Search

Aims: To better understand the longstanding inequalities concerning alcohol and tobacco use, we aimed to quantify the effect of household economic security on alcohol and tobacco consumption and expenditure. Design Longitudinal analysis using data from the Household, Income and Labour Dynamics in Australia survey (2001–2018). Setting: Australia Participants: A nationally representative cohort of 24 134 adults aged 25–64 years (187 378 observations). Measurements Tobacco and alcohol use (Yes/No), frequency of use of each per week, household expenditure on each per week, household weekly income (Consumer Price Index [CPI]‐adjusted), employment security (based on conditions of employment) and housing affordability (housing costs relative to household income). Findings At baseline, one‐quarter of the sample used tobacco and 87% used alcohol. Annual increases in household income were associated with the increased use of both tobacco and alcohol for people in households in the lowest 40% of the national income distribution (OR = 1.13, 95% CI = 1.03–1.23 and OR = 1.12, 95% CI = 1.04–1.20, respectively) with no similar income effect observed for higher‐income households. In relation to smoking, the odds of a resident's tobacco use increased when their household was unemployed (OR = 1.32, 95% CI = 1.07–1.62). In relation to alcohol, the odds of use decreased when households were insecurely employed or unemployed, or housing costs were unaffordable (OR = 0.87, 95% CI = 0.77–0.98, OR = 0.66, 95% CI = 0.55–0.80 and OR = 0.84, 95% CI = 0.75–0.93, respectively). This was also reflected in the reduced odds of risky drinking (defined in accordance with Australian guidelines) when housing became unaffordable or households became unemployed (OR = 0.90, 95% CI = 0.81–0.99; OR = 0.82, 95% CI = 0.69–0.98, respectively). Conclusions: In Australia, smoking and drinking appear to exhibit different socio‐behavioural characteristics and household unemployment appears to be a strong determinant of smoking. [ABSTRACT FROM AUTHOR]

Humanitarian migrants face a range of challenges during the resettlement process. Foremost among these is finding affordable, secure and suitable housing. Applying a liminality lens, we use two longitudinal surveys, one specific to humanitarian migrants (Building a New Life in Australia [BNLA]) and one representative of the Australian population (Household, Income and Labour Dynamics in Australia [HILDA]), to examine the effect of precarious housing on humanitarian migrants' mental health; and compare this to the greater Australian population using fixed effects regression models. Such an approach controls for participants' previous experiences and isolates, as much as possible, the causal effect of precarious housing on mental health. Modelling of 21,462 HILDA and 2399 BLNA respondents over five years revealed a negative mental health effect attributed to unaffordable and unsuitable housing for both humanitarian migrants and the Australian population, with humanitarian migrants at greater risk of poor mental health due to unsuitable housing. Humanitarian migrants were 60 % more likely to suffer from worse mental health when they experience unaffordable housing compared to their counterparts in affordable housing, with a 2.4-fold increased risk those in unsuitable housing. Such findings suggest housing precarity can extend the process of liminality for humanitarian migrants, and future policies should facilitate greater access to affordable housing. • Humanitarian migrants struggle to find affordable, secure and suitable housing. • The effect of precarious housing on humanitarian migrants' mental health is examined. • Unaffordable and unsuitable housing impacts mental health across the population. • Humanitarian migrants face poorer mental health due to unsuitable housing. • Future policies should facilitate greater access to affordable housing. [ABSTRACT FROM AUTHOR]

Background Cigarette smoking leads to significant morbidity and pre-mature mortality. We examined the relationship between housing tenure at ages 15, 16, 17 and 18 and smoking five years later using data from a well-established cohort study. Methods We analysed the data on 15-18-year-old adolescents (n = 2305) from the Household Income and Labour Dynamics in Australia (HILDA) survey. We applied augmented inverse probability treatment weights to maximise exchangeability between those in social housing and homeowners, and private renters. By estimating potential outcomes for the exposed and unexposed, we compared risk of smoking five years later on both absolute and relative scale. Baseline covariates included household income, age at study entry, sex, family type, smoking at baseline and highest household education. Results Adolescents in social housing had an increased risk of current smoking five years later (average treatment effect (ATE): 0.24, 95% CI: 0.02, 0.47) than homeowners. On the relative scale those in social housing had 2.23 times (95% CI: 1.08, 3.39) higher risk of being a smoker than homeowners. Those in social housing also had an increased risk of being a smoker (ATE: 0.14, 95%CI: 0.04, 0.25) than private renters. On the relative scale we estimated that those in social housing had 1.46 times (95% CI: 1.09, 1.83) higher risk of smoking than private renters. Conclusions Adolescents in social housing have a higher risk of smoking than those living in owned or private rented homes. Key messages Tobacco control efforts must target adolescent in social housing for reducing inequalities in cigarette smoking. [ABSTRACT FROM AUTHOR]