:1. Introduction
2. Experimental Section
2.1. Sample and Data Collection
2.2. Measures
2.2.1. Dependent Variables
2.2.2. Independent Variables
2.3. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Castor, M.L.; Smyser, M.S.; Taualii, M.M.; Park, A.N.; Lawson, S.A.; Forquera, R.A. A nationwide population-based study identifying health disparities between American Indians/Alaska Natives and the general populations living in select urban counties. Am. J. Public Health 2006, 96, 1478–1484. [Google Scholar] [CrossRef] [PubMed]
- Bramley, D.; Hebert, P.; Tuzzio, L.; Chassin, M. Disparities in indigenous health: A cross-country comparison between New Zealand and the United States. Am. J. Public Health 2005, 95, 844–850. [Google Scholar] [CrossRef] [PubMed]
- Ho, C.S.; Tsai, A.C. Prevalence of overweight and obesity and its associated factors in aboriginal Taiwanese: Findings from the 2001 National Health Interview Survey in Taiwan. Asia Pac. J. Clin. Nutr. 2007, 16, 572–579. [Google Scholar] [PubMed]
- Pan, W.H.; Yeh, W.T.; Chang, H.Y.; Hwu, C.M.; Ho, L.T. Prevalence and awareness of diabetes and mean fasting glucose by age, sex, and region: Results from the Nutrition and Health Survey in Taiwan, 1993–1996. Diabet Med. 2003, 20, 182–185. [Google Scholar] [CrossRef] [PubMed]
- Pan, W.H.; Chang, H.Y.; Yeh, W.T.; Hsiao, S.Y.; Hung, Y.T. Prevalence, awareness, treatment and control of hypertension in Taiwan: Results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993–1996. J. Hum. Hypertens. 2001, 15, 793–798. [Google Scholar] [CrossRef] [PubMed]
- Lee, M.S.; Lin, S.C.; Chang, H.Y.; Lyu, L.C.; Tsai, K.S.; Pan, W.H. High prevalence of hyperuricemia in elderly Taiwanese. Asia Pac. J. Clin. Nutr. 2005, 14, 285–292. [Google Scholar] [PubMed]
- Australian Institute of Health and Welfare. Australia’s Health; Australian Institute of Health and Welfare: Canberra, Australia, 2010.
- American Lung Association. Tobacco Use in Racial and Ethnic Populations. Available online: http://www.lung.org/stop-smoking/smoking-facts/tobacco-use-racial-and-ethnic.html (accessed on 21 October 2015).
- Korff, J. Aboriginal Smoking: A Serious Health Problem. Creative Spirits. Available online: http://www.creativespirits.info/aboriginalculture/health/aboriginal-smoking-a-serious-health-problem#axzz3pBWj019w (accessed on 21 October 2015).
- New Zealand Ministry of Health. Maori Smoking and Tobacco Use 2011; Ministry of Health: Wellington, New Zealand, 2011.
- Health Canada. Tobacco-First Nations and Inuit Health. Available online: http://www.hc-sc.gc.ca/fniah-spnia/substan/tobac-tabac/index-eng.php (accessed on 21 October 2015).
- U.S. Department of Health and Human Services. Health consequences of tobacco use among women. In Women and Smoking: A Report of the Surgeon General; Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion; Office of Smoking and Health: Rockville, MD, USA, 2002. [Google Scholar]
- Fergusson, D.M.; Woodward, L.J.; Horwood, L.J. Maternal smoking during pregnancy and psychiatric adjustment in late adolescence. Arch. Gen. Psychiatry 1998, 55, 721–727. [Google Scholar] [CrossRef] [PubMed]
- Schwartzbaum, J.A.; George, S.L.; Pratt, C.B.; Davis, B. An exploratory study of environmental and medical factors potentially related to childhood cancer. Med. Pediatr. Oncol. 1991, 19, 115–121. [Google Scholar] [CrossRef] [PubMed]
- Martin, J.A.; Hamilton, B.E.; Sutton, P.D.; Ventura, S.J.; Menacker, F.; Kirmeyer, S.; Munson, M.L.; Division of Vital Statistics. Births: Final Data for 2005. Natl. Vital Stat. Rep. 2007, 56, 1–103. [Google Scholar] [PubMed]
- First Nations Regional Health Survey. RHS 2002/03 Youth Survey—Chapter 22: Non-Traditional Use of Tobacco (Smoking), Alcohol, and Drug Use. Available online: http://fnigc.ca/sites/default/files/ENpdf/RHS_2002/rhs2002-03-technical_report.pdf (accessed on 21 October 2015).
- World Health Organization. World Health Organization Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. Available online: http://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf (accessed on 21 October 2015).
- Chen, H.W.; Chu, N.F.; Chen, H.H.; Yeh, M.L. The smoking behaviors of indigenous Taiwanese: Individual and family/community factors of influence. J. Nurs. Res. 2014, 22, 12–19. [Google Scholar] [CrossRef] [PubMed]
- Chaloupka, F.J.; Yurekli, A.; Fong, G.T. Tobacco taxes as a tobacco control strategy. Tob. Control 2012, 21, 172–180. [Google Scholar] [CrossRef] [PubMed]
- Jha, P.; Ranson, M.K.; Nguyen, S.N.; Yach, D. Estimates of global and regional smoking prevalence in 1995, by age and sex. Am. J. Public Health. 2002, 92, 1002–1006. [Google Scholar] [CrossRef] [PubMed]
- Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults—United States, 2005–2013. Morb. Mortal. Wkly. Rep. 2014, 63, 1108–1112. [Google Scholar]
- U.S. Department of Health and Human Services. Tobacco Use among U.S. Racial/Ethnic Minority Groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Available online: http://www.cdc.gov/tobacco/data_statistics/sgr/1998/complete_report/pdfs/complete_report.pdf (accessed on 21 October 2015).
- Brady, M. Historical and cultural roots of tobacco use among Aboriginal and Torres Strait Islander people. Aust. N. Z. J. Public Health 2002, 26, 120–124. [Google Scholar] [CrossRef] [PubMed]
- Chaloupka, F.J.; Peck, R.; Tauras, J.A.; Xu, X.; Yurekli, A. Cigarette Excise Taxation: The Impact of Tax Structure on Prices, Revenues, and Cigarette Smoking; NBER Working Paper: Cambridge, MA, USA, 2010. [Google Scholar]
- Chaloupka, F.J.; Pacula, R.L. The Impact of Price on Youth Tobacco Use. Available online: http://cancercontrol.cancer.gov/brp/tcrb/monographs/14/m14_12.pdf (accessed on 28 April 2016).
- Thomas, D.P.; Ferguson, M.; Johnston, V.; Brimblecombe, J. Impact and perceptions of tobacco tax increase in remote Australian Aboriginal communities. Nicotine Tob. Res. 2013, 15, 1099–1106. [Google Scholar] [CrossRef] [PubMed]
- Townsend, J.; Roderick, P.; Cooper, J. Cigarette smoking by socioeconomic group, sex, and age: Effects of price, income, and health publicity. BMJ 1994, 309, 923–927. [Google Scholar] [CrossRef] [PubMed]
- Choi, K.; Boyle, R.G. Minnesota smokers’ perceived helpfulness of 2009 federal tobacco tax increase in assisting smoking cessation: A prospective cohort study. BMC Public Health 2013, 13, 965. [Google Scholar] [CrossRef] [PubMed]
- Keller, P.A.; Greenseid, L.O.; Christenson, M.; Boyle, R.G.; Schillo, B.A. Seizing an opportunity: Increasing use of cessation services following a tobacco tax increase. BMC Public Health 2015, 15, 354. [Google Scholar] [CrossRef] [PubMed]
- Farrelly, M.; Hussin, A.; Bauer, U. Effectiveness and cost effectiveness of television, radio and print advertisements in promoting the New York smokers’ quitline. Tob. Control 2007, 16 (Suppl. 1), i21–i23. [Google Scholar] [CrossRef] [PubMed]
- Schillo, B.A.; Mowery, A.; Greenseid, L.O.; Luxenberg, M.G.; Zieffler, A.; Christenson, M.; Boyle, R.G. The relation between media promotions and service volume for a statewide tobacco quitline and a web-based cessation program. BMC Public Health 2011, 11, 939. [Google Scholar] [CrossRef] [PubMed]
- Momin, B.; Neri, A.; McCausland, K.; Duke, J.; Hansen, H.; Kahende, J.; Zhang, L.; Stewart, S.L. Traditional and innovative promotional strategies of tobacco cessation services: A review of the literature. J. Community Health 2014, 39, 800–809. [Google Scholar] [CrossRef] [PubMed]
- Zhang, L.; Vickerman, K.; Malarcher, A.; Mowery, P. Intermediate cessation outcomes among quitline callers during a national tobacco education campaign. Nicotine Tob. Res. 2014, 16, 1478–1486. [Google Scholar] [CrossRef] [PubMed]
- Woods, S.S.; Haskins, A.E. Increasing reach of quitline services in a U.S. state with comprehensive tobacco treatment. Tob. Control 2007, 16 (Suppl. 1), i33–i36. [Google Scholar] [CrossRef] [PubMed]
Variable | 2005 (N = 15,555) | 2006 (N = 15,963) | 2007 (N = 15,623) | 2008 (N = 15,884) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Non-Indigene | Indigene | p | Non-Indigene | Indigene | p | Non-Indigene | Indigene | p | Non-Indigene | Indigene | p | |
% | % | % | % | % | % | % | % | |||||
Age | 0.072 | 0.063 | 0.387 | 0.03 | ||||||||
20–29 | 23.2 | 24.6 | 23 | 23.5 | 22.5 | 21.8 | 23 | 30 | ||||
30–39 | 24.9 | 25.4 | 24.7 | 27.5 | 24.9 | 25.5 | 24.8 | 228 | ||||
40–49 | 22.2 | 24.6 | 22.3 | 21.9 | 22.4 | 26.5 | 22.3 | 20.1 | ||||
50–59 | 12.7 | 14.9 | 13.2 | 16 | 13.1 | 12.3 | 13.2 | 10.7 | ||||
60 and above | 17 | 10.5 | 16.8 | 11.1 | 17.1 | 13.9 | 16.7 | 16.4 | ||||
Level of education | <0.001 | <0.001 | <0.001 | <0.001 | ||||||||
Junior high school and below | 45 | 63.3 | 44.4 | 66.7 | 43.8 | 63.6 | 44.3 | 58.3 | ||||
Senior high school | 27.9 | 23.2 | 28.1 | 23.1 | 28.5 | 23.8 | 28.2 | 29.3 | ||||
Junior college or above | 27.1 | 13.5 | 27.5 | 10.2 | 27.7 | 12.6 | 27.5 | 12.4 | ||||
Gender | 0.389 | 0.005 | 0.011 | 0.463 | ||||||||
Male | 51.1 | 53.9 | 51.4 | 43.1 | 50.9 | 58.5 | 50.8 | 48.8 | ||||
Female | 48.9 | 46.1 | 48.6 | 56.9 | 49.1 | 41.5 | 49.2 | 51.2 | ||||
Marital status | 0.038 | 0.11 | 0.036 | 0.533 | ||||||||
Married/living together with someone | 73.1 | 66.2 | 67.8 | 66.7 | 66.3 | 59.9 | 65.8 | 65.2 | ||||
Never married | 23.9 | 29.7 | 24.5 | 22.5 | 24.9 | 27.7 | 25.8 | 24.8 | ||||
Divorced/widowed/separated | 3 | 4.1 | 7.7 | 10.8 | 8.8 | 12.4 | 8.4 | 10 | ||||
Average household income | ||||||||||||
Less than NT$20,000 | 26.3 | 43.8 | <0.001 | 23.6 | 35.2 | <0.001 | 24.2 | 38.5 | <0.001 | 25.3 | 39.7 | <0.001 |
NT$20,001–NT$40,000 | 27.3 | 25 | 27.2 | 30.1 | 26.5 | 28.7 | 29.2 | 34.2 | ||||
NT$40,001 or more | 46.4 | 31.2 | 49.2 | 34.7 | 49.3 | 32.8 | 45.5 | 26.2 | ||||
Having a job | 0.899 | 0.815 | 0.762 | 0.553 | ||||||||
Fulltime | 58.5 | 59 | 60.3 | 59.6 | 60.4 | 61.4 | 62.2 | 60.6 | ||||
None or part-time | 41.5 | 41 | 39.7 | 40.4 | 39.6 | 38.6 | 37.8 | 39.4 | ||||
Self-rated health status | ||||||||||||
Very poor/poor/fair | 16.7 | 30.4 | <0.001 | 19.7 | 25.8 | 0.011 | 20.2 | 28.7 | <0.001 | 19.2 | 22.8 | 0.089 |
Very good/good | 83.3 | 70.6 | 80.3 | 74.5 | 79.8 | 71.3 | 80.8 | 77.2 | ||||
Exposure to environmental tobacco smoke at home | 44.1 | 53.2 | 0.003 | 33.4 | 41.9 | 0.144 | 30.9 | 42.9 | <0.001 | 27.4 | 37.5 | 0.012 |
Ever smoked more than 100 cigarettes | 29.8 | 32.7 | 0.314 | 31.2 | 29.2 | 0.491 | 30.9 | 38.4 | 0.008 | 31.2 | 35.1 | 0.113 |
Being a current smoker | 24.1 | 28.6 | 0.096 | 23.4 | 26.6 | 0.194 | 23.5 | 31.2 | 0.002 | 23.2 | 27.3 | <0.001 |
Variable | 2005 | 2006 | 2007 | 2008 | ||||
---|---|---|---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | OR (95% CI) | p | |
Age | 0.97 (0.97–0.98) | <0.001 | 0.97 (0.97–0.98) | <0.001 | 0.97 (0.97–0.98) | <0.001 | 0.97 (0.97–0.98) | <0.001 |
Ethnicity | ||||||||
Indigene | 1.03 (0.72–1.49) | 0.839 | 1.41 (0.98–20.02) | 0.057 | 0.82 (0.58–1.15) | 0.255 | 0.96 (0.70–1.30) | 0.809 |
Non-indigene | 1 | 1 | 1 | 1 | ||||
Level of education | ||||||||
Junior high school and below | 3.57 (3.01–4.23) | <0.001 | 2.70 (2.27–3.20) | <0.001 | 2.56 (2.17–3.01) | <0.001 | 3.28 (2.81–3.83) | <0.001 |
Senior high school | 2.78 (2.39–3.24) | <0.001 | 2.76 (2.38–3.20) | <0.001 | 2.28 (1.97–2.62) | <0.001 | 2.57 (2.25–2.94) | <0.001 |
Junior college or above | 1 | 1 | 1 | |||||
Gender | ||||||||
Male | 17.90 (15.40–20.80) | <0.001 | 17.88 (15.30–20.80) | <0.001 | 14.65 (12.70–16.80) | <0.001 | 14.95 (13.00–17.10) | <0.001 |
Female | 1 | 1 | 1 | |||||
Marital status | ||||||||
Never married | 0.73 (0.63–0.85) | <0.001 | 0.80 (0.69–0.93) | 0.005 | 0.72 (0.62–0.84) | <0.001 | 0.92 (0.80–1.05) | 0.256 |
Divorced/widowed/separated | 2.66 (1.95–3.63) | <0.001 | 1.71 (1.39–2.13) | <0.001 | 2.02 (1.67–2.45) | <0.001 | 1.58 (1.29–1.92) | <0.001 |
Married/living together with someone | 1 | 1 | 1 | |||||
Average household income | ||||||||
Less than NT$20,000 | 0.61 (0.51–0.73) | <0.001 | 0.91 (0.76–1.10) | 0.369 | 0.78 (0.65–0.93) | 0.005 | 0.81 (0.70–0.94) | 0.008 |
NT$20,001–NT$40,000 | 0.77 (0.67–0.88) | <0.001 | 0.90 (0.79–1.03) | 0.151 | 0.82 (0.72–0.85) | 0.003 | 0.84 (0.75–.95) | 0.007 |
NT$40,001 or more | 1 | 1 | 1 | |||||
Having a job | ||||||||
Fulltime | 1.24 (1.08–1.43) | 0.002 | 1.28 (1.10–1.48) | <0.001 | 1.24 (1.08–1.41) | 0.002 | 1.27 (1.12–1.43) | <0.001 |
None or part-time | 1 | 1 | 1 | |||||
Self-related health status | ||||||||
Very poor/poor/fair | 2.00 (1.74–2.29) | <0.001 | 1.81 (1.58–2.07) | <0.001 | 1.81 (1.60–2.06) | <0.001 | 1.69 (1.50–1.90) | <0.001 |
Very good/good | 1 | 1 | 1 | |||||
Exposure to environmental tobacco smoke at home | ||||||||
Yes | 2.54 (2.28–2.84) | <0.001 | 2.63 (2.35–2.93) | <0.001 | 2.78 (2.50–3.09) | <0.001 | 2.64 (2.39–2.92) | <0.001 |
No | 1 | 1 | 1 | |||||
Cox & Snell R square | 0.271 | 0.261 | 0.25 | 0.249 | ||||
Nagelkerke R square | 0.401 | 0.39 | 0.371 | 0.373 |
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Tsai, L.-T.; Lo, F.-E.; Yang, C.-C.; Lo, W.-M.; Keller, J.J.; Hwang, C.-W.; Lin, C.-F.; Lyu, S.-Y.; Morisky, D.E. Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan. Int. J. Environ. Res. Public Health 2016, 13, 1044. https://doi.org/10.3390/ijerph13111044
Tsai L-T, Lo F-E, Yang C-C, Lo W-M, Keller JJ, Hwang C-W, Lin C-F, Lyu S-Y, Morisky DE. Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan. International Journal of Environmental Research and Public Health. 2016; 13(11):1044. https://doi.org/10.3390/ijerph13111044
Chicago/Turabian StyleTsai, Liang-Ting, Feng-En Lo, Chih-Chien Yang, Wen-Min Lo, Joseph Jordan Keller, Chiou-Wei Hwang, Ching-Feng Lin, Shu-Yu Lyu, and Donald E. Morisky. 2016. "Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan" International Journal of Environmental Research and Public Health 13, no. 11: 1044. https://doi.org/10.3390/ijerph13111044