title: Smoking and (Not) Voting: The Negative Relationship Between a Health-Risk Behavior and Political Participation in Colorado.
abstract: BACKGROUND
  Considerable evidence suggests that cigarette smokers are an increasingly marginalized population, involved in fewer organizations and activities and with less interpersonal trust than their nonsmoking counterparts. However, only two previous studies, both among Swedish populations, have investigated smokers' attitudes toward political systems and institutions. The current, cross-sectional study examines smoking in relation to voting, a direct behavioral measure of civic and political engagement that at least partly reflects trust in formal political institutions.
  
  
  METHODS
  Secondary analyses were conducted of interview data from 11 626 respondents in the Colorado Tobacco Attitudes and Behaviors Survey. Data were collected via telephone between October 2005 and mid-April 2006 and included respondents' reported voting behavior in the 2004 national election; the participation rate was 89.7%. Balanced multiple logistic regression was used to examine associations between smoking and voting while controlling for other covariates known to be associated with both variables.
  
  
  RESULTS
  In the final model, daily smokers were less than half as likely as nonsmokers to report having voted in the election.
  
  
  CONCLUSIONS
  The results suggest possible consonance with previous work linking smoking with political mistrust. Possible causal mechanisms are discussed. This study is the first to link a health-risk behavior with electoral participation, and provides initial evidence that smoking is negatively associated with political participation. Future research should investigate how public health might enhance tobacco control efforts by taking nonvoting behavior into consideration, or creatively combining smoking cessation interventions with voter registration and other civic engagement work, particularly among socioeconomically disadvantaged populations.
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO; Colorado Health Outcomes Program, University of Colorado School of Medicine, Aurora, CO; Karen.Albright@ucdenver.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Albright
authors.affiliation: Community Properties of Ohio (CPO) Management Services, Columbus, OH;
authors.forename: Nancy
authors.initials: N
authors.lastname: Hood
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO;
authors.forename: Ming
authors.initials: M
authors.lastname: Ma
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO; University of Colorado Cancer Center, Division of Cancer Prevention and Control, Aurora, CO.
authors.forename: Arnold H
authors.initials: AH
authors.lastname: Levinson
mesh_terms: D000328:Adult; D003120:Colorado / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011057:Politics; D011634:Public Health / Q000639:trends; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires