Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study.
BACKGROUND
The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse.


METHODS
The sample comprised 6,216 people aged > or 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models.


RESULTS
Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D > or 3a re men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D > or = 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D > or = 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D > or = 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men.


CONCLUSIONS
Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures.
Baumann
Michèle
M
Ntegrative research unit on Social and Individual DEvelopment (INSIDE), University of Luxembourg, Faculty LSHASE, Luxembourg. michele.baumann@uni.lu
Spitz
Elisabeth
E
Guillemin
Francis
F
Ravaud
Jean-François
JF
Choquet
Marie
M
Falissard
Bruno
B
Chau
Nearkasen
N
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D016001:Confidence Intervals; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D011203:Poverty; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D018570:Risk Assessment; D017678:Sex Distribution; D012907:Smoking / Q000191:economics / Q000453:epidemiology*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014026:Nicotiana
D011619:Psychotropic Drugs