标题：Association of Smoking Cessation With Financial Stress and Material Well-Being: Results From a Prospective Study of a Population-Based National Survey
摘要：Objectives. We used 4 waves of prospective data to examine the association of smoking cessation with financial stress and material well-being. Methods. Data (n = 5699 at baseline) came from 4 consecutive waves (2001–2005) of the Household Income and Labour Dynamics in Australia survey. We used mixed models to examine the participant-specific association of smoking cessation with financial stress and material well-being. Results. On average, a smoker who quits is expected to have a 25% reduction ( P <.001; odds ratio [OR]=0.75; 95% confidence interaval [CI]=0.69, 0.81) in the odds of financial stress. Similarly, the data provided strong evidence ( P <.001) that a smoker who quits is likely to experience an enhanced level of material well-being. Conclusions. Our findings indicate that interventions to encourage smoking cessation are likely to improve standards of living and reduce deprivation. The findings provide grounds for encouraging the social services sector to incorporate smoking cessation efforts into their programs to enhance the material or financial conditions of disadvantaged groups. The findings also provide additional incentives for smokers to stop smoking and as such can be used in antismoking campaigns and by smoking cessation services. Tobacco smoking in Australia is estimated to kill over 19000 people each year and is responsible for about 10% of the entire national burden of disease and injury. 1 The social costs of smoking (e.g., loss of national productive capacity and health care cost) were estimated to be over Aus $21 billion (about US $18.6 billion) during 1998 to 1999. 2 Smoking has also been linked to deteriorated standards of living and financial stress in Australia and elsewhere. 3 – 6 Although many studies have shown the health benefits of smoking cessation, even for people 65 years or older, 7 – 9 there are no published prospective reports of the financial consequences of cessation. Several studies, however, have focused on the consequences of financial stress and hardship in terms of smoking behavior. Graham used cross-sectional and qualitative data from a sample of working class mothers in the United Kingdom and reported that the major reason for relapse after cessation was difficulty coping with everyday problems and stress, including financial stress. 10 She concluded that restricted access to material resources (income, employment, adequate housing, and the items needed to maintain a reasonable standard of living) hinders smoking cessation. Dorsett and Marsh used longitudinal data from a sample of single mothers in the United Kingdom and reported that smoking provides an affordable palliative for stress and that financial hardship was the main barrier to cessation. Hardship was referred to as the experience of financial anxiety, being in debt that cannot be paid off easily, and not being able to afford essential consumer items such as food and clothing. 11 Similarly, Siah-push and Carlin used national data from 2 waves of a longitudinal study in Australia and reported that smokers who had more financial stress (e.g., difficulty paying electricity, gas, or telephone bills; going without meals because of a shortage of money) were less likely to quit and that ex-smokers who had more financial stress were more likely to relapse than those without stress. 5 We used 4 waves of prospective data from a national sample in Australia to examine the longitudinal effect of smoking cessation on the likelihood of financial stress and levels of material well-being.
