ArticlePloS one2018
A structural equation modeling approach to understanding pathways that connect socioeconomic status and smoking.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 71 citations in OpenAlex.
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- Structural equation modeling of associated factors and regional variations in major depressive disorders and generalized anxiety disorders among reproductive-age Bangladeshi women: a nationally representative study.Annals of general psychiatry · 2025Article
- Evaluating the interrelationship of mindfulness, sexual relational concern, and health related behaviors on women's life satisfaction through path analysis.BMC women's health · 2025Article
- Is structural equation modeling applicable in a population health determinants assessment? An experience from the European Union.PloS one · 2025Article
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- Socioeconomic determinants and self-rated health among hotel housekeepers in the Balearic Islands (Spain).Frontiers in public health · 2024Article
- Structure equation modeling in oral health research: A review of applications and considerations.Dental research journal · 2024Review
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- Clinical Spectrum and Trajectory of Innovative Therapeutic Interventions for Insomnia: A Perspective.Aging and disease · 2023Article
- Helping low-income smokers quit: findings from a randomized controlled trial comparing specialized quitline services with and without social needs navigation.Lancet regional health. Americas · 2023Article
- Efficacy of mindfulness and goal setting interventions for increasing resilience and reducing smoking in lower socio-economic groups: randomised controlled trial protocol.Addiction science & clinical practice · 2023Article
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- Prevalence, frequency, intensity, and location of cigarette use among adolescents in China from 2013-14 to 2019: Findings from two repeated cross-sectional studies.The Lancet regional health. Western Pacific · 2022Article
- Interrogating Patterns of Cancer Disparities by Expanding the Social Determinants of Health Framework to Include Biological Pathways of Social Experiences.International journal of environmental research and public health · 2022Review
- Association between heaviness of cigarette smoking and serious psychological distress is stronger in women than in men: a nationally representative cross-sectional survey in Japan.Harm reduction journal · 2021Article
- Individual and neighbourhood socioeconomic status increase risk of avoidable hospitalizations among Canadian adults: A retrospective cohort study of linked population health data.International journal of population data science · 2020Article
- A cross-sectional survey examining motivation and beliefs to participating in a web-based prospective cohort study on nutrition and health among individuals with a low socioeconomic status.BMC public health · 2020Article
- The Association Between Education and Smoking Prevalence, Independent of Occupation: A Nationally Representative Survey in Japan.Journal of epidemiology · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
The inverse association between socioeconomic status and smoking is well established, yet the mechanisms that drive this relationship are unclear. We developed and tested four theoretical models of the pathways that link socioeconomic status to current smoking prevalence using a structural equation modeling (SEM) approach. Using data from the 2013 National Health Interview Survey, we selected four indicator variables (poverty ratio, personal earnings, educational attainment, and employment status) that we hypothesize underlie a latent variable, socioeconomic status. We measured direct, indirect, and total effects of socioeconomic status on smoking on four pathways through four latent variables representing social cohesion, financial strain, sleep disturbance, and psychological distress. Results of the model indicated that the probability of being a smoker decreased by 26% of a standard deviation for every one standard deviation increase in socioeconomic status. The direct effects of socioeconomic status on smoking accounted for the majority of the total effects, but the overall model also included significant indirect effects. Of the four mediators, sleep disturbance and psychological distress had the largest total effects on current smoking. We explored the use of structural equation modeling in epidemiology to quantify effects of socioeconomic status on smoking through four social and psychological factors to identify potential targets for interventions. A better understanding of the complex relationship between socioeconomic status and smoking is critical as we continue to reduce the burden of tobacco and eliminate health disparities related to smoking.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.