Smoking status and social and health-related characteristics among Ohio Appalachian women

Background: Smoking is a factor in cervical cancer etiology. Not much is known about smoking patterns in Appalachian women who are at increased risk for this cancer. This investigation reports associations between social and health-related characteristics and tobacco use among Appalachian women.

Methods: A random sample (n=570) from a listing of women from 14 Appalachian Ohio clinics completed a survey on sociodemographics, health-related information, and self-reported smoking status. Eligibility included age 18+, not pregnant, no history of cervical cancer or hysterectomy, resident of Appalachia, and a clinic visit in past two years.

Results: Women were categorized as never (52%), former (20.5%), or current (27.5%) smokers. A multinomial logistic regression model was fit to the data, with former and current smokers compared to never smokers. The final adjusted model indicated that women with low socioeconomic position (SEP) during childhood and at present were more likely to be former smokers (OR=3.16; CI 1.56,6.43) and current smokers (OR=5.32; CI 2.61,10.82) as compared to never smokers. Women with high SEP during childhood but low SEP at present were more likely to smoke (OR=2.69; CI 1.26, 5.71) compared to never smokers. Other factors significantly associated with current smoking included age ≥ 51 (OR=0.41; CI 0.20,0.85), depression (OR=1.91;CI 1.18, 3.10), first pregnancy < 20 years (OR=1.95; CI 1.21, 3.14), and alcohol use (< one drink/week OR=2.61;CI 1.59,4.29 and > 1 drink/week OR=3.36; CI 1.46,7.74).

Implications: Social factors, depression, and alcohol use are associated with past or current smoking and should be considered when planning future interventions.