The Association of Tobacco and Alcohol Consumption with the Use of Health Care Services in Spain

The Association of Tobacco and Alcohol Consumption with the Use of Health Care Services in Spain

Background. Information on the impact of tobacco and alcohol consumption on the use of health services is scant and partially inconsistent. This paper examines the relationship between tobacco and alcohol consumption and the use of health care services in Spain. Methods. Data were drawn from the 199...

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Published in:Preventive medicine Vol. 31; no. 5; pp. 554 - 561
Main Authors: Rodrȷguez Artalejo, Fernando, de Andrés Manzano, Belén, Guallar-Castillón, Pilar, Puente Mendizabal, Marȷa Teresa, González Enrȷquez, Jesús, del Rey Calero, Juan
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-11-2000
Subjects:
Adolescent
Adult
alcohol
Alcohol Drinking
Ambulatory Care - utilization
Emergency Service, Hospital - utilization
Female
health care services
Health Services - utilization
Health Surveys
Hospitalization - statistics & numerical data
Humans
Male
Odds Ratio
Smoking
Spain
tobacco
Spain
alcohol
health care services
tobacco
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Summary:Background. Information on the impact of tobacco and alcohol consumption on the use of health services is scant and partially inconsistent. This paper examines the relationship between tobacco and alcohol consumption and the use of health care services in Spain. Methods. Data were drawn from the 1993 Spanish National Health Survey, covering a random 21,120-person representative sample of Spain's noninstitutionalized population ages 16 years and older. Information was obtained through home-based interviews. Results. Compared with never smokers, male smokers of more than 20 cigarettes/day tend to be hospitalized more frequently (odds ratio (OR) 1.31; 95% confidence limits (CL) 0.89–1.93) and make greater use of hospital emergencies (OR 1.51; 95%CL 1.13–2.01; P < 0.01). Among female smokers of more than 20 cigarettes/day, hospitalizations (OR 1.62; 95%CL 0.80–3.26) and medical visits (OR 1.35; 95%CL 0.79–2.30) are also higher than among never smokers, although the associations do not reach statistical significance. Compared with never smokers, ex-smokers of both sexes make greater use of health care services (P < 0.01 for most services). There is a negative dose–response relationship (P < 0.001) between alcohol consumption and utilization of hospital and ambulatory services, for both sexes. Results are reasonably consistent across all age groups and are observed after adjustment for the principal confounding factors. We have found no evidence of a tobacco–alcohol interaction with the use of health care services. Conclusions. Smokers and ex-smokers make greater use of health care services. Control of smoking might reduce the use of such services and the ensuing human and economic costs. However, as alcohol consumption increases, the use of health care services decreases. This finding should not be used to promote even the moderate consumption of alcoholic drinks.
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ISSN:0091-7435
1096-0260
DOI:10.1006/pmed.2000.0734