PT  - JOURNAL ARTICLE
AU  - Christopher Bruce McClure
AU  - Unnur A Valdimarsdóttir
AU  - Arna Hauksdóttir
AU  - Ichiro Kawachi
TI  - Economic crisis and smoking behaviour: prospective cohort study in Iceland
AID  - 10.1136/bmjopen-2012-001386
DP  - 2012 Jan 01
TA  - BMJ Open
PG  - e001386
VI  - 2
IP  - 5
4099  - http://bmjopen.bmj.com/content/2/5/e001386.short
4100  - http://bmjopen.bmj.com/content/2/5/e001386.full
SO  - BMJ Open2012 Jan 01; 2
AB  - Objective To examine the associations between the 2008 economic collapse in Iceland and smoking behaviour at the national and individual levels. Design A population-based, prospective cohort study based on a mail survey (Health and Wellbeing in Iceland) assessed in 2007 and 2009. Setting National mail survey. Participants Representative cohort (n=3755) of Icelandic adults. Main outcome measure Smoking status. Results A significant reduction in the prevalence of smoking was observed from 2007 (pre-economic collapse) to 2009 (postcollapse) in both males (17.4–14.8%; p 0.01) and females (20.0–17.5%; p 0.01) in the cohort (n=3755). At the individual level of analysis, male former smokers experiencing a reduction in income during the same period were less likely to relapse (OR 0.37; 95% CI 0.16 to 0.85). Female smokers were less likely to quit over time compared to males (OR 0.65; 95% CI 0.45 to 0.93). Among male former smokers who experienced an increase in income between 2007 and 2009, we observed an elevated risk of smoking relapse (OR 4.02; 95% CI 1.15 to 14.00). Conclusions The national prevalence of smoking in Iceland declined following the 2008 economic crisis. This could be due to the procyclical relationship between macro-economic conditions and smoking behaviour (ie, hard times lead to less smoking because of lower affordability), or it may simply reflect a continuation of trends already in place prior to the crisis. In individual-level analysis, we find that former smokers who experienced a decline in income were less likely to relapse; and conversely, an increase in income raises the risk. However, caution is warranted since these findings are based on small numbers.