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Social participation, social capital and daily tobacco smoking: a population-based multilevel analysis in Malmö, Sweden

Department of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden, martin.lindstrom{at}smi.mas.lu.se

Mahnaz Moghaddassi

Department of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden

Kristian Bolin

Department of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden, Department of Economics, Lund University, Lund, Sweden, LUCHE, Lund University Centre for Health Economics, Lund, Sweden

Björn Lindgren

Department of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden, Department of Economics, Lund University, Lund, Sweden, LUCHE, Lund University Centre for Health Economics, Lund, Sweden, Vårdal Institute (Swedish Institute for Health Sciences), Lund University

Juan Merlo

Department of Community Medicine, University Hospital MAS, Lund University, Malmö, Sweden

Aims: The aim of this study was to investigate the influence of contextual and individual factors on daily tobacco smoking. Methods: The public-health survey in Malmö 1994 is a cross-sectional study. A total of 5,600 individuals aged 20 - 80 years were invited to answer a postal questionnaire. The participation rate was 71%. A multilevel logistic regression model, with individuals at the first level and neighbourhoods at the second, was performed. We analysed the effect (intra-area correlation, cross-level modification and odds ratios) of individual and neighbourhood factors on smoking after adjustment for individual factors. Results: Neighbourhood factors accounted for 2.5% of the crude total variance in daily tobacco smoking. This effect was significantly reduced when the individual factors such as education were included in the model. However, individual social capital, measured by social participation, only marginally affected the total neighbourhood variance in daily tobacco smoking. In fact, no significant variance in daily tobacco smoking remained after the introduction of the individual factors other than individual social capital in the model. Conclusion: In Malmö, the neighbourhood variance in daily tobacco smoking is mainly affected by individual factors other than individual social capital, especially socioeconomic status measured as level of education.

Key Words: multilevel analysis • smoking • social capital • social participation.

Scandinavian Journal of Public Health, Vol. 31, No. 6, 444-450 (2003)
DOI: 10.1080/14034940310006203


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