Association between health literacy and current smoking among middle-aged Japanese ever smokers

Abstract

Introduction Previous studies suggest that low health literacy is associated with current smoking. In this study, we assessed the association between health literacy and current smoking among middle-aged Japanese ever smokers. Methods A cross-sectional mail survey using a selfadministered questionnaire was conducted from October 2020 to March 2021. A convenience sample involved all community residents with National Health Insurance, aged 40–64 years, in five cities of three areas of Osaka Prefecture, Japan. We received 12446 (36.7%) responses from people who agreed to participate in the mail survey. After we excluded non-smokers and those with missing data, a total of 4751 ever smokers were included in the analysis. Health literacy was measured using the Japanese Communicative and Critical Health Literacy scale. The statistical methods included chi-squared tests, analysis of variance, and logistic regression analysis. Results Of the 4751 ever smokers, 2389 (50.3%) were current smokers, and 2362 (49.7%) were ex-smokers. After adjusting for confounding factors, multivariable adjusted odds ratios for current smoking were calculated for the medium health literacy group (AOR=1.11; 95% CI: 0.97– 1.28) and the low health literacy group (AOR=1.40; 95% CI: 1.20–1.64), with the high health literacy as reference group. Further analysis revealed that the association was significant, even when stratified by educational level. Conclusions Low health literacy was positively associated with current smoking among middle-aged Japanese ever smokers. These results suggest that improving health literacy may help middle-aged smokers to quit smoking.

Keywords

• japan
• health literacy
• current smoking
• ever smokers