Trends in socioeconomic inequalities in smoking prevalence, consumption, initiation, and cessation between 2001 and 2008 in the Netherlands. Findings from a national population survey

Abstract

BackgroundWidening of socioeconomic status (SES) inequalities in smoking prevalence has occurred in several Western countries from the mid 1970’s onwards. However, little is known about a widening of SES inequalities in smoking consumption, initiation and cessation.MethodsRepeated cross-sectional population surveys from 2001 to 2008 (n ≈ 18,000 per year) were used to examine changes in smoking prevalence, smoking consumption (number of cigarettes per day), initiation ratios (ratio of ever smokers to all respondents), and quit ratios (ratio of former smokers to ever smokers) in the Netherlands. Education level and income level were used as indicators of SES and results were reported separately for men and women.ResultsLower educated respondents were significantly more likely to be smokers, smoked more cigarettes per day, had higher initiation ratios, and had lower quit ratios than higher educated respondents. Income inequalities were smaller than educational inequalities and were not all significant, but were in the same direction as educational inequalities. Among women, educational inequalities widened significantly between 2001 and 2008 for smoking prevalence, smoking initiation, and smoking cessation. Among low educated women, smoking prevalence remained stable between 2001 and 2008 because both the initiation and quit ratio increased significantly. Among moderate and high educated women, smoking prevalence decreased significantly because initiation ratios remained constant, while quit ratios increased significantly. Among men, educational inequalities widened significantly between 2001 and 2008 for smoking consumption only.ConclusionsWhile inequalities in smoking prevalence were stable among Dutch men, they increased among women, due to widening inequalities in both smoking cessation and initiation. Both components should be addressed in equity-oriented tobacco control policies.

Socioeconomic Inequality in the Prevalence of Smoking and Smokeless Tobacco use in India

“…In line with previous studies, (Eek et al, 2012;Harper and Kinnon, 2012;Hosseinpoor et al, 2012;Nagelhout et al, 2012;Palpudi et al, 2012) we found that respondents with lower education and income were more likely to consume tobacco than respondents with higher education and income. Study utilizing data from GATS-India highlighted total tobacco consumption in rural areas of country to be 38.4% compared to urban areas with smoking prevalence of 25.3% (Bhawna, 2013).…”

“…However, in a big country like India there are variations across states and regions. More often studies in the past have combined both forms of tobacco use for analysis (Harper and Kinnon, 2012;Palipudi et al, 2012) or have measured the smoking tobacco consumption only (Eik et al, 2010;Hosseinpoor et al, 2012;Nagelhout et al, 2012). They need to be analyzed separately as smokeless tobacco consumption is a major problem in India.…”

Trends in smoking initiation in Canada: Does non-inclusion of young adults in tobacco control strategies represent a missed opportunity?

“…21 This issue remains critically important in light of the deficient evidence on interventions able to reliably reduce smoking-related inequalities 22,23 and the widening of inequalities in smoking initiation over time. [24][25][26] Consistent with an increasing amount of research on young adult initiation, [10][11][12][13] we found that proportions of initiation made during young adulthood had not decreased in our retrospective cohorts between 2001 and 2013. This means that initiation during young adulthood also represented a progressively larger proportion of initiation behaviour, which is in stark contrast with the first reports to study this issue.…”

“…These include school-based and community interventions, anti-smoking media campaigns, tobacco advertising restrictions, and youth access restrictions. 2,3 Certain public health institutions, including the Surgeon General's Office 4 and the Institute of Medicine, 5 have proposed to extend this age bracket up to 25 years of age and establish new priorities specific to the young adult (18)(19)(20)(21)(22)(23)(24)(25) age group. In Canada, cigarette smoking prevalence is now highest among young adults.…”

Long-Term Results of Smoking Cessation Therapy

“…[33][34][35][36][37] In the Global Adult Tobacco Survey conducted in Turkey, a low level of education and a low socioeconomic level were shown to influence smoking. 38 Although not statistically significant, our results showed that patients with a primary level of education remained cigarette-free shorter when compared to those with higher education (50.45 ± 5.6 months compared to 58.3 ±5.56).…”