Study Shows Prevalence of Current Cigarette Smokers Depends on Sociodemographic Characteristics

Image Credit: vchalup - stock.adobe.com

A cross-sectional study in the NHIS concluded individuals with similar sociodemographic characteristics, such as lack of education, unmarried participants, and lower socioeconomic status were more prevalent to smoke, regardless of their cancer history.

The study, published in Substance Use & Misuse, was looking to prove the smoking prevalence in participants depends mainly on similar sociodemographic disparities in both cancer survivors and those without cancer history.

Researchers analyzed data from the 2019 National Health Interview Survey (NHIS). A total of 31,029 NHIS participants (cancer survivors: n = 3679; without cancer history: n = 27,350) were included in the data if they were 18 years or older, completed information about cancer history, current smoking status, and the age of cancer diagnosis, if applicable.

The current cigarette smoking status was the dependent variable in the study. Of the cancer survivors, 12.3% were current smokers (n = 428) and 87.7% (n = 3,251) were noncurrent smokers. Those reported without cancer history had 14.1% (n = 3851) current smokers and 85.9% (n = 23,499) as noncurrent smokers.

Sociodemographic characteristics for both groups consisted of age (18-39, 40-64, > 65 years), sex (male, female), education level (less than high school, high school degree or equivalent, some college or associate degree, bachelor’s degree, graduate degree), race (Black, White, other), marital status (married, living as unmarried couple, neither), employment (employed, unemployed), health insurance (insured, uninsured), and poverty status (in poverty, not in poverty) as independent variables.

For cancer-related independent variables, data included cancer history status (cancer survivors, without cancer history), the type of cancer (smoking related; nonsmoking related), age at first cancer diagnosis (0-39, > 40 years), and time passed since the first diagnosis (0-4, > 5 years).

Among the cancer survivors, the average age was 64.9 years and slightly more than half of the population female (n = 2151; 56.1%). The education level majority had at or above some college or associate degree (n = 1118; 31%), with more survivors of nonsmoking-related cancer (n = 2874; 77.4%). Participant marital status was mostly married (n = 1822; 60.4%) and incorporated a larger population of White people (n = 3293; 89.4%) in comparison to Black or populations labeled as other. Despite the current employment rate of cancer survivors leaning unemployed (n = 2444; 62.9%), a significant number reported they were not living in poverty (n = 3371; 91.6%) and were insured (n = 3575;96.4%). Most cancer survivors reported they were 40 years old or older (n = 3017; 79.2%), and most received their first diagnosis 5 or more years ago (n = 2,505; 66.4%).

The prevalence of current smokers was similar between the cancer survivor and the no cancer history groups (12.3% vs 14.1%). In both groups, younger individuals were more likely to smoke than the older participants, especially amongst cancer survivors.

Overall, a significantly lower smoking prevalence of cancer survivors was found among those who had higher education levels (n = 963; 30.5%), were not living in poverty (n = 3,047; 93.4%), had insurance (n = 3186; 97.3%), and were married (n = 1670; 62.5%). Among noncurrent smokers without a cancer history, a majority had some form of higher education (n = 6754; 31.2%), were not living in poverty (n = 21,171; 89.6%), are insured (n = 21,912; 91.3%), and were married (n = 11,586; 53.7%).

Study limitations included relying on self-reported data, which were potentially affected by recall error. Regarding racial groups, the “other” option combined multiple races due to the small numbers of population participants. If the study collected data from individual racial groups, the results would have a different smoking prevalence, claimed the authors. In nonsmoking-related and smoking-related cancer survivors, the statistical power to examine multiplicative interaction was limited. The authors said that the study may not be generalizable to other countries nor non-respondents of the NHIS survey.

The unmarried individuals with a low education level, living in poverty, and/or lack health insurance should be considered target groups for anti-smoking interventions.

The authors concluded, “Our findings contribute to the understanding of the current smoking burden in subpopulations of cancer survivors and those without cancer history, which may strengthen efforts to reduce sociodemographic disparities in current smoking prevalence and to lower the overall smoking prevalence.”

Reference

González Ruiz LM, Mondragón Márquez LI, Domínguez Bueso DL, Liu JJ. Prevalence of current cigarette smoking by sociodemographic characteristics in U.S. cancer survivors. Subst Use & Misuse. Published online November 16, 2023. doi:10.1080/10826084.2023.2280587