Poor more likely to smoke and less likely to quit

Men and women from poorer backgrounds are more likely to smoke and less likely to give up the habit, a new study has found.

The annual quit rate among professional and managerial women in their 20s and 30s is almost twice that among those from unskilled manual backgrounds, says a study in the Journal of Public Health (2004:26:13-8).

Men were more likely to have smoked, but they were more likely to have given up by the age of 41, the study showed.

The prospective study was based on the smoking history and socioeconomic status of 10 500 men and women in the United Kingdom who have been monitored since 1958.

The authors looked at the reported smoking habits of the cohort and data on social class at birth and at age 23.

The results show that 40% of men and 38% of the women smoked at the age of 23. But around 30% of women from professional and managerial backgrounds at birth were current smokers at this age compared with almost half (47%) of those from unskilled manual backgrounds.

The authors, from London’s Institute of Child Health, the University of Lancaster, and the Hebrew University, Jerusalem, say that over time, clear social gradients were found in current smoking.

“At each time point, cohort members from manual and unskilled manual backgrounds were more likely to be current smokers than their counterparts from non-manual and professional backgrounds,” they wrote.

And they found clear social differences in annual quit rates. Between the ages of 23 and 33, the quite rate among men from a professional or managerial class at birth was 4% a year, whereas among those from unskilled manual backgrounds the rate was 2.9%.

By the age of 41, half of the cohort had smoked regularly at some point in their lives, the authors found, and just over a quarter were current smokers into their 40s. Very few people started smoking after the age of 23.

“Smoking prevalence declined as the cohort members moved through their twenties and thirties and into their forties. However, the decline was achieved at the cost of widening socio-economic differentials, captured in measures of both childhood and adulthood social class. This finding underlines the fundamental role of socio-economic position in shaping smoking behaviour,” wrote the authors.

They concluded that tobacco control policies should be widened to include tackling the socioeconomic circumstances linked to smoking from adolescence throughout adulthood.

Roger Dobson
BMJ. 2004 April 17; 328(7445): 914.
doi: 10.1136/bmj.328.7445.914-e.