Factors Associated With Concurrent Tobacco Smoking and Heavy Alcohol Consumption Within a Socioeconomically Disadvantaged Australian Sample

ABSTRACT

Background: Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users. Objectives: This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers. Methods: A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out. Results: The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers. Conclusion: Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.

KEYWORDS:

• Alcohol
• heavy drinking
• tobacco use
• smoking
• concurrent use
• disadvantage

Additional information

Notes on contributors

Laura Twyman

Miss Laura Twyman is a PhD Candidate within the School of Medicine and Public Health at the University of Newcastle. Miss Twyman's rese arch interests include modifiable behavioral risk factors, health disparities, and the conceptualization and operationalization of socioeconomic disadvantage.

Billie Bonevski

Associate Professor Billie Bonevski, PhD, is a National Health and Medical Research Council (NHMRC) Career Development Fellow, behavioral scientist, and University of Newcastle researcher whose smoking cessation programs are being implemented by Cancer Councils across Australia. A/Prof Bonevski's primary focus is on improving people's health behavior by developing programs so they can optimize their own health through modified behaviors. For the past five years, A/Prof Bonevski's work has focused on priority groups, such as those who may be socioeconomically disadvantaged, or people with comorbidities like cancer or chronic illness.

Christine Paul

Associate Professor Christine Paul, PhD, works with the Priority Research Centre for Health Behaviour at the University of Newcastle and Hunter Medical Research Institute. A/Prof Paul is experienced in the development and evaluation of strategies for achieving behavioral change on an individual, system and population level. Her research interests include cancer prevention and tobacco control, social disadvantage, chronic disease, and health service delivery. Her recent work involves applying behavioral approaches to multi-site intervention studies in the fields of diabetes care, stroke treatment, and improving health among disadvantaged groups including Aboriginal and Torres Strait Islander peoples.

Jamie Bryant

Jamie Bryant, PhD, is a Post-Doctoral Research fellow at the Priority Research centre for Health Behaviour at the University of Newcastle. Dr Bryant's research work includes projects examining ways of decreasing anxiety and depression among patients diagnosed with hematological cancers and their care givers, strategies to improve the care provided to patients receiving medical oncology services, and ways to improve treatment outcomes for individuals with alcohol dependence. Dr Bryant has a particular interest in reducing the gap between scientific knowledge and the health care provided to patients.

Robert West

Professor Robert West is a Professor of Health Psychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre, University College London. He undertakes research into all aspects of smoking cessation and has contributed to the development of national and international clinical practice guidelines on smoking cessation and he is the Editor-in-Chief of the journal Addiction.

Mohammad Siahpush

Professor Mohammad Siahpush, PhD, is Interim Chair and Professor of the Department of Health Promotion, Social and Behavioral Health at the University of Nebraska Medical Center. Professor Siahpush's research interests include the fields of tobacco control, obesity control, health disparities, and social epidemiology.

Catherine D'Este

Professor Catherine D’Este, PhD, is currently the Chair in Biostatistics in the National Centre for Epidemiology and Population Health at the Australian National University (ANU), in Canberra. Professor D’Este's research interests broadly include cardiovascular disease, randomized-controlled trials and challenging methodological areas such as longitudinal studies and meta-analysis.

Christopher Oldmeadow

Christopher Oldmeadow, PhD, is the Senior Statistician at the Clinical Research Design, Information Technology and Statistical Support (CReDITSS) unit, located at the Hunter Medical Research Institute (HMRI), Newcastle, Australia. Dr. Oldmeadow's specific research interests are in Bayesian statistics, model selection, genomic segmentation, and causal modelling.

Kerrin Palazzi

Kerrin Palazzi, MPH, has a Masters in Public Health from the University of Minnesota (USA) and currently works in the Clinical Research Design, Information Technology and Statistical Support (CReDITSS) unit, located at the Hunter Medical Research Institute (HMRI), Newcastle, Australia. Ms. Palazzi's particular interests are in epidemiology, public health, and cancer research.