Educational differences in smoking: international comparison

Abstract

dementia in general to any substantial extent. If anything, persistent smoking may increase rather than decrease the onset rate of dementia, but any net effect on severe dementia cannot be large in either direction.We thank the British doctors some of whom have continued to collaborate in this prospective study of their health for almost half a century, Robert Clarke, Rory Collins, and Christina Davies for their comments, and Cathy Harwood and Gale Mead for preparing the manuscript.Contributors: RD planned the study, IS has for many years conducted it, and RD, RP, and JB planned and conducted the present analyses. RD and RP prepared the report; they will act as guarantors for the paper.Funding: The Medical Research Council has supported the study since 1951 and continues to do so through direct support of the Clinical Trial Service Unit and Epidemiological Studies Unit, helped by the Imperial Cancer Research Fund and British Heart Foundation.Competing interests: None declared. Main outcome measures Relative differences (odds ratios) and absolute differences in the prevalence of ever smoking and current smoking for men and women in each age group by educational level. Results In the 45 to 74 year age group, higher rates of current and ever smoking among lower educated subjects were found in some countries only. Among women this was found in Great Britain, Norway, and Sweden, whereas an opposite pattern, with higher educated women smoking more, was found in southern Europe. Among men a similar north-south pattern was found but it was less noticeable than among women. In the 20 to 44 year age group, educational differences in smoking were generally greater than in the older age group, and smoking rates were higher among lower educated people in most countries. Among younger women, a similar north-south pattern was found as among older women. Among younger men, large educational differences in smoking were found for northern European as well as for southern European countries, except for Portugal. Conclusions These international variations in social gradients in smoking, which are likely to be related to differences between countries in their stage of the smoking epidemic, may have contributed to the socioeconomic differences in mortality from ischaemic heart disease being greater in northern European countries. The observed age patterns suggest that socioeconomic differences in diseases related to smoking will increase in the coming decades in many European countries. IntroductionSocioeconomic inequalities in health have been found in all countries where data are available, and there is an Until now only a few studies have compared the magnitude of socioeconomic differences in smoking between countries. [5][6][7] The most comprehensive comparison described differences in prevalence of smoking by educational level in the United Kingdom, Finland, Sweden, Norway, and France around 1987. 6 In all these countries, lower educated people smoked more than higher educated people. The largest differences were observed in ...

Impact of the financial crisis on COPD burden: Greece as a case study

“…Specifically, the prevalence of smoking was quite low among the population aged ⩾65 years before the crisis and this has not changed in recent years [1]. Furthermore, according to a study conducted in the midst of the crisis, the prevalence of current smoking was found to increase with higher levels of education, especially in women, which is in contrast to the patterns of smoking in the West [67,71]. It is well known that in the western social context smoking is more prevalent among individuals with lower education [67,71].…”

“…Furthermore, according to a study conducted in the midst of the crisis, the prevalence of current smoking was found to increase with higher levels of education, especially in women, which is in contrast to the patterns of smoking in the West [67,71]. It is well known that in the western social context smoking is more prevalent among individuals with lower education [67,71]. The data from RACHIOTIS et al [67] supported the findings that in western countries lower educated people smoked more than higher educated people.…”

Changes Over Time in Absolute and Relative Socioeconomic Differences in Smoking: A Comparison of Cohort Studies From Britain, Finland, and Japan

“…The patterning of smoking over time is further shaped by macro level national developments, such as economic fluctuations and social structural transformations, [11][12][13] as well as individual level sociodemographic and health-related factors. [14][15][16] The epidemic model finds support from western time trend studies suggesting that socioeconomic differences in smoking remain or even widen, [8][9][10]17 and it offers a framework and context for examining socioeconomic differences in smoking over time and across countries. Longitudinal studies following the same participants are, nevertheless, lacking although they would add to our understanding of the dynamics of both relative and absolute socioeconomic differences in smoking.…”

“…The epidemic model has been extended to include also socioeconomic differences. [8][9][10] At the early stages, the upper classes are the first to take up smoking, but over time the habit spreads disproportionately to the lower classes, with emerging socioeconomic differences. The patterning of smoking over time is further shaped by macro level national developments, such as economic fluctuations and social structural transformations, [11][12][13] as well as individual level sociodemographic and health-related factors.…”

Population-Based Study on the Prevalence of Spirometric Obstructive Pattern in Porto, Portugal

“…Contrasting with the decline in smoking habits among men in most European countries, 33 previous studies have placed Portugal at an earlier stage (transition between stage 2 and 3) of the smoking epidemic, the prevalence being higher in men and in more educated women. [34][35][36] Additionally, there is an increasing body of evidence supporting the existence of sex differences in genetic susceptibility to air-flow obstruction and COPD.…”