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Socioeconomic Variation in the Prevalence, Introduction, Retention, and Removal of Smoke-Free Policies among Smokers: Findings from the International Tobacco Control (ITC) Four Country Survey

Author

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  • Brian A. King

    (Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA)

  • Andrew J. Hyland

    (Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA)

  • Ron Borland

    (Vic Health Center for Tobacco Control, The Cancer Council Victoria, Carlton, VIC 3053, Australia)

  • Ann McNeill

    (UK Centre for Tobacco Control Studies, Division of Epidemiology & Public Health, University of Nottingham, Nottingham NG51PB, UK)

  • K. Michael Cummings

    (Department of Health Behavior, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA)

Abstract

Introduction : Exposure to secondhand smoke causes premature death and disease in non-smokers and indoor smoke-free policies have become increasingly prevalent worldwide. Although socioeconomic disparities have been documented in tobacco use and cessation, the association between socioeconomic status (SES) and smoke-free policies is less well studied. Methods : Data were obtained from the 2006 and 2007 Waves of the International Tobacco Control Four Country Survey (ITC-4), a prospective study of nationally representative samples of smokers in Canada, the United States, the United Kingdom, and Australia. Telephone interviews were administered to 8,245 current and former adult smokers from October 2006 to February 2007. Between September 2007 and February 2008, 5,866 respondents were re-interviewed. Self-reported education and annual household income were used to create SES tertiles. Outcomes included the presence, introduction, and removal of smoke-free policies in homes, worksites, bars, and restaurants. Results : Smokers with high SES had increased odds of both having [OR: 1.54, 95% CI: 1.27–2.87] and introducing [OR: 1.49, 95% CI: 1.04–2.13] a total ban on smoking in the home compared to low SES smokers. Continuing smokers with high SES also had decreased odds of removing a total ban [OR: 0.44, 95% CI: 0.26–0.73]. No consistent association was observed between SES and the presence or introduction of bans in worksites, bars, or restaurants. Conclusions : The presence, introduction, and retention of smoke-free homes increases with increasing SES, but no consistent socioeconomic variation exists in the presence or introduction of total smoking bans in worksites, bars, or restaurants. Opportunities exist to reduce SES disparities in smoke-free homes, while the lack of socioeconomic differences in public workplace, bar, and restaurant smoke-free policies suggest these measures are now equitably distributed in these four countries.

Suggested Citation

  • Brian A. King & Andrew J. Hyland & Ron Borland & Ann McNeill & K. Michael Cummings, 2011. "Socioeconomic Variation in the Prevalence, Introduction, Retention, and Removal of Smoke-Free Policies among Smokers: Findings from the International Tobacco Control (ITC) Four Country Survey," IJERPH, MDPI, vol. 8(2), pages 1-24, January.
  • Handle: RePEc:gam:jijerp:v:8:y:2011:i:2:p:411-434:d:11209
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    References listed on IDEAS

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    1. Dinno, Alexis & Glantz, Stanton, 2009. "Tobacco control policies are egalitarian: A vulnerabilities perspective on clean indoor air laws, cigarette prices, and tobacco use disparities," Social Science & Medicine, Elsevier, vol. 68(8), pages 1439-1447, April.
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    1. Giuseppe Gorini & Giulia Carreras & Barbara Cortini & Simona Verdi & Maria Grazia Petronio & Piersante Sestini & Elisabetta Chellini, 2015. "Impact of National Smoke-Free Legislation on Educational Disparities in Smoke-Free Homes: Findings from the SIDRIAT Longitudinal Study," IJERPH, MDPI, vol. 12(8), pages 1-12, July.

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