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Tobacco use and household expenditures on food, education, and healthcare in low- and middle-income countries: a multilevel analysis

Cited 13 time in Web of Science Cited 10 time in Scopus
Authors
Do, Young Kyung; Bautista, Mary Ann
Issue Date
2015-10-31
Publisher
BioMed Central
Citation
BMC Public Health, 15(1):1098
Keywords
Tobacco useHousehold expenditureEconomic impactHealth and development
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Abstract
Abstract

Background
The majority of one billion smokers worldwide live in low- and middle-income countries (LMICs) and the highest proportion of smokers in most of these countries belong to the lower socioeconomic groups. This study aimed to investigate the associations between tobacco use within households and expenditures on food, education, and healthcare in LMICs.


Methods
Using data from the World Health Survey, this cross-sectional study included a sample of 53,625 adult males aged <60 years from 40 LMICs. Multilevel, mixed-effects linear regression was used to determine the association between current tobacco use status of the main income provider (daily; occasional; no use) and three categories of (logged) household expenditures: food, education, and healthcare; controlling for age, level of education, household wealth quintile, marital status, urban–rural setting, country-level income group, and region.


Results
In the preferred random-slope models that controlled for covariates, daily tobacco use was associated with lower household expenditures on education and healthcare by 8.0 % (95 % confidence interval: −12.8 to –3.2 %) and 5.5 % (−10.7 to –0.3 %), respectively. The association between tobacco use and food expenditure was inconsistent across models.


Conclusions
Tobacco use in LMICs may have a negative influence on investment in human capital development. Addressing the tobacco use problem in LMICs could benefit not only the health and economic well-being of smokers and their immediate families but also long-run economic development at a societal level.
Language
English
URI
https://hdl.handle.net/10371/100496
DOI
https://doi.org/10.1186/s12889-015-2423-9
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College of Medicine/School of Medicine (의과대학/대학원)Health Policy and Management (의료관리학전공)Journal Papers (저널논문_의료관리학전공)
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