Key result
Between 1987 and 2014, smoking prevalence decreased among Portuguese men (35.2% to 26.7%) but increased among women (6.0% to 14.6%), with unemployed and divorced individuals at highest risk.
Cross-Sectional
Smoking prevalence in Portugal has decreased among men but increased among women between 1987 and 2014, highlighting the need for targeted prevention strategies.
May warrant targeted cessation efforts for Portuguese women and disadvantaged groups; leaves open post-2014 policy impacts.
Background Smoking is a risk factor for several diseases. Knowing smoking patterns in the Portuguese population is important for planning preventative strategies. This study aims to describe trends of tobacco consumption and measure the associated socioeconomic factors in Portugal from 1987-2014. Methods We used data from National Health Interview Surveys (NHIS) (1987, 1998/99, 1995/96, 2005/06 and 2014). For each NHIS, we estimated sex specific smoking age-standardized prevalence, stratified by education, occupation, marital status and region. We fitted NHIS- and sex-stratified logistic regression models, adjusting for the above mentioned variables. For each sex we describe the evolution of smoking prevalence and associated socioeconomic factors inequalities (using Adjusted Odds Ratio (aOR)) from 1987-2014. Results For men smoking prevalence and inequalities generally decreased (1987-2014: 35.2-26.7%). For education, inequalities increased in the 2014 NHIS. For women inequalities decreased for region, age and occupation. These changes occurred through an increase and convergence in prevalence for all groups. For occupation, marital status and education, inequalities have been stable but there with a generalized increase in smoking prevalence (1987-2014: 6.0-14.6%). For both sexes unemployed (aOR 2014: Men-2.3; Women-2.8) and divorced (aOR 2014: Men-2.1; Women: 2014-3.2) persistently have the highest prevalence and aOR of smoking. While for 1987/95/99 NHIS we observed higher aOR of smoking among low-educated men and highly-educated women, for 2005/14 NHIS the higher aOR was in low-educated in both. Conclusions Smoking trends among men show a positive evolution with decreasing prevalence and inequalities. For women inequalities were stable but there is a generalized increase in prevalence. Unemployed and divorced remain with high tobacco consumption in both sexes. Smoking prevention and cessation policies in Portugal should consider inequalities and focus on women. Key messages: Smoking trends among Portuguese men show a positive evolution with decreasing prevalence and inequalities. For women inequalities were stable but there is a generalized increase in prevalence More vulnerable groups should be targeted when planning smoking prevention and cessation policies
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Pinto et al. (2016) conducted a cross-sectional in Tobacco consumption. Socioeconomic factors (unemployment, divorce, education) was evaluated on Smoking prevalence. Between 1987 and 2014, smoking prevalence decreased among Portuguese men (35.2% to 26.7%) but increased among women (6.0% to 14.6%), with unemployed and divorced individuals at highest risk.
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