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RESEARCH PRODUCT

Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas

Evangelos EvangelouEvangelos EvangelouAndré F. CarvalhoPing-tao TsengCristiano A. KöhlerDavy VancampfortAi KoyanagiAi KoyanagiBrendon StubbsMarco SolmiA. Mathew PrinaPao-yen LinPao-yen LinNicola Veronese

subject

GerontologyAdultMalemedicine.medical_specialtyMultivariate analysisAsiaCross-sectional studySciencemedicine.medical_treatmentDeveloping countryPerceived Stress ScaleLogistic regressionArticle03 medical and health sciences0302 clinical medicineMIDDLE-INCOME COUNTRIESmedicineHumansTOBACCO SMOKING030212 general & internal medicineProspective cohort studyDeveloping CountriesPovertyAgedHEALTH SURVEYSMultidisciplinarybusiness.industryPublic healthQRMiddle AgedEuropeCross-Sectional StudiesLogistic ModelsAfricaMultivariate AnalysisIncomeMedicineSmoking cessationFemalePerceptionSmoking CessationCIGARETTE-SMOKINGAmericasbusiness030217 neurology & neurosurgeryStress PsychologicalDemography

description

Within recent years, there has been a seismic shift in smoking rates from high-income to low- and middle-income countries (LMICs). Evidence indicates that perceived stress may comprise a barrier for smoking cessation, but little is known about the association of perceived stress and smoking in LMICs. We conducted a cross-sectional, community-based study comprising 217,561 people [mean age 38.5 (SD = 16.1) years, 49.4% males]. A perceived stress score [range 2 (lowest-stress) 10 (highest-stress)] was computed from the Perceived Stress Scale. Multivariable logistic regression analyses were conducted. In the overall sample, a one-unit increase in perceived-stress resulted in a 5% increased odds of smoking (OR = 1.05; 95%CI = 1.03-1.06). Increased stress was associated with smoking in Africa (OR = 1.06; 95%CI = 1.04-1.09), Americas (OR = 1.03; 95%CI = 1.01-1.05), and Asia (OR = 1.06; 95%CI = 1.04-1.08), but not Europe (OR = 0.99; 95%CI = 0.95-1.02). Increasing levels of perceived stress were significantly associated with heavy smoking (≥30 cigarettes per day) among daily smokers (OR = 1.08; 95%CI = 1.02-1.15). A country-wide meta-analysis showed that perceived stress is associated with daily smoking in most countries. Prospective studies are warranted to confirm/refute this relationship, which may have meaningful public health implications. ispartof: Scientific Reports vol:7 issue:1 pages:7597- ispartof: location:England status: published

10.1038/s41598-017-07579-whttp://hdl.handle.net/10447/460243