Socioeconomic Inequalities in Alcohol and Tobacco Consumption: A National Ecological Study in Mexican Adolescents.

Alcohol and cigarettes are the psychoactive substances that adolescents use most frequently. When both addictions are combined, they carry the worst burden of disease globally. The objective of this study was to identify whether socioeconomic factors correlate with alcohol and tobacco consumption in Mexican adolescents aged 10 years or more and to establish the relationship in the consumption between the two substances. This ecological study utilized data describing alcohol and tobacco consumption among adolescents aged 10-16 years (n = 48,837 ≈ N = 11,621,100). Having ever consumed any alcohol-containing beverage constituted alcohol consumption. Smoking a cigarette within 30 days constituted cigarette consumption. For both variables, the state-level percentages reported in the survey were used. Diverse socioeconomic variables were collected from official sources. Data on the prevalence of tobacco use and alcohol consumption were entered into an Excel database estimated for each of the states of the Mexican Republic, as well as the socioeconomic variables. We performed the analysis using Stata 14. Consumption prevalence was 15.0% for alcohol and 4.2% for tobacco. Alcohol consumption was not correlated with any studied socioeconomic variable (p > 0.05). The prevalence of tobacco consumption among elementary school students correlated (p < 0.05) with the portion of the population living in private dwellings without sewage, drainage, or sanitation (r = 0.3853). The prevalence of tobacco consumption among middle-school adolescents correlated with the portion of the employed population that earned up to two minimum wages (r = 0.3960), the percentage in poverty by income 2008 (r = 0.4754) and 2010 (r = 0.4531), and the percentage in extreme poverty by income 2008 (r = 0.4612) and 2010 (r = 0.4291). Positive correlations were found between tobacco consumption and alcohol consumption among both elementary (r = 0.5762, p=0.0006) and middle-school children (r = 0.7016, p=0.0000). These results suggest that certain socioeconomic factors correlate with tobacco consumption but not alcohol consumption. A correlation between alcohol consumption and tobacco consumption was observed. The results can be used for developing interventions in adolescents.

Lip and Oral Cavity Cancer Incidence and Mortality Rates Associated with Smoking and Chewing Tobacco Use and the Human Development Index in 172 Countries Worldwide: An Ecological Study 2019-2020.

Tobacco use is associated with diseases worldwide, including cancer. This is one of the major public health problems globally, causing more than 19 million new cases in 2020. Lip and oral cavity cancer (LOCC) is neoplastic growth in the tongue, gums, and lips. The objective of this ecological study was to quantify the strength of the association between incidence and mortality of LOCC, with tobacco use and with the Human Development Index (HDI). Incidence and mortality data on LOCC were obtained for 172 countries in 2020, from the Global Cancer Observatory (GLOBOCAN). The prevalence of tobacco smoking and chewing was obtained from reports conducted in 2019. The inequality in human development was estimated using the HDI from the United Nations Development Program, Human Development Report (2019). Statistically significant correlations were observed between the incidence of LOCC and tobacco smoking and chewing prevalence, except for negative correlations between the prevalence of tobacco smoking LOCC mortality in women, just as in the case of the HDI. No statistically significant differences were found between the prevalence of tobacco chewing only and the incidence of LOCC overall and by sex. A higher LOCC incidence overall and by sex was associated with higher HDI. In conclusion, the present study found positive correlations for various HDI socioeconomic indicators and tobacco use with the incidence and mortality of LOCC, but also a few inverse correlations.