6.6 The association between addiction and socio–economic status
Show / hide chapter menu
In developed countries with well-developed tobacco control policies, smoking prevalence is1,2 and has for many years been3–7 higher among those with lower socio-economic status (SES). International research strongly suggests that levels of tobacco addiction are also greater among lower SES smokers.8,9 Data from the 2010 National Drug Strategy Household Survey2 indicates substantially higher numbers of reported cigarettes smoked each day among those with more limited educational qualifications; the unemployed compared to those in the labour force; the divorced, separated or widowed compared to those married; those of Aboriginal or Torres Strait Islander backgrounds; those living in regional compared to cities; and those living in more socially disadvantaged areas: refer to Table 6.6.1.
Comparisons of nicotine dependence in smokers in Australia, the UK, Canada and the US9 showed that in all countries, smokers of lower socio-economic status had higher levels of nicotine dependence and were less likely to make a quit attempt.10
These findings are consistent with evidence that social disadvantage is linked with higher levels of stress, relief of which is commonly given as a reason for smoking (see Chapter 9). Smokers with lower levels of education are also more likely to be less confident about their capacity to quit (lower levels of self-efficacy) than more highly educated smokers; they are also less likely to report an intention to quit.9 These findings have important implications for cessation programs, which are discussed in Chapter 7 and Chapter 9.
Table 6.6.1
Mean number of cigarettes smoked per week— by social characteristics, by sex, 2010, current smokers aged 14 years or older, (number)
|
Males |
Females |
Persons |
|
|
All persons |
108.6 |
96.9 |
103.2 |
|
Education |
|||
|
With post-school qualifications |
99.6 |
88.4 |
95.0 |
|
Without post-school qualifications |
120.3 |
104.4 |
112.2 |
|
Labour force status |
|||
|
Currently employed |
102.4 |
88.5 |
96.9 |
|
Student |
50.5 |
56.1 |
53.3 |
|
Unemployed |
140.0 |
104.6 |
125.3 |
|
Engaged in home duties |
131.1 |
99.9 |
101.5 |
|
Retired or on a pension |
121.0 |
121.7 |
121.3 |
|
Unable to work |
167.8 |
125.5 |
145.8 |
|
Other |
142.7 |
121.2 |
128.3 |
|
Main language spoken at home |
|||
|
English |
112.4 |
96.9 |
105.1 |
|
Other |
65.1 |
62.3 |
64.5 |
|
Socio-economic status |
|||
|
1st quintile (lowest status) |
132.3 |
113.5 |
123.4 |
|
2nd quintile |
113.0 |
107.0 |
110.4 |
|
3rd quintile |
109.5 |
87.9 |
99.6 |
|
4th quintile |
91.4 |
91.8 |
91.5 |
|
5th quintile (highest status) |
74.0 |
66.1 |
70.3 |
|
Geography |
|||
|
Major cities |
97.0 |
91.2 |
94.5 |
|
Inner regional |
126.5 |
100.8 |
113.5 |
|
Outer regional |
124.6 |
116.6 |
120.9 |
|
Remote and very remote |
161.3 |
111.8 |
140.7 |
|
Marital status |
|||
|
Never married |
104.0 |
85.1 |
95.9 |
|
Divorced/separated/widowed |
138.7 |
119.8 |
127.6 |
|
Married/de facto |
104.3 |
92.9 |
99.2 |
|
Household composition |
|||
|
Single with dependent children |
136.9 |
105.7 |
110.8 |
|
Couple with dependent children |
99.2 |
90.7 |
95.4 |
|
Parent with non-dependent children |
119.3 |
120.6 |
119.9 |
|
Single without children |
114.6 |
104.0 |
110.5 |
|
Couple without children |
107.9 |
94.5 |
102.2 |
|
Other |
100.7 |
77.8 |
90.7 |
Note: Base is current (daily, weekly and less than weekly) smokers
Source: 2010 National Drug Strategy Household Survey2
References
1. Siahpush M. Socioeconomic status and tobacco expenditure among Australian households; results from the 1998–99 Household Expenditure Survey. Journal of Epidemiology and Community Health 2003;57(10):798–801. Available from: http://jech.bmj.com/cgi/content/abstract/57/10/798
2. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145. Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2
3. White V, Hill D, Siahpush M and Bobevski I. How has the prevalence of cigarette smoking changed among Australian adults? Trends in smoking prevalence between 1980 and 2001. Tobacco Control 2003;12(suppl. 2):ii67–74. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/12/suppl_2/ii67
4. Marsh A and McKay S. Poor smokers. London: Policy Studies Institute, 1994.
5. Australian Bureau of Statistics. 4831.055.001 Tobacco smoking in Australia: a snapshot. Canberra: ABS, 2006 Last modified 15 September 2006, viewed September 2007. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4831.0.55.001
6. Clayton RR. The Tobacco Research Network on Disparities (TReND). Journal of Epidemiology and Community Health 2006;60(suppl. 2):S3–S4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17708003
7. Lopez A, Collishaw N and Piha T. A descriptive model of the cigarette epidemic in developed countries. Tobacco Control 1994;3(4):242–7. Available from: http://tobaccocontrol.bmj.com/content/3/4.toc
8. Bobak M, Jarvis MJ, Skodova Z and Marmot M. Smoke intake among smokers is higher in lower socioeconomic groups. Tobacco Control 2000;9(3):310–2. Available from: http://tobaccocontrol.bmj.com/cgi/reprint/9/3/310.pdf
9. Siahpush M, McNeill A, Borland R and Fong GT. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: findings from the International Tobacco Control (ITC) Four Country Survey. Tobacco Control 2006;15(suppl. 3):iii71–5. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16754950
10. Reid JL, Hammond D, Boudreau C, Fong GT and Siahpush M. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the International Tobacco Control Four Country Survey. Nicotine and Tobacco Research 2010;12 (suppl.):S20–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20889477
Copyright © 2013 The Cancer Council. All rights reserved.