Socioeconomic and gender inequalities in smoking. Findings from the Czech National Tobacco Surveys 2012-2015.

ABSTRACT

OBJECTIVE: Smoking significantly affects morbidity and mortality of the population. The incidence of smoking is determined by gender and socioeconomic status (SES) of an individual. The aim of this study is to analyse the relationship between gender and SES indicators and smoking. METHODS: The analysis is based on data from the Czech National Tobacco Surveys from 2012 to 2015 (N∼1,800 per year). The prevalence of smoking, average daily consumption of cigarettes, initiation ratio and quit ratio were monitored. Smoking habits of the respondents were surveyed using the Czech version of the standard Tobacco Questions for Surveys (TQS) questionnaire. SES was measured by a composite index comprising three variables (level of education, income and job prestige); it had four categories low, lower-middle, upper-middle, and high. RESULTS: In comparison with women, men had a higher smoking prevalence (OR=1.41, 95% CI=1.09-1.84), higher consumption of cigarettes (B=4.11, 95% CI=1.97-6.26), and higher rate of smoking initiation (OR=1.38, 95% CI=1.10-1.74), but they did not differ in the quit rate (OR=0.85, 95% CI=0.60-1.21). Persons in the low SES category had higher prevalence of smoking and higher initiation ratio compared with those in the high SES category (OR=2.59, 95% CI=1.36-4.97; OR=2.23, 95% CI=1.26-3.95). Cigarette consumption and quit ratio did not differ according to SES. The prevalence of smoking in the years 2012-2014 did not differ; in 2015, it was lower compared to the previous three years. CONCLUSIONS: Inequalities in socioeconomic status affect smoking, which significantly contributes to morbidity and mortality. Measures aimed at reducing inequalities in health must take into account both smoking as a risk factor and socioeconomic status, which affects its occurrence. Programmes to reduce tobacco use should reflect the different needs of individuals with different SES levels. It is especially necessary to seek effective approaches for smokers with low socioeconomic status.