Open AccessCurrent Inequities in Smoking Prevalence on District Level in Iran: A Systematic Analysis on the STEPS Survey
Author(s) -
Mohsen AbbasiKangevari,
Masoud Masinaei,
Nima Fattahi,
Yekta Rahimi,
Negar Rezaei,
Sina Azadnajafabad,
Ali Ghanbari,
Roozbe Fakhimi,
Zahra Jourahmad,
SeyyedHadi Ghamari,
MohammadReza Malekpour,
Naser Ahmadi,
Amirali Hajebi,
Hamed Jafarpour,
Farshad Farzadfar
Publication year - 2021
Publication title -
journal of research in health sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.317
H-Index - 20
eISSN - 2228-7809
pISSN - 2228-7795
DOI - 10.34172/jrhs.2022.75
Subject(s) - urbanization , environmental health , medicine , smoking prevalence , inequality , cross sectional study , tobacco control , cigarette smoking , demography , multilevel model , estimation , public health , geography , population , economic growth , economics , mathematical analysis , mathematics , nursing , pathology , machine learning , sociology , computer science , management
Background: The prevalence of tobacco smoking and its burden on societies is not homogenous at the national and district levels. This nationwide study aimed to investigate current inequalities in the prevalence of smoking at the district level and the association of smoking behaviors with gender, wealth, education, and urbanization in Iran. Study design: A cross-sectional study. Methods: This study was conducted by analyzing the data of the STEPS survey 2016 with 30541 participants. The small-area estimation method using the Bayesian spatial hierarchical multilevel regression model was employed to generate district-level prevalence of all types of smoking by gender. The inequalities between the groups by wealth, education, and urbanization were investigated via concentration index. Results: The prevalence rates of current daily cigarette smoking were found to be at the range of 4.6-40.9 and 0-4.5 among men and women, respectively. Current daily cigarette smoking was higher in men than in women: 19.0 (95% CI: 9.5-28.7) vs 0.7 (95% CI: 0-6.9). Women with lower wealth, education, or urbanization were more likely to smoke tobacco or be exposed to secondhand smoking. On the other hand, men with higher wealth or education indices were more likely to smoke tobacco. Men with lower wealth, education, or urbanization were more likely to be exposed to secondhand smoking. Conclusion: The smoking behavior varied significantly at the district level in Iran. Gender, wealth, education, and urbanization were determinants of smoking prevalence.