Statut d’immigrant et tabagisme dans l’étude des inégalités sociales de santé chez les jeunes adultes à Montréal
It is well-established that disadvantaged individuals have poorer health (Marmot, 2005). Smoking behaviors are a major contributor to poor health and eradication of smoking is a cornerstone of strategies to combat inequalities (Marmot 2010). As in other age groups, young adults are subject to social inequalities which can vary according to a variety of characteristics including immigrant status. However, little is known about socioeconomic variation in smoking among young adults and whether or how this varies across subgroups such as immigrants. In this current analysis, we aimed to better understand if level of education interacts with immigrant status to influence smoking behaviors in young adults. We used baseline data from the Interdisciplinary Study of Inequalities in Smoking (ISIS), a transversal investigation of young adults that aimed to study social inequalities in smoking. The sample size for the current analysis was 2,093 young adults (age 21,47 (2,28) years; 56,5% female; 18,80% immigrants). In logistic regression models, we estimated the associations: (i) between immigrant status and smoking status; and (ii) between level of education and smoking status. We then determined whether an interaction term between immigrant status and level of education was statistically significant in the model. The analyses revealed that the interaction term was statistically significant and we therefore undertook a stratified analysis to estimate the association of interest in immigrants and nonimmigrants separately. In non-immigrants, we observed a “dose-response” association such that the prevalence of smoking increased as the level of education decreased. In immigrants, the risk of smoking was similar across education levels. Hence the importance for public health authorities of taking into account the concepts of socio-economic status and immigrant status in defining strategies for tobacco control.
immigrant status socioeconomic status smoking young adults