Co-occurrence of Smoking and Unhealthy Diet in the Brazilian Adult Population

Abstract Background: Smoking and an inadequate diet are behavioral risk factors that contribute to the majority of deaths and disabilities caused by noncommunicable diseases. Objectives: To estimate the prevalence of the co-occurrence of smoking and inadequate diet and identify associated factors in adults. Methods: A cross-sectional population-based study was conducted with a sample of 28,950 Brazilian adults (18 to 59 years old). Data were obtained from Sistema de Vigilância por Inquérito Telefônico (Vigitel [Brazilian Health Surveillance Telephone Survey]) in 2014. Independent associations were investigated using Poisson hierarchical regression analysis with 5% significance level. Results: The prevalence of the co-occurrence of smoking and unhealthy eating was 8.6% (95% CI: 7.9-9.3) and was higher among individuals residing in the southern region of the country than in those living in the central western region (PR = 1.50; 95% CI: 1.18-1.89), those with no private health insurance (PR = 1.14; 95% CI: 1.03-1.25), those who drank alcohol abusively (binge drinkers) (PR = 3.22; 95% CI: 2.70-3.85) and those who self-rated their health as fair (PR = 1.65; 95% CI: 1.36-1.99) or poor/very poor (PR = 1.70; 95% CI: 1.18-2.44). The prevalence of both factors was lower among individuals residing in the northeastern region of the country, women, individuals with brown skin color, those with a spouse, the more educated ones and those with overweight or obesity. Conclusion: The more vulnerable segments to the co-occurrence of the risk factors studied were men residing in the southern region of the country, individuals with a lower socioeconomic status and those who reported binge drinking. Interventions addressing multiple behavioral risk factors adapted to specific contexts could have a greater impact on the Brazilian population.

摘要
背景：吸烟及饮食不均衡作为行为风险因素，是导致非传染性疾病引起的大部分死亡和残疾的主要原因。研究目的：旨在估算吸烟与饮食不均衡同时存在的患病率，并识别成人中的相关因素。研究方法：通过一项基于人群的横断面研究，对28,950名巴西成年人（18至59岁）进行样本调查。数据来源于2014年的Sistema de Vigilância por Inquérito Telefônico（Vigitel [巴西健康监测电话调查]）。采用泊松层次回归分析，以5%的显著性水平研究独立关联。研究结果：吸烟与不健康饮食习惯同时存在的患病率为8.6%（95% CI：7.9-9.3），其中居住在国家南部地区的人群患病率高于居住在中央西部地区的人群（优势比 [PR] = 1.50；95% CI：1.18-1.89），无私人医疗保险的人群（PR = 1.14；95% CI：1.03-1.25），过度饮酒者（PR = 3.22；95% CI：2.70-3.85）以及自我评价健康状况为一般、较差或极差的人群（PR = 1.65；95% CI：1.36-1.99）的患病率较高。居住在国家东北部地区、女性、棕色皮肤色人种、有配偶、受教育程度较高以及体重过重或肥胖的人群中，这两种因素的患病率较低。结论：对于研究中的风险因素同时存在而言，最易受影响的群体为国家南部地区的男性、社会经济地位较低的人群以及报告有暴饮暴食行为的人群。针对多个行为风险因素，并适应特定背景的干预措施，可能对巴西人群产生更显著的影响。