title: Factors associated with self-assessed increase in tobacco consumption among over-indebted individuals in Germany: a cross-sectional study.
abstract: BACKGROUND
  Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. Nonetheless, few studies have explored smoking among over-indebted individuals.
  
  
  METHODS
  A cross-sectional survey (n=949) on retrospectively assessed changes in tobacco consumption was carried out in 2006 and 2007 among clients of 84 officially approved debt and insolvency counselling centres in Germany (response rate 39.7%). Logistic regressions were performed to explore factors associated with reports of increased smoking after onset of over-indebtedness.
  
  
  RESULTS
  63% of all respondents stated daily or occasional tobacco consumption. Almost one fifth reported an increase in smoking after becoming over-indebted. Females were less likely to report increased smoking than men (aOR 0.66, 95% CI 0.44-0.99) whereas respondents who had been over-indebted for more than 10 years were more likely to report increased smoking than those who had been over-indebted for less than five years (aOR 1.66; 95%-CI 1.00-2.76). The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14).
  
  
  CONCLUSIONS
  The study identifies over-indebted individuals and particularly over-indebted men as a high-risk group of smokers. Low levels of social embeddedness/support were associated with a further increase in smoking after becoming over-indebted. Given recent increases of over-indebtedness, the findings highlight the need to develop appropriate public health policies.
authors.forename: Heiko
authors.initials: H
authors.lastname: Rueger
authors.forename: Heide
authors.initials: H
authors.lastname: Weishaar
authors.forename: Elke B
authors.initials: EB
authors.lastname: Ochsmann
authors.forename: Stephan
authors.initials: S
authors.lastname: Letzel
authors.forename: Eva
authors.initials: E
authors.lastname: Muenster
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012959:Socioeconomic Factors; D013997:Time Factors; D064424:Tobacco Use / Q000191:economics* / Q000453:epidemiology*; D055815:Young Adult