Predictors of smoking initiation – Results from the Global Adult Tobacco Survey (GATS) in Poland 2009–2010
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Department of Preventive Medicine, Medical University of Łódź, Poland
Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Łódź, Poland
Department of Biopharmacy, Medical University of Łódź, Poland
Ann Agric Environ Med. 2013;20(4):756-766
Improving the access to information on determinants of the smoking epidemic is essential for increasing the effectiveness of tobacco control policies. While the statistics of smoking prevalence in Poland are available, data on smoking initiation and its social correlates are still poorly described.

To investigate the association of socio-demographic indicators with regular smoking initiation among adults.

Material and Methods:
Data from the Global Adult Tobacco Survey (GATS) on socio-demographic and smoking-related characteristics of respondents were used. GATS is a nationally representative household survey. GATS provided data on a representative sample of 7,840 adult individuals – 2,207 male and 1,321 female ever smokers. Logistic regression analysis was performed and the χ2 test for relevant calculations.

Among males, the regular smoking initiation rate was significantly higher compared to females (59.2% vs. 34.2%; p<0.01). Mean age of smoking initiation was lower in men compared to women (18.4±3.6 vs. 20.0± 4.7 p<0.01). Lack of awareness on smoking health consequences was strongly associated with initiating of regular smoking among both genders (unaware vs. aware respondents: OR = 3.0 CI 2.3–4.0; p<0.001 in men and OR = 3.07 CI 2.3–3.9; p<0.001 in women). Older age, vocational education and unemployment were associated with regular smoking initiation among men and women. Also, not being religious considerably contributed to increased likelihood of smoking initiation in women (OR = 4.4 CI 2.5–7.7; p<0.001).

The results indicate that policies focused on preventing smoking onset among Poles are needed to reduce tobacco epidemic, with the ultimate goal of translating evidence into policy.

McCartney G, Mahmood L, Leyland A, Batty D, Hunt K. Contribution of smoking-related and alcohol-related deaths to the gender gap in mortality: evidence from 30 European countries. Tob Control. 2011; 20(2): 166–168. doi:10.1136/tc.2010.037929.
Fronczak A, Polańska K, Usidame B, Kaleta D. Comprehensive tobacco control measures-the overview of the strategies recommended by WHO. Cent Eur J Public Health. 2012; 20(1): 81–86.
World Health Organization. European Tobacco Control Report. WHO; Copenhagen 2007.
Shafey O, Eriksen M, Ross H, Mackay J. Tobacco Atlas, American Cancer Society, 2009.
World Health Organization (WHO). WHO global report: mortality attributable to tobacco. Geneva: WHO; 2012.
World Health Organization. Tools for advancing tobacco control in the 21st century Tobacco control legislation: an introductory guide. WHO, Geneva, 2004.
World Health Organization (WHO). The current status of the tobacco epidemic in Poland. WHO, Copenhagen, 2009.
Kaleta D, Makowiec-Dabrowska T, Dziankowska-Zaborszczyk E, Fronczak A. Prevalence and socio-demographic correlates of daily cigarette smoking in Poland: Results from the Global Adult Tobacco Survey (2009–2010). Int J Occup Med Environ Health 2012; 25(2): 126–136.
Schaap MM, Kunst A. Monitoring of socio-economic inequalities in smoking: Learning from experiences of recent scientific studies. Public Health 2009; 123(2): 103–9.
Kaleta D, Polańska K, Jegier A. Smoking predictors among economically active individuals. Int J Occup Med Environ Health 2007; 20(4): 357– 363.
Kaleta D, Makowiec-Dabrowska T, Polańska K, DziankowskaZaborszczyk E, Drygas W. Tobacco smoking and other negative lifestyle behaviors among economically active individuals. Med Pr. 2009; 60(1): 7–14. [in Polish].
Kaleta D, Makowiec-Dabrowska T, Dziankowska-Zaborszczyk E, Fronczak A. Determinants of heavy smoking: Results from the global adult tobacco survey in Poland (2009–2010). Int J Occup Med Environ Health 2012; 25(1): 66–79.
Ministry of Health of Poland. Global Adult Tobacco Survey. Poland 2009–2010. Warsaw 2010.
Gilman SE, Abrams DB, Buka SL. Socioeconomic status over the life course and stages of cigarette use: initiation, regular use, and cessation. J Epidemiol Community Health 2003;57:802–8.
Oh DL, Heck JE, Dresler C, Allwright S, Haglund M, Del Mazo SS, Kralikova E, Stucker I, Tamang E, Gritz ER, Hashibe M. Determinants of smoking initiation among women in five European countries: a cross-sectional survey. BMC Public Health 2010 17;10:74.
La Vecchia C, Decarli A, Pagano R. Patterns of Smoking Initiation in Italian Males and Females from 1955 to 1985. Prev Med. 1995; 24: 293–296.
Schulze, A, Mons, U. Trends in cigarette smoking initiation and cessation among birth cohorts of 1926–1970 in Germany. Eur J Cancer Prev. 2005; 14(5): 477–483.
Giovino GA, Mirza SA, Samet JM, Gupta PC, Jarvis MJ, Bhala N, et al. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet 2012; 18; 380(9842): 668–79.
Thun M., Peto R, Boreham J, Lopez A. Stages of the cigarette epidemic on entering its second century. Tob Control 2012;21:96-101 doi:10.1136/ tobaccocontrol-2011-050294.
Baron-Epel O., Haviv-Messika A. Factors associated with age of smoking initiation in adult populations from different ethnic backgrounds. European J Pub Health 2004;14(3): 301–305.
Legleye S, Khlat M, Beck F, Peretti-Watel P. Widening inequalities in smoking initiation and cessation patterns: a cohort and gender analysis in France. Drug Alcohol Depend. 2011; 117: 233–41.
Breslau N, Peterson EL. Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Public Health. 1996; 86(2): 214–20.
Bacigalupe A, EsnaolaS, Martín U, Borrell C. Two decades of inequalities in smoking prevalence, initiation and cessation in a southern European region: 1986–2007. Eur J Public Health (2012) doi: 10.1093/eurpub/ cks104.
Giskes K, Kunst A, Benach J, Borrell C, Costa G, Dahl E, et al. Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health 2005;59:395–401 doi:10.1136/jech.2004.025684.
World Health Organization (WHO). WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. Geneva: WHO; 2011.
Nagelhout GE, Korte-de Boer D, Kunst AE, van der Meer R, de Vries H, van Gelder B, et al. Trends in socioeconomic inequalities in smoking prevalence, consumption, initiation, and cessation between 2001 and 2008 in the Netherlands. Findings from a national population survey. BMC Public Health 2012, 12:303 doi:10.1186/1471-2458-12-303.
Leinsalu M, Tekkel M, Kunst AE. Social determinants of ever initiating smoking differ from those of quitt ing: a crosssectional study in Estonia. Eur J Public Health 2007; 17: 572–8.
van Loon A, Tijhuis M, Surtees P, Ormel J. Determinants of smoking status: cross-sectional data on smoking initiation and cessation. Eur J Public Health 2005; 15(3): 256–261. doi: 10.1093/eurpub/cki077.
Schaap MM, Kunst AE, Leinsalu M, Regidor E, Espelt A, Ekholm O, et al. Female ever-smoking, education, emancipation and economic development in 19 European countries. Soc Sci Med. 2009; 68(7): 1271–8.
Borras JM, Fernandez E, Schiaffino A, Borrell C, La Vecchia C. Pattern of smoking initiation in Catalonia, Spain, from 1948 to 1992. Am J Public Health. 2000; 90(9): 1459–62.
Fernandez E, Garcia M, Schiaffi no A, Borras JM, Nebot M, Segura A. Smoking initiation and cessation by gender and educational level in Catalonia, Spain. Prev Med 2001; 32: 218–23.
Fernandez E, Schiaffino A, Garcia M, Borras JM. Widening social inequalities in smoking cessation in Spain, 1987–1997. J Epidemiol Community Health 2001; 55: 729–30.
Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grötvedt L, Helmert U, et al. Educational differences in smoking: international comparison. BMJ. 2000; 320(7242): 1102–7.
Kim YN, Cho YG, Kim CH, Kang JH, Park HA, Kim KW, et al. Socioeconomic indicators Associated with Initiation and Cessation of Smoking among Women in Seoul. Korean J Fam Med. 2012; 33: 1–8.
Federico B, Costa G, Kunst AE. Educational inequalities in initiation, cessation, and prevalence of smoking among 3 Italian birth cohorts. Am J Public Health 2007; 97: 838–45.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992; 82: 816–820.
Kestilä L, Koskinen S, Martelin T, Rahkonen O, Pensola T, Pirkola S, et al. Influence of parental education, childhood adversities, and current living conditions on daily smoking in early adulthood. Eur J Public Health. 2006; 16(6): 617–26.
Kaleta D, Usidame B, Polańska K. Tobacco advertisements targeted on women: creating an awareness among women. Cent Eur J Public Health. 2011; 19(2): 73–78.
Koenig HG, George LK, Cohen HJ, Hays JC, Larson DB, Blazer DG. The relationship between religious activities and cigarette smoking in older adults. J Gerontol A Biol Sci Med Sci. 1998; 53: 426- 434.
Wallace JM Jr, Forman TA. Religion’s role in promoting health and reducing risk among American youth. Health Educ Behav. 1998; 25721- 741.
Nonnemaker J, McNeely C, Blum R. Public and private domains of religiosity and adolescent health risk behaviors: evidence from the National Longitudinal Study of Adolescent Health. Soc Sci Med. 2003; 57, 11: 2049–2054.
Jabbour S, Fouad F. Religion-based tobacco control interventions: how should WHO proceed? Bull World Health Organ [online]. 2004,82,12, pp. 923–927. ISSN 0042-9686.
Whooley M, Boyd A, Gardin J, Williams D. Religious Involvement and Cigarette Smoking in Young Adults. The CARDIA Study. Arch Intern Med. 2002; 162(14): 1604–1610. doi:10-1001/pubs.
Timberlake D, Rhee S, Haberstick B, Hopfer C, Ehringer M, Lessem, J, et al. The Moderating Effects of Religiosity on the Genetic and Environmental Determinants of Smoking Initiation. Nicotine Tob Res. 2006; 8(1): 123–133. doi: 10.1080/14622200500432054.
Maziak W, Asfar T, Mzayek F. Socio-demographic determinants of smoking among low-income women in Aleppo, Syria. International Journal of Tuberculosis and Lung Disease 2001; 5: 307–12.
Nonnemaker J, McNeely C, Blum R. Public and private domains of religiosity and adolescent smoking transitions. Soc Sci Med. 2006; 62(12): 3084–3095.
Kaleta D, Polańska K, Wojtysiak P, Kozieł A, Kwaśniewska M, Miśkiewicz P, et al. Effective protection from exposure to environmental tobacco smoke in Poland: The World Health Organization perspective. Int J Occup Med Environ Health. 2010; 23(2): 123–131.
Act on the Protection of Health against the Consequences of the Use of Tobacco and Tobacco Products. Law Gazette 1995; 10: 55 [in Polish].
Farrelly MC, Nonnemaker J, Davis KC, Hussin A. The influence of the national truth campaign on smoking initiation. Am J Prev Med. 2009; 36(5): 379–384.
Wechsler H, Lee JE, Rigotti NA. Cigarette use by college students in smoke-free housing: results of a national study. Am J Prev Med. 2001; 20(3): 202–207.
Pabayo R, O’Loughlin J, Barnett T, Cohen J, Gauvin L. Does Intolerance of Smoking at School or in Restaurants or Corner Stores Decrease Cigarette Use Initiation in Adolescents? Nicotine Tob Res.b2012;b14(10): 1154–1160. doi: 10.1093/ntr/ntr326.
Hersey JC., Niederdeppe J, Evans WD, Nonnemaker J, Blahut S, Farrelly MC et al. The effects of state counter industry media campaigns on beliefs, attitudes, and smoking status among teens and young adults. Preventive Med. 2003; 37: 544–552.
Hammond D. Health warning messages on tobacco products: a review. Tob Control. 2011; 20: 327e337. doi:10.1136/tc.2010.037630.
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