Socioeconomic distribution of smoking in a population of 10 529 New Zealanders
Whitlock G., MacMahon S., Vander Hoorn S., Davis P., Jackson R., Norton R.
Aims. This study aimed to investigate the associations of several smoking variables with socioeconomic status. Methods. Cross-sectional analyses of data about smoking behaviour and socioeconomic status (education, occupation and neighbourhood income) were performed using baseline data from the Fletcher Challenge-University of Auckland Heart and Health Study (10 529 participants). Results. After adjustment for age and sex, lower educational level was associated with: (1) higher frequency of ever having smoked (65% of participants who had attended secondary school for fewer than two years, versus 43% of participants who had attended university; 2p<0.0001); (2) lower likelihood of having quit (46% versus 71%; 2p<0.0001); (3) higher likelihood of being a current smoker (35% versus 12%; 2p<0.0001); (4) higher tobacco consumption per smoker (13 manufactured cigarettes/day versus 8 manufactured cigarettes/day; 2p<0.0001); and (5) higher tobacco consumption per participant (1980 cigarette-equivalents/year versus 450 cigarette-equivalents/year; 2p<0.0001). Similar, but shallower, associations of these smoking variables were observed with occupation and neighbourhood income (with the exception that tobacco consumption per smoker was not associated with neighbourhood income). The socioeconomic gradients of tobacco consumption per study participant with all three socioeconomic indicators were particularly steep among younger participants, men and Maori. Conclusions. Participants of low socioeconomic status consumed a disproportionately large amount of tobacco. Policies that prevent smoking initiation and promote smoking cessation in low socioeconomic groups are therefore needed. These should include targeting of mass media messages to low socioeconomic groups, public subsidisation of nicotine replacement therapy and higher taxes on tobacco.