Gender differences in correlates of smoking among unionized construction workers in California

Background and Objective. Smoking prevalence remains elevated among blue-collar compared to white-collar workers, and construction workers have the highest rate (39%) among blue-collar occupational groups. The study's objective is to identify gender differences in smoking correlates among this traditionally male-dominated occupation so as to better guide smoking prevention and cessation programs to this population. Methods. In cooperation with a large union representing construction workers in Northern California, confidential data were obtained via telephone interview from workers (n=1088; 10% female) who voluntarily participated in a cross-sectional occupational health survey (response rate 53%). A series of gender-specific multivariate logistic regression models were developed to test the association of occupational, demographic, psychosocial, and other substance use correlates to current (past-30 day) smoking. Results. Smoking prevalence (29.8%) didn't differ by gender (chi square = 0.027, 1 df; p=0.87). Among males, being unemployed (OR=1.41; 95% CI=1.02, 1.96), experiencing perceived workplace racial/ethnic discrimination (OR=1.02; 95% CI 1.00, 1.05), not having completed high school (OR=4.06; 95% CI 1.85, 8.91), impulsivity (OR=1.45; 95% CI 1.21, 1.73), and hazardous drinking (OR=1.08; 95% CI 1.05, 1.11) were positively associated with likelihood of being a smoker; increasing age (OR=0.98; 95% CI 0.97, 0.99) and Hispanic ethnicity (OR=0.33; 95% CI 0.21, 0.52) were protective. Among females, only adverse childhood experiences (e.g., childhood maltreatment) was significantly associated with likelihood of being a smoker (OR=1.41; 95% CI 1.03, 1.92). Conclusion. Despite having the same prevalence, striking gender differences are seen in correlates of smoking among this sample of unionized construction workers, warranting further investigation.