Association between tobacco and alcohol use among young adult bar patrons: a cross-sectional study in three cities
1 School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, Room A5-08 21 Sassoon Road, Hong Kong, People’s Republic of China
2 Public Health and Environment Division, RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
3 Center for Tobacco Control Research and Education and Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA
BMC Public Health 2014, 14:500 doi:10.1186/1471-2458-14-500Published: 24 May 2014
Bars and nightclubs are key public venues where young adults congregate and use both tobacco and alcohol, and young adult bar patrons are at high risk for substance use. This study examined the association between cigarette smoking and alcohol use among a random sample of young adult bar patrons from three different cities in the USA.
Cross-sectional data was collected from a random sample of young adult bar patrons aged 18–29 in San Diego, CA (N = 1,150), Portland, ME (N = 1,019), and Tulsa, OK (N = 1,106) from 2007–2010 (response rate 88%) using randomized time location sampling. Respondents reported the number of days they smoked cigarettes, drank alcohol, and binge drank in the past 30 days. Multinomial logistic regression was used to analyze the association between smoking (nonsmoker, occasional smoker, and regular smoker) and drinking and binge drinking for each city controlling for age, gender, race/ethnicity, and education. Predicted probabilities of each smoking category were calculated by drinking and binge drinking status. The association between smoking and drinking and binge drinking among combined samples was also analyzed, controlling for demographic variables and city.
Respondents reported high current smoking rates, ranging from 51% in Portland to 58% in Tulsa. Respondents in Tulsa were more likely to report regular smoking than those in San Diego and Portland, with demographic variables being controlled. Young adult bar patrons also exhibited a strong association between smoking and drinking. In general, as the frequency of drinking and binge drinking increased, the predicted probability of being a smoker, especially a regular smoker, increased in each city.
Young adult bar patrons consistently reported a high smoking rate and a strong relationship between smoking and drinking, regardless of the different bar cultures and tobacco control contexts in each of the three cities. While smoke-free bar policies were negatively associated with regular smoking, these policies alone may not be enough to influence the association between smoking and drinking, particularly if tobacco marketing continues in these venues, or in the absence of programs specifically addressing the co-use of tobacco and alcohol.