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Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study

Samantha Marie Harris, Magnus Jørgensen, Emily Lowthian Orcid Logo, Sara Madeleine Kristensen

BMC Public Health, Volume: 23, Issue: 1

Swansea University Author: Emily Lowthian Orcid Logo

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Abstract

Background: Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called “alcohol harm paradox” (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more a...

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Published in: BMC Public Health
ISSN: 1471-2458
Published: Springer Science and Business Media LLC 2023
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Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible “smoking harm paradox” (SHP). We aim to fill this gap.Methods: We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report.Results: Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income.Conclusions: While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. 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spelling v2 65423 2024-01-08 Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study db5bc529b8a9dfca2b4a268d14e03479 0000-0001-9362-0046 Emily Lowthian Emily Lowthian true false 2024-01-08 EDUC Background: Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called “alcohol harm paradox” (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible “smoking harm paradox” (SHP). We aim to fill this gap.Methods: We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report.Results: Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income.Conclusions: While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking. Journal Article BMC Public Health 23 1 Springer Science and Business Media LLC 1471-2458 Disparities; Socioeconomic status; Smoking caused Disease 17 10 2023 2023-10-17 10.1186/s12889-023-16952-6 COLLEGE NANME Education COLLEGE CODE EDUC Swansea University Another institution paid the OA fee Funding This project is funded by Norges Forskningsråd (Grant number 302225). Open access funding provided by University of Bergen. 2024-03-21T13:35:09.4040754 2024-01-08T15:44:21.2094627 Faculty of Humanities and Social Sciences School of Social Sciences - Education and Childhood Studies Samantha Marie Harris 1 Magnus Jørgensen 2 Emily Lowthian 0000-0001-9362-0046 3 Sara Madeleine Kristensen 4 65423__29423__53fbffa639054d258cf6a59a57006f2a.pdf 65423.VOR.pdf 2024-01-09T16:52:32.3184380 Output 1829108 application/pdf Version of Record true © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
spellingShingle Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
Emily Lowthian
title_short Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
title_full Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
title_fullStr Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
title_full_unstemmed Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
title_sort Up in smoke? Limited evidence of a smoking harm paradox in 17-year cohort study
author_id_str_mv db5bc529b8a9dfca2b4a268d14e03479
author_id_fullname_str_mv db5bc529b8a9dfca2b4a268d14e03479_***_Emily Lowthian
author Emily Lowthian
author2 Samantha Marie Harris
Magnus Jørgensen
Emily Lowthian
Sara Madeleine Kristensen
format Journal article
container_title BMC Public Health
container_volume 23
container_issue 1
publishDate 2023
institution Swansea University
issn 1471-2458
doi_str_mv 10.1186/s12889-023-16952-6
publisher Springer Science and Business Media LLC
college_str Faculty of Humanities and Social Sciences
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hierarchy_top_id facultyofhumanitiesandsocialsciences
hierarchy_top_title Faculty of Humanities and Social Sciences
hierarchy_parent_id facultyofhumanitiesandsocialsciences
hierarchy_parent_title Faculty of Humanities and Social Sciences
department_str School of Social Sciences - Education and Childhood Studies{{{_:::_}}}Faculty of Humanities and Social Sciences{{{_:::_}}}School of Social Sciences - Education and Childhood Studies
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description Background: Socioeconomic differences in the impact of alcohol consumption on health have been consistently reported in the so-called “alcohol harm paradox” (i.e., individuals from higher socioeconomic backgrounds (SES) drink more alcohol than individuals from lower SES, but the latter accrue more alcohol-related harm). Despite the severe health risks of smoking however, there is a scarcity of studies examining a possible “smoking harm paradox” (SHP). We aim to fill this gap.Methods: We conducted a prospective cohort study with adolescents from the Norwegian Longitudinal Health Behaviour Study (NLHB). Our study used data from ages 13 to 30 years. To analyse our data, we used the random-intercept cross-lagged panel model (RI-CLPM) with smoking and self-reported health as mutual lagged predictors and outcomes as well as parental income and education as grouping variables. Parental income and education were used as proxies for adolescent socioeconomic status (SES). Smoking was examined through frequency of smoking (every day, every week, less than once a week, not at all). General health compared to others was measured by self-report.Results: Overall, we found inconclusive evidence of the smoking harm paradox, as not all effects from smoking to self-reported health were moderated by SES. Nevertheless, the findings do suggest that smoking predicted worse subjective health over time among individuals in the lower parental education group compared with those in the higher parental education group. This pattern was not found for parental income.Conclusions: While our results suggest limited evidence for a smoking harm paradox (SHP), they also suggest that the impact of adolescent smoking on later subjective health is significant for individuals with low parental education but not individuals with high parental education. This effect was not found for parental income, highlighting the potential influence of parental education over income as a determinant of subjective health outcomes in relation to smoking.
published_date 2023-10-17T13:35:10Z
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