title: Factors Associated With Concurrent Tobacco Smoking and Heavy Alcohol Consumption Within a Socioeconomically Disadvantaged Australian Sample.
abstract: BACKGROUND
  Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users.
  
  
  OBJECTIVE
  This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers.
  
  
  METHODS
  A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out.
  
  
  RESULTS
  The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers.
  
  
  CONCLUSIONS
  Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.
authors.affiliation: a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Twyman
authors.affiliation: a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.
authors.forename: Billie
authors.initials: B
authors.lastname: Bonevski
authors.affiliation: a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.|b Hunter Medical Research Institute , Newcastle , Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Paul
authors.affiliation: c Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute , Newcastle , Australia.
authors.forename: Jamie
authors.initials: J
authors.lastname: Bryant
authors.affiliation: d Department of Epidemiology and Public Health , University College London , London , United Kingdom.
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.affiliation: e Department of Health Promotion, Social and Behavioral Health , University of Nebraska Medical Center , Omaha , Nebraska , USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Siahpush
authors.affiliation: f National Centre for Epidemiology and Population Health, Australian National University , Canberra , Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: D'Este
authors.affiliation: a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.|b Hunter Medical Research Institute , Newcastle , Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Oldmeadow
authors.affiliation: b Hunter Medical Research Institute , Newcastle , Australia.
authors.forename: Kerrin
authors.initials: K
authors.lastname: Palazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Alcohol; concurrent use; disadvantage; heavy drinking; smoking; tobacco use