Social capital, institutional (vertical) trust and smoking: a study of daily smoking and smoking cessation among ever smokers.
OBJECTIVE
The associations between vertical (institutional) trust in the healthcare system and the mass media (newspapers and television), and daily smoking and smoking cessation were investigated.


METHODS
The 2004 public-health survey in Scania is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between institutional trust in the healthcare system and the mass media, and daily smoking and smoking cessation. A multivariate analysis was performed to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people) on the differences in daily smoking and smoking cessation according to trust in the healthcare system and the mass media.


RESULTS
14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than the young. Respondents with low trust in the healthcare system had significantly higher odds ratios of daily smoking, 1.88 (95% CI 1.38-2.57) among men and 2.05 (95% CI 1.51-2.78) among women, while respondents with low trust in the mass media had no significant odds ratios of daily smoking, 1.01 (0.67-1.52) among men and 1.55 (0.97-2.47) among women, after multiple adjustments.


CONCLUSIONS
Institutional (vertical) trust in the healthcare system but not the mass media was significantly associated with lower odds of daily smoking and higher odds of having quit smoking if ever smoker. The healthcare system seems to be a potent arena for tobacco prevention.
Lindström
Martin
M
Department of Clinical Sciences, Malmö University Hospital, Sweden. martin.lindstrom@smi.mas.lu.se
Janzon
Ellis
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009524:Newspapers as Topic; D012907:Smoking / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D016540:Smoking Cessation / Q000208:ethnology / Q000523:psychology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology / Q000208:ethnology; D013690:Television; D035502:Trust