title: Which group of smokers is more vulnerable to the economic crisis?
abstract: OBJECTIVE
  Studies investigating whether smoking increases or decreases during economic downturn provided contrasting results. For the first time, we used direct questions to analyse changes in smoking behaviour due to the 2008 financial crisis, comparing socio-economic characteristics of smokers who changed with those who kept their smoking intensity.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  We used data from three annual surveys conducted in Italy in 2012-2014 on representative samples of the Italian general population aged ≥15 years.
  
  
  RESULTS
  A total of 1919 current smokers were asked specific questions on the influence of the economic crisis that started in 2008 on their smoking behaviour. Overall, 77.4% of 1919 current smokers reported not to have changed their smoking behaviour, 19.1% to have reduced, and 3.5% to have increased their smoking intensity as a consequence of the economic crisis. The reduction in cigarette smoking increased with age: compared to the respondents aged <25 years, the multivariate odds ratio (OR) for those aged 25-44, 45-64 and ≥65 years were 0.65, 0.46 and 0.33, respectively (P for trend<0.001). Reduction was significantly lower among intermediate (OR = 0.68 compared to low) and high education levels (OR = 0.28; P for trend<0.001). A significant inverse trend for increasing consumption was observed with age (P = 0.022), education (P = 0.003) and family income (P < 0.001).
  
  
  CONCLUSIONS
  The large majority of current smokers did not change their smoking habit following the economic crisis. However, there are specific vulnerable subgroups of smokers, constituted by the young and subjects with low socio-economic status, that were reactive to the global economic crisis. These groups are more prone to change their smoking behaviours, either for better or -, in a smaller proportion -, for worse.
authors.affiliation: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. Electronic address: silvano.gallus@marionegri.it.
authors.forename: S
authors.initials: S
authors.lastname: Gallus
authors.affiliation: Department of Sciences for the Health Promotion and Mother and Child Care "G. D'Alessandro", Hygiene Section, University of Palermo, Palermo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Asciutto
authors.affiliation: Wittgenstein Centre for Demography and Global Human Capital (IIASA, VID/ÖAW, WU), Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Muttarak
authors.affiliation: Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pacifici
authors.affiliation: Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Department of Epidemiology, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Lugo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D057172:Economic Recession; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Economic crisis; Smoking consumption; Tobacco smoking; Unemployed; Vulnerable population