Socioeconomic patterning of vaping by smoking status among UK adults and youth

Green, M. J. , Gray, L. , Sweeting, H. and Benzeval, M. (2020) Socioeconomic patterning of vaping by smoking status among UK adults and youth. BMC Public Health, 20, 183. (doi: 10.1186/s12889-020-8270-3) (PMID:32036787) (PMCID:PMC7008571)

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Abstract

Background: Smoking contributes significantly to socioeconomic health inequalities. Vaping has captured much interest as a less harmful alternative to smoking, but may be harmful relative to non-smoking. Examining inequalities in vaping by smoking status, may offer insights into potential impacts of vaping on socioeconomic inequalities in health. Methods: Data were from 3291 youth (aged 10–15) and 35,367 adults (aged 16+) from wave 7 (2015–17) of the UK Household Longitudinal Study. In order to adjust for biases that could be introduced by stratifying on smoking status, marginal structural models were used to estimate controlled direct effects of an index of socioeconomic disadvantage (incorporating household education, occupation and income) on vaping by smoking status (among adults and youth), adjusting for relevant confounders and for selection into smoking states. We also estimated controlled direct effects of socioeconomic disadvantage on being an ex-smoker by vaping status (among adult ever-smokers; n = 18,128). Results: Socioeconomic disadvantage was associated with vaping among never smoking youth (OR for a unit increase in the socioeconomic index: 1.17; 95%: 1.03–1.34), and among ex-smoking adults (OR: 1.17; 95% CI: 1.09–1.26), with little to no association among never smoking (OR: 0.98; 95% CI: 0.91–1.07) and current smoking (OR: 1.00; 95% CI: 0.93–1.07) adults. Socioeconomic disadvantage was also associated with reduced odds of being an ex-smoker among adult ever-smokers, but this association was moderately weaker among those who vaped (OR: 0.88; 95% CI: 0.82–0.95) than those who did not (OR: 0.82; 95% CI: 0.80–0.84; p-value for difference = 0.081). Conclusions: Inequalities in vaping among never smoking youth and adult ex-smokers, suggest potential to widen health inequalities, while weaker inequalities in smoking cessation among adult vapers indicate e-cigarettes could help narrow inequalities. Further research is needed to understand the balance of these opposing potential impacts, and how any benefits can be maximised whilst protecting the vulnerable.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Green, Dr Michael and Gray, Dr Linsay and Benzeval, Dr Michaela and Sweeting, Dr Helen
Authors: Green, M. J., Gray, L., Sweeting, H., and Benzeval, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
ISSN (Online):1471-2458
Copyright Holders:Copyright © The Author(s) 2020
First Published:First published in BMC Public Health 20:183
Publisher Policy:Reproduced under a Creative Commons license
Related URLs:
Data DOI:10.5255/UKDA-SN-6614-12

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727641SPHSU Core Renewal: Setting and Health Improvement Research ProgrammeKathryn HuntMedical Research Council (MRC)MC_UU_12017/12IHW - MRC/CSO SPHU
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU
SPSHU12
SPSHU13