Socioeconomic factors associated with tobacco smoking in Turkey: a cross-sectional, population-based study

Background: Gender and lower socioeconomic status are associated with smoking.

Aims: This study aimed to determine the association between socioeconomic factors and cigarette tobacco smoking in Balcova, Izmir, Turkey, with a focus on gender differences.

Methods: The study population was all men and women [36 187] aged over 30 years living in Balcova from October 2007 to May 2009. Data were collected in interviews and included smoking status [current, former, never], age, gender, marital status, educational level, occupational class/working status, health insurance and having a chronic disease. Logistic regression analysis was used to evaluate the association between socioeconomic characteristics and smoking status.

Results: Of the 36 187 study subjects, 16 080 [44%] agreed to participate and 15 174 [42%] with complete data were evaluated. The majority were women [66.2%]; mean ages of men and women were 53.1 [SD 13.1] and 51.3 [SD 13.2] respectively. Current smoking was higher in men [41.7% versus 31.2% of women], and more men were ex-smokers [33.1% versus 13.5% of women] but more women had never smoked [55.3% versus 25.2% of men]. For women, being married and having low educational level were associated with current smoking and previous smoking [P < 0.05]. Current smoking was also more frequent among working women [P < 0.05]. For men, low educational level and occupational class were associated with being a current smoker and an ex-smoker [P < 0.05].

Conclusions: Socially disadvantaged groups, especially those with low education or unemployed men, were more likely to be current smokers and smoking cessation was lower in these groups. Smoking habits were different in men and women. Socioeconomic factors should always be considered when developing smoking cessation policies.

Smoking habits and cessation success. What differs among adults and elderly?

To determine factors affecting smoking cessation success in different age groups. This was an intervention study consisting of 761 patients attending the Balcova Municipality, Smoke Cessation Center, Izmir, Turkey, between November 2009 and December 2011. Variables were successful smoking cessation for one year, socio-demographic features, previous attempts at smoking cessation, a smoking spouse, nicotine dependency level, risk of depression, method of smoking cessation, presence of chronic disease, and decreasing smoking in the last year. Data was analyzed by logistic regression. Approximately 43.8% of the elderly, and 62.7% of the adults reduced the number of cigarettes smoked in the past year. Approximately 83.6% of the elderly and 90.6% of the adults reported previously smoking 11 or more cigarettes daily. Two-thirds of the participants in both groups had tried smoking cessation. Smoking cessation was 49% in the elderly group and 33.4% in the adult group. The logistic regression test showed that moderate and less nicotine dependency level increased the success of cessation in the elderly group [odds ratio [OR]=2.39, 95% confidence interval [95% CI] 1.11-5.17, p=0.026], while in the adult group: increasing age [OR=1.02, 95% CI: 1.01-1.04, p=0.044], male gender [OR=1.69, 95% CI: 1.07-2.68, p=0.025], moderate and less nicotine dependency level [OR=1.65, 95% CI: 1.09-2.49, p=0.018], and the use of medication [OR=1.70, 95% CI: 1.13-2.56, p=0.011] increased the success. Different variables in different age groups may affect successful smoking cessation. These should be taken into consideration in efforts at smoking cessation

Can spirometry, pulse oximetry and dyspnea scoring reflect respiratory failure in patients with chronic obstructive pulmonary disease exacerbation?

To evaluate the extent to which oximetry, spirometry and dyspnea scoring can reflect hypoxemia and hypercapnia among patients admitted to the emergency department [ED] with acute exacerbations of chronic obstructive pulmonary disease. Spirometry, oxygen saturation by pulse oximetry [SpO[2]], arterial blood gas analysis and dyspnea scoring assessments were made in the ED. Correlations of these parameters were evaluated by means of Pearson's test. Pulse oximetry cutoff values to express hypoxemia were demonstrated by receiver operating characteristic [ROC] curves. 76 patients with a mean age of 68.0 years were included in the study. Mean spirometric values, expressed as percentages of predicted values, were forced expiratory volume in 1 s [FEV[1]] = 23.1 +/- 9%; forced vital capacity [FVC] = 32.8 +/- 11%, and mean FEV1/FVC = 72.4 +/- 21.6%. While there was a positive correlation between the SpO[2],SaO[2] and PaO[2] values [r = 0.91 and 0.80, respectively], a negative correlation [r = -0.74] was observed between PaCO[2]and SpO[2]. In determining hypoxemia, both SpO[2] and FEV1 were sensitive [83.9 and 90.3%, respectively] while dyspnea scoring was the most sensitive [93.5%]. In the evaluation by means of an ROC curve, a saturation of 88.5% for the pulse oximeter was the best cutoff value to reflect hypoxemia [sensitivity 95.6%, specificity 80.6%]. SpO[2] alone appears to be as highly specific as a combination of other tests in the evaluation of hypoxemia. A cutoff value for SpO2 of