Sex-specific trends in smoking prevalence over seven years in different Austrian populations: results of a time-series cross-sectional analysis

Objectives: Aim of this study was to examine trends over time in smoking status in men and women, and in subgroups, in Austria, a country with poor smoking regulation policies.

Design and participants: Two cross-sectional surveys (Austrian Health Interview Surveys for 2007 and 2014), each with more than 15 000 participants from the general population, aged ≥15 years.

Outcome measures: Prevalence of self-reported daily smoking. ORs for daily smoking in subgroups, presented as results of logistic regression models, adjusted for sociodemographic variables and presence of chronic diseases.

Results: Prevalence of daily cigarette smoking was 26.0% for men in both years, and increased from 19.1% to 22.0% (p<0.001) in women from 2007 to 2014. Smoking prevalence increased especially in female patients with diabetes mellitus (from 9.9% to 16.4%, p=0.005), obesity (from 17.1% to 21.6%, p=0.010) and hypertension (from 11.2% to 14.2%, p=0.010). Smoking prevalence increased significantly in unemployed men (from 43.6% to 57.1%, p<0.001). In women, smoking prevalence increased in those aged 30-64 years (from 21.9% to 26.3%, p<0.001) and 65+ (from 3.9% to 6.2%, p=0.002), with primary (from 17.2% to 24.4%, p<0.001) and secondary education (from 21.4% to 23.4%, p=0.021), and with a European (from 16.6% to 26.1%, p<0.001) and non-European migration background (from 25.0% to 32.8%, p=0.003). In the adjusted analysis for women in 2014, there was a higher likelihood of smoking (OR 1.22, 95% CI 1.12 to 1.32, p<0.001) compared with 2007, and for those affected by a chronic disease (OR 1.15, 95% CI 1.06 to 1.25, p=0.002).

Conclusions: There has been a remarkable increase in smoking prevalence over the 7-year period in women in Austria, especially for those with chronic diseases, higher age, lower education and a migration background. Better political and clinical efforts are needed to reduce the high tobacco use in Austria.