Socio-economic Status and the Use of Six Psychoactive Substances among Male Adults in Taiwan
Date Issued
2012
Date
2012
Author(s)
Huang, Chao-Tzu
Abstract
Purpose: To examine how socio-economic status is associated with the use of six psychoactive substances (cigarette, alcohol, betel nuts, alcoholic tonic beverage, coffee, and tea) among male adults, not only for the consumption of individual substance but also concomitant consuming clusters of different substances. Particularly, this study attempts to explore the roles knowledge, attitude, and health status play in substance use in specific socio-economic groups.
Method: Data on which this study is based come from the “2005 National Health Interview Survey.” A total of 6087 male adults 18-64 years of age are included in this study. Socio-economic status is measured by education and occupation and a combination of both. Bivariate analysis is used to describe the association between education, occupation and the consumption of each substance. Spearman correlation and cluster analysis are used to explore patterns of substance co-consumption in relation to SES. Finally, ordinal logistic regression model is employed to clarify the effects of knowledge, attitudes and health status on substance use.
Result: The major findings are: (1) Overall, statistically significant association was found between education, occupation and the use of six substances. Particularly, cigarette, alcohol, betel nuts and alcoholic tonic beverage are more likely to be used by participants occupying lower occupational and educational level. On the contrary, coffee is more commonly used by persons with higher educational and occupational positions, (2) Alcohol drinking, smoking, betel nuts chewing, and alcoholic tonic beverage drinking are most often co-existent, and the strongest relationship is found between betel nuts chewing and smoking. Whereas tea drinking, smoking, alcohol drinking, and coffee intake are highly correlated, most common concomitant consumption is for coffee and tea, (3) Among three sets of intervening factors, health status, both physical and mental health, is weakly correlated with substance use; knowledge only has significant association with smoking and betel nuts chewing, and the most powerful determinant is attitude, which is strongly correlated with each type of substance use, and (4) Cluster analysis generates the following six distinctive types of substance use: (i) multiple addiction, (ii) typical triple addiction, (iii) heavy smoking and high coffee-tea consumption, (iv) alcohol-coffee double preference, (v) tea favoritism, and (vi) total substance avoidance. In general, significant gradient associations are present between consumption type and two SES variables. Higher level of educational and occupational attainment leads to the consumption type of “tea favoritism” and “total substance avoidance” and, in contrast, the lower attainment in education and occupation tends to be engaged in “multiple addiction” and “typical triple addiction.”
Suggestions: Research on substance use behavior should take a more comprehensive and holistic perspective without simply focusing only on the use of individual substance each time. Investigations should also be placed in the context of daily life to capture how substance consumption is determined by various structural and socio-psychological factors. Implications from this point of view may inform the current efforts of health communication and education to develop more sensitive and valid interventions.
Subjects
psychoactive substance use behavior
education
occupation
socio-economic status
cluster analysis
SDGs
Type
thesis
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