BACKGROUND-AIM:
Tobacco smoking and alcohol drinking are the major causes of premature and cancer mortality, especially in men. Epidemiological studies show that dual use of cigarettes and alcohol is particularly dangerous to health, especially when continued long-time and in high doses. Sociodemographic and cultural factors strongly influence on the prevalence and behavioural patterns of smoking and alcohol drinking. This paper is aimed to o evaluate the role of sociodemographic inequalities in cigarette smoking, alcohol drinking and dual use of these psychoactive substances among Polish farmers.

METHODS:
A questionnaire survey on health conditions, disease treatment and health behaviours was conducted among 612 farmers who were participating in 21-day rehabilitation courses organised between August 2021 and September 2022 by the Farmer’s Rehabilitation Centre in Jedlec, western part of Poland. Majority of study subjects were women, farmers at middle age (50-59 years old) and with low education. Cross-sectional statistical univariate analysis (by sex, age and level of education) of current cigarette smoking, current alcohol drinking and dual current use of cigarettes and alcohol was based on results of Pearson’s and Cramer’s chi-square tests with the use the IBM SPSS Statistics Package.

RESULTS:
The prevalence of current cigarette smoking was significantly associated with age of farmers (p=0.003), especially in women where smoking rates were lowering with age (from 13.3% among women aged up to 49 to 2.9% among women aged 60 and over). Differences in smoking rates in gender and educational groups were not statistically significant. Alcohol drinking was strongly and significantly associated with gender, age and level of education. Men drunk alcohol very often and two times more often (51.1%) than women (20.9%). In men, alcohol drinking rates were the highest in oldest farmers (47.1%) and decreasing with their education (from 25.1% in low educated to 18.6% in highly educated). In women, alcohol drinking prevalence was decreasing with age and the highest among those with moderate education (16.4%). Dual use of cigarettes and alcohol was significantly associated with all analysed sociodemographic variables. Almost one of ten farmers was dual user of cigarettes and alcohol while one of two was dual abstainer. More dual users were found among men, oldest subjects and low educated persons whereas dual abstinence was more frequent among women, at middle age and among farmers with the highest education.

CONCLUSIONS:
Cigarette smoking, alcohol drinking and dual use of both psychoactive substances are strongly determined by sociodemographic status of farmers. To effectively reach vulnerable populations such farmers, where access to health education and health care settings seems to be lower and health illiteracy at higher level than in towns, tobacco and alcohol prevention and cessation programs should address demographic and social inequalities.