Health Risk Distribution by Socio-economic Status and Educational Levels of Thai Households: Who Smoke and Drink More?-บุหรี่และสุรา ความแตกต่างของปัจจัยเสี่ยงทางสุขภาพระหว่างครัวเรือนไทยที่มีเศรษฐานะและระดับการศึกษาที่แตกต่างกัน

Abstract

     Tobacco and alcohol remained the two major contributors to Disable Adjusted Life Year (DALY)loss as evident by the 1999 and 2004 Burden of Diseases Study. This study was aimed to assess the prevalence of cigarette smoking and alcohol drinking, and household expenditure on tobacco, alcohol, and health across different educational levels and income quintiles. The study analyzed two
major nationally household surveys conducted by the National Statistical Office, the Health and Welfare Survey for 2544, 2546 and 2549 (B.E.) and Household Socioeconomic Survey for 2545,2547 and 2549 (B.E.).

    Results revealed a negative correlation of cigarette smoking between those in the lower and higher educational levels, and between the poorer and higher income quintiles. The inequitable indexes (ratio of prevalence between the first and the fifth income quintiles, and between the lowest and the highest educational levels) of risk exposure to tobacco increased over the period of 2544 to 2549, indicating those with limited education and the poor did not benefit from government campaigns against tobacco. In contrast, the inequitable indexes of risk exposure to alcohol shown an impact of the government campaigns on highly educated people, but no different impact on those in different income quintiles. It was likely that benefits from the campaigns against tobacco were mostly yielded to the richer and higher income groups, while there might be no difference of benefits gained from the campaigns against alcohol among those with different income categories. In addition, of the total household consumption expenditure, around 6 to 7.5 percent were for alcohol, 2 to 4 percent for tobacco, and 2-4 percent for healthcare. Household spending on these hazardous goods was 4-8 percent higher than that on healthcare.

    Urgent revisit of effective policy interventions for alcohol consumption control was proposed. This includes demand and supply side interventions, especially on taxation and price policy due to income and price elasticity of tobacco and alcohol. Control of accessibility to alcohol should include hours of sale, minimum purchasing age, prohibit of alcohol sale and consumption in high-risk situations, and drunk-driving breath testing. In addition, more extensive analyses can be most beneficial if the national household surveys include questions on frequency and volume of household alcohol consumption.