[Effet du statut socio-économique du quartier de résidence sur le tabagisme dans l'étude de cohorte CARVAR 92]

Tobacco is one of the strongest modifiable cardiovascular risk factors, contributing significantly to cardiovascular morbidity and mortality. We aimed to assess the impact of neighborhood deprivation on smoking status and smoking intensity.

Between 2010 and 2018, we studied smoking status and intensity in 7821 participants residing in Paris west suburb included in the CARVAR 92 prospective cohort. Moderate or high-intensity smoking was defined as consuming more than 10 cigarettes a day Three neighborhood clusters of decreasing socioeconomic status (SES) were obtained after a hierarchical clustering analysis applied to eighteen measures of SES. We used multivariate logistic models to estimate the association between neighborhood SES (NSES) clusters and smoking status and intensity.

Of the 7821 participants (mean age: 55.1 ± 9.7 years, 56.8% women), 16.4% were smokers (N=1284): 18.8% of males (N=635) and 14.6% of females (N=649, p < 0.0001). The overall proportions of smokers were similar in the three groups: 16.2%, 15.6% and 18.2% in high, medium, and low NSES, respectively (p for trend=0.171). We observed a higher proportion of males among smokers in each NSES: 17.6%, 20.1% and 20.2% (p for trend=0.03) in high, medium and low NSES, respectively, versus 15.2%, 12.3%, and 15.9% (p for trend=0.801) among women. Lowest SES neighborhood was independently associated with moderate or high-intensity smoking in the whole population (OR=1.66; 95% CI 1.27-2.04, p = 0.02), in men (OR 1.59, 95% CI 1.06-2.40), and in women (OR 1.79, 95% CI 1.17-2.72).

In conclusion, the intensity of smoking is greatly influenced by neighborhood SES. We found an association between lowest SES neighborhoods and moderate or high-intensity smoking, regardless of sex, with a slightly more pronounced effect among women.