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Socioeconomic position as a common cause for smoking, drinking, and psychiatric distress over the transition to adulthood -PhD thesis-


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Psychiatric distress, smoking and excessive alcohol consumption are
common health problems which often occur together and are patterned by
socioeconomic position. Smoking and drinking behaviours and mental
health problems tend to develop over the transition from adolescence to
adulthood, so this thesis aimed to investigate the mechanisms by which
socioeconomic factors influence their co-development during this stage
of life as young people make transitions into adult social roles. Data
were primarily taken from three UK cohort studies (two nationwide birth
cohorts respectively born in 1958 and 1970, and a cohort of adolescents
from Glasgow who were also born in the early 1970s), so it was possible
to examine whether mechanisms were context-dependent. Additional data
from the youth sub-sample of the British Household Panel Study allowed
investigation of socioeconomic inequalities in early adolescent smoking
development in more recent history (1994-2008). A combination of person
and variable centred analysis techniques (latent class analysis,
structural equation modelling, propensity weighting, and event history
analysis) were employed to investigate the role of socioeconomic
background and transitions to adulthood in development of smoking,
drinking and psychiatric distress in adolescence and early adulthood.
Inverse probability weighting and multiple imputation were employed to
account for missing data. A strong association was identified between
socioeconomic disadvantage and adolescent smoking, despite recent
increases in tobacco control in the UK. Smoking appeared to be an
important mechanism, or at least a marker for other mechanisms, linking
socioeconomic disadvantage to heavier drinking, psychiatric distress,
and early school-leaving. Aside from smoking, there were other
mechanisms leading to heavy drinking and psychiatric distress. For
psychiatric distress, these were still mainly associated with
socioeconomic disadvantage, especially in early adulthood, whereas for
drinking there were mechanisms associated with socioeconomic advantage.
Participation in tertiary education appeared to be an important example
of such a mechanism, linking socioeconomic advantage to heavier drinking
in early adulthood. Remaining in education was strongly linked to
delaying other adulthood transitions, but different patterns of early
transitions exhibited different associations with smoking, drinking and
distress in different contexts. Tackling inequalities in smoking may
help reduce inequalities in drinking and distress in adolescence and
early adulthood, and policies increasing access to tertiary education
should consider the deleterious effects on drinking behaviours.


Drug/Alcohol Abuse, Young People, Well Being, Health, and Social Stratification



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