Fatores Associados ao Consumo de Cigarro em um Distrito Peruano de Nível Socioeconômico Alto
DOI:
https://doi.org/10.17533/udea.rfnsp.e357489Palavras-chave:
consumo de cigarrillo, factores socioeconómicos, salud públicaResumo
Objetivo: Identificar e classificar os fatores socioeconômicos associados ao consumo de cigarros em um distrito peruano de alto nível socioeconômico.
Métodos: Estudo transversal utilizando dados do “Censo de Saúde e Determinantes do Distrito de San Borja” (2021–2022), com 49.082 participantes. A análise focou nos indivíduos que responderam se haviam fumado cigarros nos últimos 12 meses. Variáveis como consumo de cigarros, sexo, idade, nível educacional, estado civil, situação laboral e outras foram analisadas usando regressão logística binária e a árvore de decisão CHAID (Chi-Squared Automatic Interaction Detection).
Resultados: A taxa de fumantes foi de 3,70%. Adultos sem parceiro foram 1,46 vezes mais propensos a fumar (OR = 1,461; IC 95% = 1,184–1,803). Aqueles que vivem em apartamentos compartilhados foram 1,38 vezes mais propensos (OR = 1,383; IC 95% = 1,120–1,707), e pessoas sem casa própria foram 2,01 vezes mais propensas (OR = 2,010; IC 95% = 1,353–2,954). Homens foram 2,574 vezes mais propensos a fumar do que mulheres (OR = 2,574; IC 95% = 2,078–3,190). A árvore de decisão CHAID revelou que a instabilidade laboral foi um fator chave para os homens, enquanto crises econômicas e incidentes criminais no lar foram significativos para as mulheres.
Conclusões: A instabilidade laboral nos homens e as condições precárias de vida nas mulheres estão associadas ao consumo de cigarros. O principal perfil socioeconômico dos fumantes inclui ser homem, não possuir casa própria e estar solteiro.
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Referências
1. Bryazka D, Reitsma MB, Abate YH, et al. Forecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050: A systematic analysis for the Global Burden of Disease Study 2021. Lancet Public Health. 2024;9(10):e729-44. DOI: http://dx.doi.org/10.1016/s2468-2667(24)00166-x
2. Anuththiga. Global tobacco control information & statistics I. Tobacco Atlas. [internet]. 2022 [citado 2024 oct. 30]. Disponible en: https://tobaccoatlas.org/?form=MG0AV3
3. Benowitz NL. Pharmacology of nicotine: Addiction, smoking-induced disease, and therapeutics. Annu Rev Pharmacol Toxicol. 2009;49(1):57-71. DOI: http://dx.doi.org/10.1146/annurev.pharmtox.48.113006.094742
4. Livingstone-Banks J, Fanshawe TR, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Libr. 2023;(6):CD006103. DOI: http://dx.doi.org/10.1002/14651858.cd006103.pub9
5. Li X, Semenova S, D’Souza MS, et al. Involvement of glutamatergic and GABAergic systems in nicotine dependence: Implications for novel pharmacotherapies for smoking cessation. Neuropharmacology. 2014;76:554-65. DOI: http://dx.doi.org/10.1016/j.neuropharm.2013.05.042
6. Serrano Gotarredona MP, Navarro Herrero S, et al. Enfermedades pulmonares intersticiales relacionadas con el tabaco. Radiología. 2022;64:277-89. DOI: https://doi.org/10.1016/j.rx.2022.10.008
7. Fernández González EM, Figueroa Oliva DA. Tabaquismo y su relación con las enfermedades cardiovasculares. Rev Habanera Cienc Médicas [internet]. 2018 [citado 2023 jul. 9];17(2):225-35. Disponible en: http://scielo.sld.cu/scielo.php?pid=S1729-519X2018000200008&script=sci_arttext
8. Kondo T, Nakano Y, et al. Effects of tobacco smoking on cardiovascular disease. Circ J. 2019;83(10):1980-5. DOI: https://doi.org/10.1253/circj.cj-19-0323
9. NHS. Passive smoking. nhs.uk [internet]. 2024 [citado 2024 oct. 30]. Disponible en: https://www.nhs.uk/live-well/quit-smoking/passive-smoking-protect-your-family-and-friends/
10. Dai X, Gakidou E, Lopez AD. Evolution of the global smoking epidemic over the past half century: Strengthening the evidence base for policy action. Tob Control. 2022;31(2):129-37. DOI: http://dx.doi.org/10.1136/tobaccocontrol-2021-056535
11. Bernabé-Ortiz A, Carrillo-Larco RM. Prevalencia y tendencias de tabaquismo activo y pasivo en adolescentes peruanos. Rev Peru Med Exp Salud Publica [internet]. 2022 [citado 2024 jun. 16]; 39(2):193-200. Disponible en: http://www.scielo.org.pe/pdf/rins/v39n2/1726-4642-rpmesp-39-02-193.pdf
12. Urbina Padilla ED, Zarsosa Osorio IA. Prevalencia del consumo de drogas ilícitas (marihuana) y lícitas (tabaco y alcohol) en los adolescentes del Colegio Alfonso Laso Bermeo de la ciudad de Quito en el período 2017-2018 [tesis de pregrado]. [Quito]: Universidad de las Américas [internet]; 2019 [citado 2023 jul. 9]. Disponible en: https://dspace.udla.edu.ec/handle/33000/11612
13. Fernando HN, Wimaladasa ITP, Sathkoralage AN, et al. Socioeconomic factors associated with tobacco smoking among adult males in Sri Lanka. BMC Public Health. 2019;19(1). DOI: http://dx.doi.org/10.1186/s12889-019-7147-9
14. Qattan AMN, Boachie MK, et al. Socioeconomic determinants of smoking in the Kingdom of Saudi Arabia. Int J Environ Res Public Health. 2021;18(11):5665. DOI: http://dx.doi.org/10.3390/ijerph18115665
15. Lisha NE, Delucchi KL, et al. Prevalence and correlates of social smoking in young adults: Comparisons of behavioral and self-identified definitions. Nicotine Tob Res. 2015;17(9):1076-84. DOI: https://doi.org/10.1093/ntr/ntu242
16. Orco Díaz A. Gasto público en inversiones y reducción de la pobreza regional en el Perú, período 2009-2018. Quipukamayoc. 2020;28(56):9-16. DOI: https://doi.org/10.15381/quipu.v28i56.17087
17. Gobierno de Perú, Gerencia de Red Integrada de Salud de la Municipalidad Distrital de San Borja. Censo de Salud y Determinantes del Distrito de San Borja [internet]; 2021-2022 [citado 2024 jun. 16]. Disponible en: https://www.datosabiertos.gob.pe/dataset/censo-de-salud-y-determinantes-del-distrito-de-san-borja-municipalidad-distrital-de-san
18. Programa de las Naciones Unidas para el Dasarrollo. El reto de la igualdad. Una lectura de las dinámicas territoriales en el Perú. Lima [internet]; 2019 [citado 2024 jun. 16]. https://www.undp.org/sites/g/files/zskgke326/files/migration/pe/PNUD-Peru---El-Reto-de-la-Igualdad.pdf
19. Instituto Nacional de Estadística e Informática. Cuadros estadísticos de población, vivienda y hogar. En: Resultados Definitivos de la provincia de Lima. Tomo I. Lima [internet]. 2018 [citado 2023 jul. 9]. pp. 63-951. Disponible en: https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1583/15ATOMO_01.pdf
20. Benchimol EI, Smeeth L, Guttmann A, et al., RECORD Working Committee. The Reporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement. PLoS Med. [internet] 2015 [citado año mes día]; 12(10):e1001885. Disponible en: http://www.equator-network.org/reporting-guidelines/record/
21. Szumilas M. Explaining odds ratios. J Can Acad Child Adolesc Psychiatry [internet]. 2010 [citado 2023 jul. 9]; 19(3):227-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/20842279
22. Yilmaz AE. How reliable are the multiple comparison methods for odds ratio? J Appl Stat. 2022;49(12):3141-63. DOI: https://doi.org/10.1080/02664763.2022.2104229
23. Cruz APD. Predicting the relapse category in patients with tuberculosis: A chi-square automatic interaction detector (CHAID) decision tree analysis. Open J Soc Sci. 2018;6(12):29-36. DOI: http://dx.doi.org/10.4236/jss.2018.612003
24. Asociación Médica Mundial (ANM). Declaración de Helsinki de la AMM – Principios éticos para las investigaciones médicas en participantes humanos [internet]; 2024 [citado 2024 nov. 15]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/
25. Theilmann M, Lemp JM, Winkler V, et al. Patterns of tobacco use in low and middle income countries by tobacco product and sociodemographic characteristics: Nationally representative survey data from 82 countries. BMJ. 2022;e067582. DOI: http://dx.doi.org/10.1136/bmj-2021-067582
26. Castillo-Riquelme M, Bardach A, et al. Health burden and economic costs of smoking in Chile: The potential impact of increasing cigarettes prices. PLoS One. 2020;15(8):e0237967. DOI: http://dx.doi.org/10.1371/journal.pone.0237967
27. Van Bui T, Blizzard L, Luong KN, et al. Declining prevalence of tobacco smoking in Vietnam. Nicotine Tob Res. 2015;17(7):831-8. DOI: http://dx.doi.org/10.1093/ntr/ntu202
28. Dozier AM, Ossip-Klein DJ, Diaz S, et al. Tobacco use in the Dominican Republic: Understanding the culture first. Tob Control. 2006;15(Supl. 1):i30-6. DOI: http://dx.doi.org/10.1136/tc.2005.014852
29. Pérez-Pareja FJ, García-Pazo P, Jiménez R, et al. Dejar de fumar, terapia cognitivo-conductual y perfiles diferenciales con árboles de decisión. Clin Salud. 2020; 31(3):137-45. DOI: https://dx.doi.org/10.5093/clysa2020a12
30. Syamlal G, Mazurek JM, Dube SR. Gender differences in smoking among U.S. working adults. Am J Prev Med. 2014;47(4):467-75. Disponible en: https://pubmed.ncbi.nlm.nih.gov/25049215/
31. Peters SA, Huxley RR, Woodward M. Do smoking habits differ between women and men in contemporary Western populations? Evidence from half a million people in the UK Biobank study. BMJ Open. 2014;4(12):e005663. DOI: https://doi.org/10.1136/bmjopen-2014-005663
32. Reddy-Jacobs C, Téllez-Rojo MM, Meneses-González F, et al. Pobreza, jóvenes y consumo de tabaco en México. Salud Pública Méx [internet]. 2006 [citado 2024 oct. 31];48(Supl. 1):s83-90. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0036-36342006000700010
33. Bader P, Boisclair D, Ferrence R. Effects of tobacco taxation and pricing on smoking behavior in high risk populations: A knowledge synthesis. Int J Environ Res Public Health. 2011;8(11):4118-39. DOI: http://dx.doi.org/10.3390/ijerph8114118
34. Keir EF, Bu F, Polkey MI, et al. Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England. Lancet Reg Health Eur. 2022;14(100302):100302. DOI: https://doi.org/10.1016/j.lanepe.2021.100302
35. Pichon-Riviere A, Bardach A, Rodríguez Cairoli F, et al. Health, economic and social burden of tobacco in Latin America and the expected gains of fully implementing taxes, plain packaging, advertising bans and smoke-free environments control measures: A modelling study. Tob Control. 2024;33:611-21. DOI: https://doi.org/10.1136/tc-2022-057618
36. Amiri S. Smoking and alcohol use in unemployed populations: a systematic review and meta-analysis. J Addict Dis. 2022;40(2):254-77. DOI: http://dx.doi.org/10.1080/10550887.2021.1981124
37. Prochaska JJ, Michalek AK, Brown-Johnson C, et al. Likelihood of unemployed smokers vs nonsmokers attaining reemployment in a one-year observational study. JAMA Intern Med. 2016;176(5):662-70. DOI: https://doi.org/10.1001/jamainternmed.2016.0772
38. Kim B, Lee Y, Kwon YD, et al. Factors associated with indoor smoking at home: A focus on socioeconomic status in South Korea. Epidemiol Health. 2020;42:e2020067. DOI: http://dx.doi.org/10.4178/epih.e2020067
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