TY - JOUR
T1 - Smoking inequality trends by disability and income in Australia, 2001 to 2020
AU - Disney, George
AU - Petrie, Dennis
AU - Yang, Yi
AU - Aitken, Zoe
AU - Gurrin, Lyle
AU - Kavanagh, Anne
N1 - Publisher Copyright:
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2023/3
Y1 - 2023/3
N2 - BACKGROUND: While policies to reduce smoking in many countries have been successful, disadvantaged groups (such as low-income groups) have only seen minor gains. People with disability are one such disadvantaged group and are more likely to smoke. However, evidence is limited on trends and inequalities in smoking for disabled people and on whether those also on low incomes are more likely to smoke. METHODS: We use annual data from 2001 to 2020 of the Household Income and Labour Dynamics in Australia survey. We use a Bayesian model to estimate smoking prevalence trends and inequalities for people with disability (2020, n = 1,370) and without disability (2020, n = 6,229) across the whole population and within income tertiles. To avoid reverse causation (smoking causing disability), we focus on younger people (15-44 years). RESULTS: Absolute reductions (per 100 people, [95% credible intervals]) in smoking were similar for people with (-13 [-16, -11]) and without disability (-15 [-16, -14]), with stable absolute but increasing relative inequalities. In the low-income group, absolute reductions in smoking prevalence for people with disability (-10 [-14, -6]) were smaller than in people without disability (-14 [-15, -12]), resulting in moderate evidence for increasing absolute inequalities (4 [0, 8]) and strong evidence for increasing relative inequalities. In high-income groups, disability-related absolute inequalities narrowed (-6 [-10, -3]), and relative inequalities were stable. CONCLUSIONS: Disabled people in Australia, especially those on low incomes, show signs of being left behind in efforts to reduce smoking.
AB - BACKGROUND: While policies to reduce smoking in many countries have been successful, disadvantaged groups (such as low-income groups) have only seen minor gains. People with disability are one such disadvantaged group and are more likely to smoke. However, evidence is limited on trends and inequalities in smoking for disabled people and on whether those also on low incomes are more likely to smoke. METHODS: We use annual data from 2001 to 2020 of the Household Income and Labour Dynamics in Australia survey. We use a Bayesian model to estimate smoking prevalence trends and inequalities for people with disability (2020, n = 1,370) and without disability (2020, n = 6,229) across the whole population and within income tertiles. To avoid reverse causation (smoking causing disability), we focus on younger people (15-44 years). RESULTS: Absolute reductions (per 100 people, [95% credible intervals]) in smoking were similar for people with (-13 [-16, -11]) and without disability (-15 [-16, -14]), with stable absolute but increasing relative inequalities. In the low-income group, absolute reductions in smoking prevalence for people with disability (-10 [-14, -6]) were smaller than in people without disability (-14 [-15, -12]), resulting in moderate evidence for increasing absolute inequalities (4 [0, 8]) and strong evidence for increasing relative inequalities. In high-income groups, disability-related absolute inequalities narrowed (-6 [-10, -3]), and relative inequalities were stable. CONCLUSIONS: Disabled people in Australia, especially those on low incomes, show signs of being left behind in efforts to reduce smoking.
UR - http://www.scopus.com/inward/record.url?scp=85147186525&partnerID=8YFLogxK
U2 - 10.1097/EDE.0000000000001582
DO - 10.1097/EDE.0000000000001582
M3 - Article
C2 - 36722813
AN - SCOPUS:85147186525
SN - 1044-3983
VL - 34
SP - 302
EP - 309
JO - Epidemiology
JF - Epidemiology
IS - 2
ER -