Zhou, Xingzuo;
Li, Yiang;
Zhu, Tianning;
Xu, Yiran;
(2023)
Individuals with long-term illness, disability or infirmity are more likely to smoke than healthy controls: An instrumental variable analysis.
Frontiers in Public Health
, 10
, Article 1015607. 10.3389/fpubh.2022.1015607.
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Abstract
Despite the prevalence of smoking cessation programs and public health campaigns, individuals with long-term illness, disability, or infirmity have been found to smoke more often than those without such conditions, leading to worsening health. However, the available literature has mainly focused on the association between long-term illness and smoking, which might suffer from the possible bidirectional influence, while few studies have examined the potential causal effect of long-term illness on smoking. This gap in knowledge can be addressed using an instrumental variable analysis that uses a third variable as an instrument between the endogenous independent and dependent variables and allows the identification of the direction of causality under the discussed assumptions. Our study analyzes the UK General Household Survey in 2006, covering a nationally representative 13,585 households. We exploited the number of vehicles as the instrumental variable for long-term illness, disability, or infirmity as vehicle numbers may be related to illness based on the notion that these individuals are less likely to drive, but that vehicle number may have no relationship to the likelihood of smoking. Our results suggested that chronic illness status causes a significantly 28% higher probability of smoking. The findings have wide implications for public health policymakers to design a more accessible campaign around smoking and for psychologists and doctors to take targeted care for the welfare of individuals with long-term illnesses.
| Type: | Article |
|---|---|
| Title: | Individuals with long-term illness, disability or infirmity are more likely to smoke than healthy controls: An instrumental variable analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fpubh.2022.1015607 |
| Publisher version: | https://doi.org/10.3389/fpubh.2022.1015607 |
| Language: | English |
| Additional information: | © 2023 Zhou, Li, Zhu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | Smoking, long-term illness or disability, causal inference, instrumental variable (IV), public health, simultaneous effect |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10164278 |
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