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Objectives: Research on the association between income and smoking cessation has examined income as a static phenomenon, either cross-sectionally or as a predictor variable in longitudinal studies. This study recognizes income as a dynamic entity and examines the relationship between a change in income and subsequent smoking behaviour. Method: Longitudinal data from the National Population Health Survey (1994/5 to 2008/9) were used to examine the impact of 1) change in income and 2) change in poverty status, on the probability of being a former or current smoker among a sample of Canadians identified as having ever smoked. Covariates include socio-demographic characteristics, number of cigarettes smoked per day, and smoking in the home. Results: Smoking behaviour was not associated with a change in household income but was associated with a change in household income that moved an individual across the poverty threshold. Canadians whose income increased to above the poverty threshold were less likely to continue smoking than someone who remained in poverty (OR=0.72, 95% CI: 0.62-0.84). Those who remained out of poverty were also less likely to continue smoking than someone who remained in poverty (OR=0.66, 95% CI: 0.57-0.75). There was no significant difference between those who remained in poverty and those whose income decreased to below the poverty level. Conclusion: This study strengthens the link between smoking and poverty and supports strategies that address income as a socio-economic determinant of health. Policies that increase household incomes above the poverty line may lead to improvements in smoking cessation rates. Key words: Income; longitudinal studies; low-income populations; poverty; smoking; smoking cessation La traduction du resume se trouve a la fin de l'article. Objectifs : Les etudes sur l'association entre le revenu et l'arret du tabac voient le revenu comme un phenomene statique, soit transversalement, soit comme une variable predictive dans des etudes longitudinales. Notre etude reconnait que le revenu est une entite dynamique et examine la relation entre un changement du revenu et l'usage subsequent du tabac. Methode : Les donnees longitudinales de l'Enquete nationale sur la sante de la population (1994-1995 a 2008-2009) ont servi a examiner l'effet : 1) d'un changement du revenu et 2) d'un changement du niveau de pauvrete sur la probabilite d'etre un ancien fumeur ou un fumeur actuel au sein d'un echantillon de Canadiens et de Canadiennes designes comme ayant deja fume. Nos covariables etaient le profil sociodemographique, le nombre de cigarettes fumees par jour et le tabagisme a la maison. Resultats : L'usage du tabac n'etait pas associe a un changement du revenu du menage, sauf lorsque ce changement faisait franchir le seuil de la pauvrete a une personne. Les Canadiens et les Canadiennes dont le revenu avait suffisamment augmente pour les hisser au-dessus du seuil de pauvrete etaient moins susceptibles de continuer a fumer que les personnes restees pauvres (RC=0,72, IC de 95 % : 0,62-0,84). Les personnes restees au-dessus du seuil de pauvrete etaient, elles aussi, moins susceptibles de continuer a fumer que celles restees pauvres (RC=0,66, IC de 95 % : 0,57-0,75). Il n'y avait pas d'ecart significatif entre les personnes restees pauvres et celles dont le revenu etait passe sous le seuil de pauvrete. Conclusion : Notre etude renforce la preuve de l'existence d'un lien entre le tabagisme et la pauvrete et appuie les strategies qui abordent le revenu en tant que determinant socioeconomique de la sante. Les politiques qui font passer le revenu des menages au-dessus du seuil de pauvrete pourraient ameliorer les taux d'arret du tabac. Mots cles : revenu; etudes longitudinales; populations a faible revenu; pauvrete; tabagisme; arret du tabac, It is well recognized that smoking is concentrated among those who are materially deprived. (1,2) A number of authors have examined the link between smoking and low income and have [...]

Objectives: Since October 2000, the nicotine patch, nicotine gum and bupropion have been reimbursed under Quebec's public drug insurance plan. The objective of this study is to describe use of these medications between October 2000 and December 2004 by smokers covered by the public plan, as well as the costs of reimbursing these medications. Methods: Data from the Regie de l'assurance maladie du Quebec were used to analyze prescriptions for smoking cessation medication issued to persons insured under the public drug insurance plan. Results: Between October 1, 2000, and December 31, 2004, more than 300,000 Quebeckers covered by the public drug insurance plan were reimbursed for smoking cessation medications. This corresponds to a yearly average of 14% of all smokers insured under the public plan. The proportion of employment assistance recipients who used these medications was higher than the proportion of seniors or "other" insurance plan participants. Nicotine patches were the treatment of choice for most users. A total of $55 million was reimbursed by the public drug insurance plan for the nicotine patch, nicotine gum and bupropion over this four-year period. Conclusion: The reimbursement provisions put in place in Quebec in 2000 were successful in reaching financially disadvantaged smokers, at a cost that was comparable with other effective smoking cessation services. Key words: Tobacco; cessation; reimbursement; nicotine patch; nicotine gum; bupropion La traduction du resume se trouve a la fin de l'article. Can j Public Health 2009;100(6):417-20. Objectif : Depuis octobre 2000, les timbres et les gommes de nicotine de meme que le bupropion sont rembourses par le regime public d'assurance medicaments du Quebec. Cette etude vise a decrire l'utilisation de ces medicaments entre octobre 2000 et decembre 2004 par les fumeurs assures par le regime public de meme que les couts des remboursements effectues durant cette periode. Methodes : Les donnees de la Regie de l'assurance maladie du Quebec ont ete utilisees pour analyser les prescriptions des medicaments d'aide a l'arret tabagique remises aux personnes assurees par le regime public d'assurance medicaments. Resultats : Du 1er octobre 2000 au 31 decembre 2004, plus de 300 000 Quebecois assures par le regime public d'assurance-medicaments ont ete rembourses pour des aides pharmacologiques a l'arret tabagique, ce qui represente en moyenne, annuellement, 14% des fumeurs assures par le regime public. La proportion de prestataires de l'assistance-emploi ayant utilise ces aides pharmacologiques est plus elevee que celle des personnes agees de 65 ans ou plus et que celle des adherents. Le timbre de nicotine constitue le choix de la majorite des utilisateurs. Durant cette periode de quatre ans, 55 millions de dollars ont ete rembourses par le regime public d'assurance medicaments pour le timbre de nicotine, la gomme de nicotine et le bupropion. Conclusion : La mesure de remboursement mise en place au Quebec en 2000 a rejoint les fumeurs desavantages financierement, a un cout comparable a celui d'autres mesures efficaces en abandon du tabac. Mots cles : abandon du tabac; remboursement; timbre de nicotine; gomme de nicotine; bupropion, In order to combat a smoking epidemic that claims more than 37,000 lives in Canada each year, (1) a variety of intervention measures are needed to help current smokers free [...]

Objectives. We examined whether the impact of televised smoking cessation ads differed by a population's education and income. Methods. We used longitudinal data from the Wisconsin Behavioral Health Survey, a statewide sample of 452 adult smokers who were interviewed in 2003 to 2004 and followed up 1 year later. Logistic regression was used to assess whether baseline recall of secondhand smoke ads and 'keep trying to quit' ads was associated with quit attempts and smoking abstinence at 1 year. Interaction terms were used to assess whether these associations differed by the smokers' education and income levels. Results. Overall, neither keep-trying-to-quit nor secondhand smoke ad recall was associated with quit attempts or smoking abstinence. Keep-trying-to-quit ads were significantly more effective in promoting quit attempts among higher- versus lower-educated populations. No differences were observed for secondhand smoke ads by the smokers' education or income levels. Conclusions. Some media campaign messages appear less effective in promoting quit attempts among less-educated populations compared with those who have more education. There is a need to develop media campaigns that are more effective with less-educated smokers. (doi: 10.2105/AJPH.2007.117499)

Objectives. We used 4 waves of prospective data to examine the association of smoking cessation with financial stress and material well-being. Methods. Data (n = 5699 at baseline) came from 4 consecutive waves (2001-2005) of the Household Income and Labour Dynamics in Australia survey. We used mixed models to examine the participant-specific association of smoking cessation with financial stress and material well-being. Results. On average, a smoker who quits is expected to have a 25% reduction (P Conclusions. Our findings indicate that interventions to encourage smoking cessation are likely to improve standards of living and reduce deprivation. The findings provide grounds for encouraging the social services sector to incorporate smoking cessation efforts into their programs to enhance the material or financial conditions of disadvantaged groups. The findings also provide additional incentives for smokers to stop smoking and as such can be used in antismoking campaigns and by smoking cessation services.

A large increase in the number of people who quit smoking may lower health care costs in the short run but would raise them in the long run. This was the conclusion reached by researchers who used life tables to estimate the change in health care costs over time if many smokers quit. Since smokers generally have poorer health, their health care costs are 40% higher than non-smokers' costs. However, if all smokers in a population quit, health care costs would initially drop but then rise to a higher rate than at present. This is because ex-smokers would live longer and would incur greater costs as they aged.

In response to these well known health consequences of cigarette smoking, American consumers over time have reacted fairly predictably. As might be expected, with increased knowledge about the adverse health [...]

If only 1% of pregnant women who smoke would quit smoking, it would prevent 1,300 low-birth-weight babies from being born and save $21 million in direct medical costs in the first year alone. This was the conclusion of researchers who analyzed the medical costs of low birth weight caused by smoking. The total cost to treat low birth weight caused by smoking was $263 million., Objectives. To estimate excess direct medical costs of low birth weight from maternal smoking and short-term cost savings from smoking cessation programs before or during the first trimester of pregnancy. Methods. Simulations using data on neonatal costs per live birth. Outcome measures are mean US excess direct medical cost per live birth, total excess direct medical cost, reductions in low birth weight, and savings in medical costs from an annual 1 percentage point drop in smoking prevalence among pregnant women. Results. Mean average excess direct medical cost per live birth for each pregnant smoker (in 1995 dollars) was $511; total cost was $263 million. An annual drop of 1 percentage point in smoking prevalence would prevent 1300 low birth weight live births and save $21 million in direct medical costs in the first year of the program; it would prevent 57 200 low birth weight infants and save $572 million in direct medical costs in 7 years. Conclusions. Smoking cessation before the end of the first trimester produces significant cost savings from the prevention of low birth weight. Pediatrics 1999;104:1312-1320; tobacco, pregnancy, economics, smoking cessation., ABBREVIATIONS. LBW, low birth weight; NICU, neonatal intensive care unit; IUGR, intrauterine growth retardation; RR, relative risk; VLBW, very low birth weight; MLBW, moderately low birth weight; PAR, population attributable [...]