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Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels

BACKGROUND: Tobacco expenditure has adverse impacts on expenditure on basic needs and resource allocation of the households. Using data from a nationally representative survey, we measured socioeconomic inequality in tobacco expenditure as the share of household budget (TEHB) and explained its main...

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Autores principales: Rezaei, Satar, Pulok, Mohammad Habibullah, Ebrahimi, Mohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325296/
https://www.ncbi.nlm.nih.gov/pubmed/32600457
http://dx.doi.org/10.1186/s12889-020-09144-z
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author Rezaei, Satar
Pulok, Mohammad Habibullah
Ebrahimi, Mohammad
author_facet Rezaei, Satar
Pulok, Mohammad Habibullah
Ebrahimi, Mohammad
author_sort Rezaei, Satar
collection PubMed
description BACKGROUND: Tobacco expenditure has adverse impacts on expenditure on basic needs and resource allocation of the households. Using data from a nationally representative survey, we measured socioeconomic inequality in tobacco expenditure as the share of household budget (TEHB) and explained its main determinants among Iranian households at the national and sub-national levels. METHODS: This cross-sectional study used data from the Iranian Household Income and Expenditure Survey (IHIES), 2018. We included a total of 7649 households with tobacco expenditure more than zero in the analysis. Province-level data on the Human Development Index (HDI) was obtained from the Institute for Management Research at Radbound University. The concentration curve (CC) and the concentration index (C) were used to measure socioeconomic inequality in TEHB at national and sub-national levels. The C was decomposed to identify the factors explaining the observed socioeconomic inequality in TEHB. RESULTS: At the national level, households with at least one smoker spent more than 5% of their budget for tobacco consumption in the last month. Households from the urban areas allocated less of their budgets on tobacco products compared to rural households (4.6% vs. 5.8%). Overall, TEHB was more concentrated among the poorer households (C = 0.1423, 95% CI: − 0.1552 to − 0.1301). In other words, the distribution of TEHB was pro-poor in Iran. Pro-poor inequality in TEHB was also found in urban (C = − 0.1707, 95% CI: − 0.1998 to − 0.1516) and rural (C = − 0.1314, 95% CI: − 0.1474 to − 0.1152) areas. We also found that pro-poor inequalities were higher in Iranian provinces with low HDI. The decomposition results indicate that wealth and education were the main factors contributing to the concentration of TEHB among the poorer households. CONCLUSION: This study found that TEHB was disproportionality concentrated among poorer households in Iran. The extent of inequality in TEHB was higher in urban areas and less developed provinces. Designing and implementing tobacco control interventions to decrease the smoking prevalence and increase smoking cessation could protect worse-off households against the financial burden of tobacco spending.
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spelling pubmed-73252962020-06-30 Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels Rezaei, Satar Pulok, Mohammad Habibullah Ebrahimi, Mohammad BMC Public Health Research Article BACKGROUND: Tobacco expenditure has adverse impacts on expenditure on basic needs and resource allocation of the households. Using data from a nationally representative survey, we measured socioeconomic inequality in tobacco expenditure as the share of household budget (TEHB) and explained its main determinants among Iranian households at the national and sub-national levels. METHODS: This cross-sectional study used data from the Iranian Household Income and Expenditure Survey (IHIES), 2018. We included a total of 7649 households with tobacco expenditure more than zero in the analysis. Province-level data on the Human Development Index (HDI) was obtained from the Institute for Management Research at Radbound University. The concentration curve (CC) and the concentration index (C) were used to measure socioeconomic inequality in TEHB at national and sub-national levels. The C was decomposed to identify the factors explaining the observed socioeconomic inequality in TEHB. RESULTS: At the national level, households with at least one smoker spent more than 5% of their budget for tobacco consumption in the last month. Households from the urban areas allocated less of their budgets on tobacco products compared to rural households (4.6% vs. 5.8%). Overall, TEHB was more concentrated among the poorer households (C = 0.1423, 95% CI: − 0.1552 to − 0.1301). In other words, the distribution of TEHB was pro-poor in Iran. Pro-poor inequality in TEHB was also found in urban (C = − 0.1707, 95% CI: − 0.1998 to − 0.1516) and rural (C = − 0.1314, 95% CI: − 0.1474 to − 0.1152) areas. We also found that pro-poor inequalities were higher in Iranian provinces with low HDI. The decomposition results indicate that wealth and education were the main factors contributing to the concentration of TEHB among the poorer households. CONCLUSION: This study found that TEHB was disproportionality concentrated among poorer households in Iran. The extent of inequality in TEHB was higher in urban areas and less developed provinces. Designing and implementing tobacco control interventions to decrease the smoking prevalence and increase smoking cessation could protect worse-off households against the financial burden of tobacco spending. BioMed Central 2020-06-29 /pmc/articles/PMC7325296/ /pubmed/32600457 http://dx.doi.org/10.1186/s12889-020-09144-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Rezaei, Satar
Pulok, Mohammad Habibullah
Ebrahimi, Mohammad
Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title_full Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title_fullStr Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title_full_unstemmed Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title_short Socioeconomic inequality in tobacco expenditure in Iran: a cross-sectional analysis at national and subnational levels
title_sort socioeconomic inequality in tobacco expenditure in iran: a cross-sectional analysis at national and subnational levels
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325296/
https://www.ncbi.nlm.nih.gov/pubmed/32600457
http://dx.doi.org/10.1186/s12889-020-09144-z
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