Sex-stratified and age-adjusted social gradients in tobacco in Argentina and Uruguay: Evidence from the Global Adult Tobacco Survey (GATS)

Objective:To compare social gradients in tobacco use in Argentina and Uruguay, countries with different records on tobacco control policy.

Methods: Secondary analysis of Global Adult Tobacco Survey data from Argentina (N = 6,645) and Uruguay (N = 5,581).  Social gradients in current tobacco use, exposure to second-hand smoke, and cessation attempt were examined with sex-stratified and age-adjusted logistic regression.

Results: Among males, there is evidence of higher odds of being a current smoker among respondents with lower levels of education, but the effect is only significant for respondents with less than primary education in Uruguay (OR = 2.15, 95% CI = 1.22 – 3.77).  Similarly, women with lower levels of education have higher odds of being a current smoker in Uruguay.  The effect of education on exposure to second-hand smoke is broadly similar for both sexes in both countries, with generally higher odds among groups with low education, though the effect is only significant among males in Uruguay (OR = 1.77, 95% CI = 1.08 – 2.92).  In both countries, respondents with lower levels of education in general have higher odds of having attempted to quit smoking in the past year, although these effects did not attain significance.

Conclusions: Social gradients in tobacco use, exposure to second-hand smoke, and cessation attempts are broadly similar in both countries. Efforts to evaluate the long-term effects of tobacco control efforts in these countries should monitor how policies affect not only national averages, but also the social gradients that are embedded in aggregate data.