Cited by 1,572Smoking Behavior and CessationHealth disparities and outcomesGlobal Cancer Incidence and Screening

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Socioeconomic status and smoking: a review

Hiscock, Rosemary, Bauld, Linda, Amos, Amanda, Fidler, Jennifer A., Munafò, Marcus·2012·Annals of the New York Academy of Sciences

DOI 10.1111/j.1749-6632.2011.06202.x

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Abstract

Smoking prevalence is higher among disadvantaged groups, and disadvantaged smokers may face higher exposure to tobacco's harms. Uptake may also be higher among those with low socioeconomic status (SES), and quit attempts are less likely to be successful. Studies have suggested that this may be the result of reduced social support for quitting, low motivation to quit, stronger addiction to tobacco, increased likelihood of not completing courses of pharmacotherapy or behavioral support sessions, psychological differences such as lack of self‐efficacy, and tobacco industry marketing. Evidence of interventions that work among lower socioeconomic groups is sparse. Raising the price of tobacco products appears to be the tobacco control intervention with the most potential to reduce health inequalities from tobacco. Targeted cessation programs and mass media interventions can also contribute to reducing inequalities. To tackle the high prevalence of smoking among disadvantaged groups, a combination of tobacco control measures is required, and these should be delivered in conjunction with wider attempts to address inequalities in health.

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“(Nishi et al., 2004; Huisman et al., 2005; Kuper et al., 2007; Mackenbach et al., 2008; Tabuchi and Kondo, 2017) Further, in a variety of contexts worldwide, individuals and households with lower levels of education have been shown to be more likely to smoke, less successful at quitting smoking,…”
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Trends in smoking rates among individuals with serious psychological distress: Analysis of data from a Japanese national survey, 2007–2016
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Leppänen, A., Lindgren, P., Sundberg, C. J., Petzold, M., & Tomson, T. (2016) · JMIR Research Protocols · doi:10.2196/resprot.6180 · Cited by 5
“Other influencing factors include targeted marketing by the tobacco industry and lower adherence to treatment [13].”
Background
Racial and Socioeconomic Disparities in Complex Abdominal Wall Reconstruction Referrals
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Ammar, A., Salem, A., Trabelsi, K., Montalván, M., Bouaziz, B., Boujelbane, M. A., Kerkeni, M., Masmoudi, L., Ghazzawi, H., Amawi, A. T., et al. (2026) · Sports · doi:10.3390/sports14050186 · Cited by 4
The Effects of Supplemental Vitamin C in Mandibular Fracture Patients: A Randomized Clinical Trial
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Tax increases as an incentive to quit smoking: is thinking about quitting due to a tobacco tax increase associated with post-tax increase smoking cessation?
Geboers, C., Candel, M. J. J. M., Nagelhout, G. E., van den Putte, B., & Willemsen, M. C. (2024) · BMC Public Health · doi:10.1186/s12889-024-19530-6 · Cited by 4
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“Socioeconomic status has been positively associated with SOC 13 but negatively associated with substance use 14,15 .”
Background
Estimating the Prevalence of and Clarifying Factors Associated With Multiple Tobacco Product Use in Japan: A Cross-sectional Study in 2022
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“37 Considering that MTP use leads to frequent smoking behavior, these associations can be explained by previous studies that have shown the correlation between low education, 30 poor mental health, 31 and smoking.”
Socio‐Economic Evolution and Tobacco Products Sales in Spain: A Long‐Term Analysis of the Tobacco Kuznets Curve
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“These considerations are particularly important since smoking prevalence is higher among economically disadvantaged groups, and lower SES groups have significantly less successful cessation attempts, lower reported motivation to quit, and reduced social support for quitting.(66) Furthermore, our study did not stratify…”
Background
Socioeconomic differences in the motivation to stop using e-cigarettes and attempts to do so
Jahnel, T., Ferguson, S. G., Partos, T., & Brose, L. S. (2020) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2020.100247 · Cited by 4
Socioeconomic inequalities, modifiable lifestyle risk factors, and retinal vessel calibers: The African‐PREDICT Study
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“It also suggests that broader social projects (e.g., alleviating disadvantage and disrupting gender scripts) may have greater long-term impact in reducing young people’s access to tobacco (Hiscock et al., 2012).”
BackgroundInfluentialSelf-citation
Electronic Cigarette Vaping Did Not Enhance the Neural Process of Working Memory for Regular Cigarette Smokers
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“, 2009) and socioeconomic status (Hiscock et al., 2012) but not the personality (Munafo et al.”
Background
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“Stratifying neighborhood deprivation quintiles by urbanity level, the suburb had a greater proportion of the more deprived neighborhoods (Q3–Q5), whereas the urban areas were found to have a greater proportion of less deprived neighborhoods (Q1–Q2) (see Supplementary Appendix 4).”
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Smoking is associated with an increased risk for fractures in women after childbirth: a nationwide population-based cohort study in Finland
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“) leading to a higher number of low-energy fractures (18), or by risky behavior, which has been found to be more common among people of lower socioeconomic status (SES) (12,13), leading to accident-proneness.”
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“We adjusted for 13 factors selected based on the literature (Hiscock et al., 2012; Upson, 2015).”
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“38,39”
Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke
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Fuzzy group fixed-effects estimation with spatial clustering
Cerqueti, R., D’Urso, P., & Mattera, R. (2025) · AStA Advances in Statistical Analysis · doi:10.1007/s10182-024-00522-1 · Cited by 4
“We highlight that smoking rates tend to be lower in urban, highly educated areas, where health awareness is stronger (Hiscock et al. 2012).”
Perceived and internalized smoking stigma among pregnant women: association with smoking reduction, reactance to smoking health warnings, and intention to discuss smoking with health professionals
David, J.-C., Rascle, N., Auriacombe, M., Serre, F., Sutter‐Dallay, A., & Loyal, D. (2025) · Journal of Behavioral Medicine · doi:10.1007/s10865-025-00556-z · Cited by 4
“Of note, because smoking is more widespread among people living in disadvantaged conditions (Gallus et al., 2021; Hiscock et al., 2012) and is often passed down from generation to generation (Alves et al., 2022; Melchior et al., 2010), it is a major contributor to the perpetuation of social…”
The link between tobacco smoking and susceptibility to misinformation
Piksa, M., Zaniewska, M., Cieslik-Starkiewicz, A., Kunst, J. R., Morzy, M., Piasecki, J., & Ryguła, R. (2025) · Psychopharmacology · doi:10.1007/s00213-025-06802-1 · Cited by 4
Is the provision of a national opt-out tobacco dependence treatment service in acute hospitals in England equitable? A national cohort study
Agrawal, S., Corte, P. C. L., Frost, T., Hodgson, J., Phagura, R., Adamson, A., & Quint, J. K. (2025) · Thorax · doi:10.1136/thorax-2025-223890 · Cited by 4
“19 20 36 37 40 The quit rate of 20.2% for this hospital population was lower than people who actively seek out treatment of tobacco dependency from community stop smoking services, 41 but similar to other hospital-based observational studies of smoking cessation intervention, 22 24 largely…”
Influential
Promoting pre-quit physical activity to reduce cue reactivity among low-income sedentary smokers: A randomized proof of concept study
Nair, U. S., Collins, B. N., Patterson, F., & Rodriguez, D. (2015) · Contemporary Clinical Trials · doi:10.1016/j.cct.2015.03.002 · Cited by 4
“However, uptake of pharmacotherapy is low and standard care advice/self-help materials are not adequately tailored or intensive for underserved populations [20–22].”
Background
What Explains Socioeconomic Differences in the Speed of Heart Rate Recovery to Postural Challenge?
McCrory, C., Berkman, L. F., Moore, P., & Kenny, R. A. (2017) · The Journals of Gerontology Series A · doi:10.1093/gerona/glx060 · Cited by 4
“Smoking is strongly socially patterned and individuals from lower socioeconomic backgrounds are not only more likely to smoke but they also tend to smoke at a greater intensity (25).”
BackgroundInfluential
Gender related issues
Doğan, H. Ö., & Piyal, B. (2017) · Türkiye Halk Sağlığı Dergisi · doi:10.20518/tjph.341173 · Cited by 4
School-level disadvantage and failed cessation treatment among adolescent smokers
Horn, K. A., Ali, M., Gray, T. R., Anesetti‐Rothermel, A., & Branstetter, S. A. (2018) · Tobacco Prevention & Cessation · doi:10.18332/tpc/87074 · Cited by 4
Perception of Lay People Regarding Determinants of Health and Factors Affecting It: An Aggregated Analysis from 29 Countries.
(2015) · PubMed Central · Cited by 8

Authors: Hiscock, R., Bauld, L., Amos, A., Fidler, J. A., & Munafò, M.
Affiliations: University of Bath (GB)
University of Stirling (GB)
University of Edinburgh (GB)
University College London (GB)
Corresponding author: Hiscock, Rosemary
ORCID: Hiscock, Rosemary
Bauld, Linda
Amos, Amanda
Venue: Annals of the New York Academy of Sciences
Publisher: Wiley
Published: 2011-11-17
Volume: 1248
Issue: 1
Pages: 107-123
ISSN: 0077-8923 (ISSN-L)
1749-6632
DOI: 10.1111/j.1749-6632.2011.06202.x
OpenAlex: W1948861157
Cited by: 1,572
References: 147
Citations by year: 2026: 100 · 2025: 125 · 2024: 119 · 2023: 124 · 2022: 132 · 2021: 138 · 2020: 124 · 2019: 147 · 2018: 110 · 2017: 111 · 2016: 104 · 2015: 103 · 2014: 69 · 2013: 44 · 2012: 18
FWCI: 4.49
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Annals of the New York Academy of Sciences (publishedVersion)
PubMed (publishedVersion)
Stirling Online Research Repository (University of Stirling) (publishedVersion)
Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
Bristol Research (University of Bristol) (submittedVersion)
Funders: Cancer Research UK
British Heart Foundation
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
Keywords: socioeconomic status, smoking, health disparities, tobacco control, smoking cessation, tobacco industry marketing, self-efficacy, tobacco pricing, mass media interventions, disadvantaged groups
MeSH terms: Smoking Prevention, Humans, Poverty, Smoking, Social Support, Socioeconomic Factors, Substance Withdrawal Syndrome, Tobacco Use Disorder, Smoking Cessation, Health Status Disparities

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Socioeconomic status and smoking: a review

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