Relationship between housing tenure and cigarette smoking among adolescents – A population-based study

Abstract

Background Cigarette smoking leads to significant morbidity and pre-mature mortality. We examined the relationship between housing tenure at ages 15, 16, 17 and 18 and smoking five years later using data from a well-established cohort study. Methods We analysed the data on 15-18-year-old adolescents (n = 2305) from the Household Income and Labour Dynamics in Australia (HILDA) survey. We applied augmented inverse probability treatment weights to maximise exchangeability between those in social housing and homeowners, and private renters. By estimating potential outcomes for the exposed and unexposed, we compared risk of smoking five years later on both absolute and relative scale. Baseline covariates included household income, age at study entry, sex, family type, smoking at baseline and highest household education. Results Adolescents in social housing had an increased risk of current smoking five years later (average treatment effect (ATE): 0.24, 95% CI: 0.02, 0.47) than homeowners. On the relative scale those in social housing had 2.23 times (95% CI: 1.08, 3.39) higher risk of being a smoker than homeowners. Those in social housing also had an increased risk of being a smoker (ATE: 0.14, 95%CI: 0.04, 0.25) than private renters. On the relative scale we estimated that those in social housing had 1.46 times (95% CI: 1.09, 1.83) higher risk of smoking than private renters. Conclusions Adolescents in social housing have a higher risk of smoking than those living in owned or private rented homes. Key messages Tobacco control efforts must target adolescent in social housing for reducing inequalities in cigarette smoking.