RESUMEN
BACKGROUND: The relationship between smoking and various socio-demographic or socio-economic factors, as well as the interactions between depressive mood and smoking are already known. However, the respective contribution of psychological factors and stressful life antecedents during childhood and adolescence warrants further specification. METHODS: 2315 consecutive subjects, aged 16 to 59, consulting for a free work-up in a preventive health centre, supported by the National French Health insurance system, were invited to fill out a series of questionnaires: the GHQ-28 and the LOT, respectively measuring psychosocial distress and dispositional optimism, as well as a questionnaire on socio-demographic, socio-economic and biographical data. RESULTS: 78.1% complete records could be analysed: the "smokers" group (n = 870, 48.1%) declared a current tobacco consumption of at least one cigarette/day. This group was characterized by a predominance of male subjects, older age, modest educational level, low income level and responded to socio-economic criteria of precariousness more frequently (p < 0.001, except for age: p = 0.006). Smoking was also associated with higher levels of psychosocial distress, as assessed by GHQ-28, especially for the depressive mood and anxiety items of the questionnaire (p < 0.001), and with lower levels of dispositional optimism (p < 0.01). As regards biographical data, smokers were characterized by a way of life marked by financial problems, reduced social contacts, and a higher frequency, before the age of 18, of divorce or separation of the parents (p = 0.002), frequent parental quarrels (p < 0.001) or separation from the parents (p < 0.001). The presence of a depressive mood at GHQ-28 as well as frequent parental quarrels remained independent risk factors for smoking in multiple logistic regression (odds ratio respectively equal to 1.61 and 1.34), after adjustment on gender, educational level and the notion of socio-economic precariousness. CONCLUSION: These results highlight the complementary role of socio-economic, psychological factors and certain stressful life antecedents among the determinants of smoking and should be taken into account for tailoring smoking cessation programs.
Asunto(s)
Depresión/complicaciones , Fumar/psicología , Estrés Psicológico , Adolescente , Adulto , Estudios Transversales , Demografía , Divorcio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Clase Social , Apoyo SocialRESUMEN
OBJECTIVE: Obesity is a complex multi-factorial disease. The role of socioeconomic factors is known but few studies have attempted to analyse separately the impact of the various participating factors: oncome, level of education, cultural and social status. METHOD: These factors were analysed in 26,278 persons aging from 16 to 59 years, living in the district and having benefited from a medical check-up in the Seine-Saint-Denis health and social prevention centre, district particularly concerned by socio-economic insecurity. Among these persons, a representative sample of 1804 filled-in an additional questionnaire including questions on their income, level of education, marital status and the area or country of origin. RESULTS: The prevalence of obesity (body mass index or BMI > or = 30 kg/m2) and overweight (MCI = 25 to 29.9 kg/m2) was respectively of 17.6 and 32.7%. Using univariate analysis, the prevalence of obesity was significantly associated with age, gender (higher in women), settled way of life, socio-professional category, low education, marital status and origin (higher in persons from Africa and North Africa). Using a logistic regression model, the risk of obesity was increased 1.45-fold in persons earning less than 838,47 euros and 1.67-fold in persons with low education. Moreover, it was 2.28-fold greater in the un-working population, 1.62-fold in the redundant and 1.5-fold in the working class, compared with the executive-freelance population. CONCLUSION: The risk of obesity is therefore independently related to cultural, economic and social parameters.