Economic crisis and smoking behaviour: prospective cohort study in Iceland

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Economic crisis and smoking behaviour: prospective cohort study in Iceland

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Title: Economic crisis and smoking behaviour: prospective cohort study in Iceland
Author: McClure, Christopher Bruce; Valdimarsdóttir, Unnur A; Hauksdóttir, Arna; Kawachi, Ichiro

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Citation: McClure, Christopher Bruce, Unnur A Valdimarsdóttir, Arna Hauksdóttir, and Ichiro Kawachi. 2012. Economic crisis and smoking behaviour: prospective cohort study in Iceland. BMJ Open 2(5): e001386.
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Abstract: Objective: To examine the associations between the 2008 economic collapse in Iceland and smoking behaviour at the national and individual levels. Design: A population-based, prospective cohort study based on a mail survey (Health and Wellbeing in Iceland) assessed in 2007 and 2009. Setting: National mail survey. Participants: Representative cohort (n=3755) of Icelandic adults. Main outcome measure: Smoking status. Results: A significant reduction in the prevalence of smoking was observed from 2007 (pre-economic collapse) to 2009 (postcollapse) in both males (17.4–14.8%; p 0.01) and females (20.0–17.5%; p 0.01) in the cohort (n=3755). At the individual level of analysis, male former smokers experiencing a reduction in income during the same period were less likely to relapse (OR 0.37; 95% CI 0.16 to 0.85). Female smokers were less likely to quit over time compared to males (OR 0.65; 95% CI 0.45 to 0.93). Among male former smokers who experienced an increase in income between 2007 and 2009, we observed an elevated risk of smoking relapse (OR 4.02; 95% CI 1.15 to 14.00). Conclusions: The national prevalence of smoking in Iceland declined following the 2008 economic crisis. This could be due to the procyclical relationship between macro-economic conditions and smoking behaviour (ie, hard times lead to less smoking because of lower affordability), or it may simply reflect a continuation of trends already in place prior to the crisis. In individual-level analysis, we find that former smokers who experienced a decline in income were less likely to relapse; and conversely, an increase in income raises the risk. However, caution is warranted since these findings are based on small numbers.
Published Version: doi:10.1136/bmjopen-2012-001386
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488705/pdf/
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Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:10579571
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