Background
The marginalisation of smokers
Research hypothesis
Methods
Data
Ethical clearance process
Measures
-
Occupational position was assessed by asking about the person’s employment status, where the response alternatives “unemployed”, “on social benefit” and “married and unemployed” (the latter suggesting economic dependence on the spouse) were combined to represent problematic status. This measure was designated not in work [31].
-
Type of housing and house ownership was assessed by combining information about accommodation type (house, flat, bedsit) and whether the respondent rented or owned the property. In Norway, in contrast to many other countries, it is common for people to be homeowners [32]. Renting a flat or bedsit was therefore defined as the problematic outcome [33].
-
Personal economic situation was assessed by asking “What is the current financial situation of your household?” with the response categories “income is not adequate” and “we/I need to use our/my savings to manage” combined to constitute the outcome perceived poor economy. This measure is often applied in research on poverty and well-being [34].
-
Respondents with elementary school only (maximum 9 years) were defined as having brief/minimal education – i.e. a problem status [33].
-
A combination of non-membership of seven named associations/organisations and meeting friends less than weekly were combined to represent small social network [35].
-
Drinking alcohol often (defined by the respondents by answering the question “How often do you drink alcohol?” with response categories “often”, “now and then”, “seldom”, “never”) was used as the outcome for potentially problematic drinking [40]. This measure is part of the Alcohol Use Disorder Identification Test - AUDIT. (No other items from AUDIT were included in the questionnaire).
-
Never exercising (registered by the question “How often would you say you exercise, i.e. are physically active?” with eight response categories ranging from “never” to “at least once a day”) were used as the outcome for low physical activity [41].
-
Self-rated health was recorded by asking the respondents to grade their health as “very good”, “good”, “moderate”, “poor”, or “very poor”. This is an established indicator to assess subjective health (SHR-5) [42]. The last two response alternatives were defined as indicators of poor self-rated health [43].
Statistical analysis
1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | |
---|---|---|---|---|---|---|---|---|---|---|
1. Not working | 0.03** | 0.05** | 0.13** | 0.10** | 0.25** | 0.05* | −0.01 | −0.04** | 0.08** | |
2. Renting home | −0.02* | −0.07** | 0.13** | −0.06** | 0.00 | 0.07** | 0.06** | 0.06** | 0.00 | |
3. Small social network | 0.06** | −0.07** | 0.02* | 0.02* | 0.06** | 0.02** | −0.05** | −0.02* | 0.10** | |
4. Poor economy | 0.12** | 0.11** | 0.00 | 0.01 | 0.09** | 0.06** | 0.05** | 0.01 | 0.04** | |
5. Elementary school only | 0.10** | −0.04** | 0.01 | 0.03** | 0.05** | 0.05** | 0.03** | −0.09** | 0.07** | |
6. Poor self-rated health | 0.28** | 0.01 | 0.05** | 0.10** | 0.05** | 0.04** | 0.00 | 0.00 | 0.11** | |
7. Low fruit and vegetable intake | 0.03** | 0.07** | 0.02** | 0.07** | 0.04** | 0.03** | 0.08** | 0.02** | 0.11** | |
8. High fast food intake | −0.01 | 0.04** | −0.03** | 0.06** | 0.04** | 0.02** | 0.07** | 0.04** | 0.05** | |
9. Drinking alcohol often | −0.05** | 0.03** | −0.01 | −0.01 | −0.10** | −0.03** | −0.01 | 0.00 | −0.01 | |
10. No exercise | 0.07** | 0.01 | 0.09** | 0.05** | 0.12** | 0.10** | 0.08** | 0.04** | −0.03** |
Results
Variable | Categories | 1999 | 2013 | ||
---|---|---|---|---|---|
Men (n = 1717a) | Women (n = 1779a) | Men (n = 2061a) | Women (n = 2063a) | ||
Job position | Unskilled manual worker | 7.9 | 7.8 | 6.2 | 5.0 |
Skilled manual worker | 16.7 | 11.7 | 17.3 | 17.0 | |
Chief executive | 4.7 | 2.9 | 5.3 | 3.0 | |
Skilled, non-manual, leader | 14.4 | 6.1 | 13.5 | 7.3 | |
Middle manager | 8.9 | 12.5 | 9.9 | 12.9 | |
Manager owner | 6.9 | 3.4 | 7.3 | 3.9 | |
Student/apprentice | 10.8 | 11.2 | 12.2 | 12.1 | |
Unemployed
b
|
1.0
|
1.1
|
1.3
|
1.4
| |
Retirement pensioner | 14.3 | 17.7 | 14.3 | 16.0 | |
Benefit recipient
|
5.1
|
9.4
|
3.8
|
6.3
| |
Married and not employed
|
0.3
|
1.7
|
0.4
|
1.1
| |
Other | 9.2 | 14.5 | 8.4 | 13.9 | |
Type of housing and ownership | Own a house, single unit | 56.0 | 54.2 | 57.9 | 56.2 |
Own a 2–4 family house or row house | 14.2 | 14.8 | 15.0 | 13.5 | |
Own a flat or bedsit | 11.2 | 12.2 | 12.6 | 15.3 | |
Own other type of home | 1.6 | 2.4 | 1.0 | 1.3 | |
Rent a house, single unit | 5.2 | 5.4 | 2.9 | 3.4 | |
Rent a 2–4 family house or row house | 4.1 | 3.9 | 2.7 | 1.5 | |
Rent a flat or bedsit
|
5.5
|
5.1
|
6.7
|
7.2
| |
Rent other type of home
|
2.2
|
2.1
|
1.1
|
1.7
| |
Social network |
No membership, never meeting friends
|
2.6
|
2.4
|
3.1
|
1.8
|
No membership, meeting friends less than weekly
|
19.3
|
22.8
|
20.3
|
22.2
| |
No membership, meeting friends at least weekly | 23.9 | 31.3 | 22.0 | 25.2 | |
1 membership, never meeting friends | 2.2 | 1.0 | 1.8 | 1.0 | |
1 membership, meeting friends less than weekly | 13.7 | 11.6 | 16.6 | 13.4 | |
1 membership, meeting friends at least weekly | 23.5 | 19.5 | 18.1 | 18.9 | |
2 memberships or more, never meeting friends | 0.5 | 0.1 | 0.4 | 0.3 | |
2 memberships or more, meeting friends less than weekly | 6.4 | 4.1 | 8.2 | 8.0 | |
2 memberships or more, meeting friends at least weekly | 7.9 | 7.2 | 9.5 | 9.2 | |
Personal economic situation |
My/our income is not adequate
|
4.9
|
7.2
|
3.5
|
3.1
|
I/we need to use my/our savings
|
4.2
|
7.6
|
3.7
|
5.4
| |
I/we just manage | 37.5 | 42.4 | 25.4 | 27.0 | |
I/we manage and can save some money | 45.0 | 37.9 | 52.6 | 51.9 | |
I/we manage and can save quite a bit | 7.0 | 3.7 | 16.3 | 12.0 | |
Don’t know | 1.4 | 1.3 | 0.8 | 0.5 | |
Education |
Elementary school (7–9 years)
|
6.2
|
9.2
|
2.8
|
2.0
|
Lower secondary/comprehensive school (9–10 years) | 16.9 | 16.8 | 9.3 | 9.4 | |
Upper secondary/high school (12–13 years) | 38.9 | 39.3 | 30.7 | 28.5 | |
College/university (14+ years) | 38.0 | 34.7 | 57.3 | 60.1 | |
General, self-rated health | Very good | 20.9 | 20.9 | 27.7 | 26.0 |
Good | 46.8 | 44.5 | 45.6 | 47.0 | |
Moderate | 27.1 | 27.6 | 21.4 | 20.7 | |
Poor
|
4.7
|
6.6
|
5.0
|
5.8
| |
Very poor
|
0.5
|
0.5
|
0.2
|
0.5
| |
Fruit and vegetable intake |
Seldom/never
|
5.7
|
3.1
|
4.4
|
1.9
|
1–2 times per week
|
4.5
|
2.2
|
2.9
|
1.2
| |
3–6 times per week | 17.4 | 9.7 | 14.9 | 9.0 | |
At least daily | 72.4 | 84.9 | 77.7 | 87.9 | |
Fast food intake | Seldom/never | 5.2 | 9.6 | 2.4 | 7.1 |
Less than weekly | 76.4 | 83.6 | 86.9 | 90.0 | |
1–4 times per week
|
17.2
|
6.8
|
10.2
|
2.8
| |
5 times or more per week
|
1.2
|
0.1
|
0.4
|
0.0
| |
Drinking alcoholic drinks |
Often
|
21.1
|
10.8
|
25.9
|
19.0
|
Now and then | 49.9 | 49.7 | 48.3 | 45.0 | |
Seldom | 21.1 | 29.7 | 18.3 | 26.9 | |
Never | 7.9 | 9.8 | 7.5 | 9.1 | |
Exercising |
Never
|
13.4
|
11.7
|
6.6
|
5.9
|
Less than once each fortnight | 14.4 | 13.3 | 9.5 | 9.0 | |
Once each fortnight | 7.2 | 6.1 | 7.0 | 5.2 | |
Once a week | 16.7 | 17.4 | 14.4 | 14.5 | |
Twice a week | 19.6 | 21.9 | 22.0 | 23.7 | |
3–4 times/week | 18.2 | 18.2 | 27.0 | 26.9 | |
5–6 times/week | 6.3 | 7.0 | 8.7 | 9.9 | |
At least once daily | 4.1 | 4.3 | 4.9 | 4.9 | |
All 10 problems | 0 | 25.6 | 29.7 | 34.0 | 37.3 |
1 | 35.7 | 34.6 | 35.9 | 38.0 | |
2 | 22.6 | 21.6 | 19.9 | 16.6 | |
3 | 10.5 | 10.1 | 7.2 | 6.1 | |
4
|
4.1
|
2.8
|
1.6
|
1.7
| |
5
|
1.2
|
1.0
|
0.9
|
0.3
| |
6
|
0.2
|
0.2
|
0.4
|
0.0
| |
7
|
0.1
|
0.1
|
0.0
|
0.0
| |
8
c
|
0.0
|
0.0
|
0.0
|
0.0
|
No. of problems | 1999 | 2001 | 2003 | 2005 | 2007 | 2009 | 2011 | 2013 | All years | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Men (n) | ONS (1151) | DS (565) | ONS (1190) | DS (551) | ONS (1276) | DS (420) | ONS (1328) | DS (354) | ONS (1521) | DS (334) | ONS (1592) | DS (333) | ONS (1731) | DS (254) | ONS (1826) | DS (229) | ONS (11 615) | DS (3041) |
0 | 30.1 | 16.4 | 27.7 | 14.5 | 28.8 | 13.0 | 28.1 | 14.6 | 30.4 | 17.3 | 31.4 | 19.8 | 34.8 | 23.7 | 35.2 | 25.1 | 31.2 | 17.1 |
1 | 37.6 | 31.8 | 33.8 | 31.0 | 34.8 | 27.0 | 35.6 | 30.0 | 34.6 | 36.2 | 37.3 | 33.8 | 38.0 | 30.7 | 37.2 | 25.5 | 36.2 | 30.9 |
2 | 21.2 | 25.4 | 23.8 | 29.2 | 23.3 | 29.5 | 21.5 | 24.5 | 23.1 | 21.2 | 21.3 | 24.1 | 19.2 | 26.7 | 19.2 | 25.7 | 21.4 | 26.1 |
3 | 7.5 | 16.8 | 10.6 | 14.0 | 9.7 | 18.8 | 10.4 | 16.5 | 7.3 | 14.9 | 7.3 | 14.7 | 5.8 | 12.0 | 6.4 | 14.1 | 7.9 | 15.5 |
4 | 2.9 | 6.3 | 2.6 | 7.4 | 2.7 | 8.8 | 3.5 | 8.4 | 3.6 | 8.4 | 1.7 | 6.3 | 2.0 | 4.9 | 1.4 | 3.2 | 2.5 | 7.0 |
5 | 0.4 | 2.8 | 1.0 | 2.1 | 0.7 | 2.7 | 0.7 | 4.3 | 0.8 | 1.5 | 0.8 | 0.3 | 0.2 | 1.7 | 0.5 | 3.9 | 0.6 | 2.4 |
6 | 0.2 | 0.1 | 0.3 | 1.4 | 0.0 | 0.2 | 0.1 | 1.6 | 0.1 | 0.0 | 0.2 | 0.6 | 0.0 | 0.3 | 0.2 | 2.4 | 0.2 | 0.8 |
7 | 0.1 | 0.3 | 0.1 | 0.4 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.2 | 0.1 | 0.4 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.2 |
8a
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.3 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |
Women (n) | ONS (1228) | DS (548) | ONS (1249) | DS (559) | ONS (1301) | DS (464) | ONS (1302) | DS (438) | ONS (1479) | DS (432) | ONS (1596) | DS (358) | ONS (1697) | DS (313) | ONS (1796) | DS (261) | ONS (11 648) | DS (3374) |
0 | 31.9 | 24.5 | 30.3 | 21.3 | 28.8 | 22.1 | 34.5 | 21.3 | 36.1 | 22.0 | 38.0 | 26.4 | 40.8 | 26.6 | 38.7 | 27.9 | 35.4 | 23.6 |
1 | 35.3 | 33.0 | 38.8 | 32.0 | 38.7 | 31.2 | 36.7 | 33.5 | 35.8 | 36.6 | 36.9 | 32.1 | 35.6 | 36.6 | 38.1 | 37.4 | 37.0 | 33.7 |
2 | 21.1 | 22.5 | 18.8 | 21.7 | 21.9 | 25.6 | 19.5 | 24.3 | 19.3 | 25.3 | 17.7 | 23.0 | 17.0 | 21.5 | 16.2 | 19.7 | 1.87 | 23.1 |
3 | 9.0 | 12.5 | 9.0 | 14.1 | 7.9 | 12.3 | 7.1 | 12.2 | 6.1 | 9.5 | 5.2 | 12.2 | 5.0 | 10.8 | 5.2 | 12.4 | 6.6 | 12.1 |
4 | 2.0 | 4.6 | 2.3 | 7.1 | 2.4 | 7.1 | 1.7 | 4.8 | 1.8 | 3.9 | 1.9 | 3.5 | 1.1 | 3.2 | 1.6 | 2.1 | 1.8 | 4.9 |
5 | 0.5 | 2.2 | 0.7 | 3.2 | 0.1 | 0.7 | 0.6 | 2.4 | 0.6 | 2.1 | 0.2 | 2.8 | 0.2 | 1.0 | 0.3 | 0.5 | 0.4 | 2.0 |
6 | 0.1 | 0.4 | 0.1 | 0.3 | 0.1 | 0.8 | 0.0 | 1.3 | 0.3 | 0.1 | 0.0 | 0.0 | 0.1 | 0.4 | 0.0 | 0.0 | 0.1 | 0.4 |
7 | 0.0 | 0.3 | 0.0 | 0.4 | 0.0 | 0.1 | 0.1 | 0.1 | 0.0 | 0.4 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.2 |
8 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 |