title: Household and area income levels are associated with smoking status in the Korean adult population.
abstract: BACKGROUND
  Some previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults.
  
  
  METHODS
  This study was based on the Korean Community Health Survey (KCHS) performed in South Korea, between September and November 2009. In total, 222,242 subjects (103,124 men and 119,118 women) were included in the analysis. Information on smoking status was collected using a standardized questionnaire. Income status was determined by monthly household income. Household income was categorized as: <1 million won; <2 million won; <3 million won; and ≥3 million won. Area-level income categorized as quartiles. Data were analyzed using multilevel regression models. The analysis was conducted separately urban and rural, by sex.
  
  
  RESULTS
  The lowest household income group had a higher risk of smoking than the highest household income group in both urban and rural areas for both men and women after adjusting for individual characteristics (urban men: odds ration [OR], 1.44; 95% confidence interval [CI], 1.36-1.53; rural men: OR, 1.33; 95% CI, 1.25-1.42; urban women: OR, 2.38; 95% CI, 2.06-2.76; rural women: OR, 1.51; 95% CI, 1.25-1.83). In men, the lowest area-level income group had a higher risk for smoking than the highest area-level income group in urban areas after adjusting for individual characteristics and household income (OR, 1.17; 95% CI, 1.02-1.33). In women, the lowest area-level income group had a lower risk for smoking than the highest area-level income group in rural areas after adjusting for individual characteristics and household income (OR, 0.52; 95% CI, 0.39-0.70). However, no association was observed between area-level income and smoking in rural areas for men or in urban areas for women.
  
  
  CONCLUSIONS
  The results showed that smoking is strongly associated with household income status in both men and women, and area-level income is partly associated with smoking. Effects of area-level income on smoking differed by sex and region. These findings suggest that area characteristics have contextual effects on health related behavior independent of individual characteristics.
authors: Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea. wjyun77@hanmail.net.
authors: Woo-Jun
authors: WJ
authors: Yun
authors: Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea. jarhee@healthis.org.
authors: Jung-Ae
authors: JA
authors: Rhee
authors: Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea. bbunisuna@hanmail.net.
authors: Sun A
authors: SA
authors: Kim
authors: Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea. ujingogo@paran.com.|Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Jeollanamdo, 519-809, Republic of Korea. ujingogo@paran.com.
authors: Sun-Seog
authors: SS
authors: Kweon
authors: Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, 570-711, Republic of Korea. lyh8275@hanmail.net.
authors: Young-Hoon
authors: YH
authors: Lee
authors: Department of Preventive Medicine, Chosun University Medical School, Gwangju, 501-759, Republic of Korea. canrsy@chosun.ac.kr.
authors: So-Yeon
authors: SY
authors: Ryu
authors: Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu, 705-718, Republic of Korea. parksw@cu.ac.kr.
authors: Soon-Woo
authors: SW
authors: Park
authors: Department of Social Medicine, Hallym University College of Medicine, Chuncheon, 200-702, Republic of Korea. dhkims@hallym.ac.kr.
authors: Dong Hyun
authors: DH
authors: Kim
authors: Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju, 501-746, Republic of Korea. mhshinx@paran.com.|Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, 501-809, Republic of Korea. mhshinx@paran.com.
authors: Min-Ho
authors: MH
authors: Shin
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors
references: Eur J Cardiovasc Prev Rehabil. 2003 Aug;10(4):289-95
references: 14555885
references: J Epidemiol Community Health. 2006 Jan;60(1):7-12
references: 16361448
references: Heart. 2001 Sep;86(3):277-83
references: 11514478
references: Prev Med. 2003 Feb;36(2):177-84
references: 12590993
references: Health Place. 2001 Dec;7(4):333-43
references: 11682332
references: Soc Sci Med. 1997 Mar;44(6):901-10
references: 9080570
references: Int J Epidemiol. 1999 Oct;28(5):841-5
references: 10597980
references: J Epidemiol Community Health. 1995 Dec;49 Suppl 2:S72-7
references: 8594138
references: JAMA. 2003 Aug 20;290(7):898-904
references: 12928466
references: Addiction. 2011 Apr;106(4):844-51
references: 21205048
references: Health Place. 1998 Mar;4(1):91-4
references: 10671014
references: Fam Pract. 2003 Aug;20(4):393-400
references: 12876109
references: Soc Sci Med. 1999 Feb;48(4):497-505
references: 10075175
references: Health Serv Res. 2005 Aug;40(4):1108-27
references: 16033495
references: J Epidemiol Community Health. 2003 Sep;57(9):711-7
references: 12933778
references: J Epidemiol Community Health. 2003 Oct;57(10):802-8
references: 14573586
references: Prev Med. 1997 Sep-Oct;26(5 Pt 1):754-66
references: 9327486
references: Scand J Public Health. 2001 Mar;29(1):32-9
references: 11355714
references: Science. 1989 Mar 17;243(4897):1441-5
references: 17839748
references: Eur J Public Health. 2005 Jun;15(3):262-9
references: 15755781
references: Soc Sci Med. 2000 Jul;51(2):265-74
references: 10832573
references: J Epidemiol Community Health. 1998 Jun;52(6):399-405
references: 9764262
references: Int J Epidemiol. 1998 Feb;27(1):33-40
references: 9563691
references: J Prev Med Public Health. 2007 Nov;40(6):475-86
references: 18063903
references: Am J Epidemiol. 2003 Feb 15;157(4):315-26
references: 12578802
references: Tob Control. 2003 Mar;12(1):60-6
references: 12612364
references: Public Health Rep. 1993 May-Jun;108(3):387-94
references: 8497578
references: Am J Public Health. 1992 Jun;82(6):816-20
references: 1585961
references: J Prev Med Public Health. 2006 Jan;39(1):30-8
references: 16613069
references: J Epidemiol Community Health. 2006 Jun;60(6):490-5
references: 16698978
references: J Epidemiol Community Health. 2006 Aug;60(8):699-705
references: 16840760
references: BMJ. 2000 Apr 22;320(7242):1102-7
references: 10775217
references: Soc Sci Med. 1991;32(9):989-1005
references: 2047903
references: Prev Med. 2001 Mar;32(3):218-23
references: 11277678
references: J Environ Public Health. 2012;2012:918368
references: 22649464
references: Addict Behav. 1990;15(3):221-33
references: 2378282
references: Health Serv Res. 2003 Dec;38(6 Pt 2):1863-83
references: 14727801
references: BMJ. 1994 Oct 8;309(6959):923-7
references: 7950662
references: Tob Control. 2010 Oct;19(5):383-90
references: 20675689
references: Ann N Y Acad Sci. 2012 Feb;1248:107-23
references: 22092035