The Relationship of Socioeconomic Status to Alcohol, Smoking, and Health: a Population-Level Study of the Multiethnic Population in Singapore

This study aimed to (a) describe the differences in the prevalence of alcohol use disorder (AUD), smoking, nicotine dependence (ND), and health conditions (physical and mental) across socioeconomic status (SES); (b) study the differences in alcohol-related characteristics (e.g., frequency, quantity); and (c) assess the association between SES with health behaviors (alcohol use, smoking) and health status. This cross-sectional study recruited participants ( N = 6126) from a population registry through disproportionate stratified random sampling. Associations between SES with health behaviors and health status were examined using logistic or multinomial regressions adjusted for sociodemographic factors. Individuals in the low SES group had a higher prevalence of AUD than the high SES group (5.1% vs 4.6%). Low SES group had a higher proportion of current smokers (29.0% vs 15.2%) and those with ND (6.7% vs 3.0%). Those in the low SES group had higher prevalence of multi-morbidity (two or more chronic conditions) than the high SES group (46.8% vs 26.1%). Regression models showed that those in the low SES group had higher odds of AUD, smoking, and ND. Socio-environmental specific interventions should be strengthened in this group to promote health behaviors and early treatment entry to prevent potential health inequalities.