Smoking-related disease risk, area deprivation and health behaviours

Smokers and ex-smokers are at risk of many chronic diseases. However, never smokers and never smokers exposed to environmental tobacco smoke (ETS) are also at risk. Additionally, smoking behaviours and their associated disease risk are socially patterned and positively associated with health inequalities. However, other lifestyle choices also contribute to health inequalities. We aim to assess the contribution of other lifestyle behaviours pertaining to alcohol, physical inactivity and weight to smoking-related disease risk across (i) the socioeconomic spectrum and (ii) smoking status. Smoking-related disease risk is modelled using probit analysis. The results are used to predict disease risk across the socioeconomic dimension and smoking status for a set of healthy and unhealthy behaviours using the administratively linked Scottish Health Surveys and Scottish Morbidity Records. The results confirm the deprivation gradient in disease risk regardless of smoking status group. Imposition of healthy (unhealthy) lifestyle behaviours decreases (increases) the predicted risk across the deprivation distribution regardless of smoking status providing evidence of the multifaceted health behavioural determinants of disease risk across the deprivation distribution. The results are of policy interest as they suggest that to reduce inequalities in smoking-related diseases, interventions reducing both smoking and other unhealthy behaviours are required.