Abstract

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.

Details

Title
Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas
Author
Stubbs, Brendon 1 ; Veronese, Nicola 2 ; Davy Vancampfort 3 ; A Mathew Prina 4 ; Pao-Yen, Lin 5 ; Ping-Tao Tseng 6   VIAFID ORCID Logo  ; Evangelou, Evangelos 7   VIAFID ORCID Logo  ; Solmi, Marco 8 ; Kohler, Cristiano 9 ; Carvalho, André F 10 ; Koyanagi, Ai 11 

1  Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom; Institute for Clinical Research and Education in Medicine, I.R.E.M., Padova, Italy 
2  Institute for Clinical Research and Education in Medicine, I.R.E.M., Padova, Italy 
3  KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium 
4  Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom 
5  Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan 
6  Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Taiwan 
7  Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece; Department of Biostatistics and Epidemiology, Imperial College London, London, UK 
8  Institute for Clinical Research and Education in Medicine, I.R.E.M., Padova, Italy; Department of Neurosciences, University of Padova, Padova, Italy; Local Health Unit 17 ULSS 17, Mental Health Department, Padova, Italy 
9  Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil 
10  Institute for Clinical Research and Education in Medicine, I.R.E.M., Padova, Italy; Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil 
11  Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain 
Pages
1-8
Publication year
2017
Publication date
Aug 2017
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-017-07579-w
ProQuest document ID
1957174047
Copyright
© 2017. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.