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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Background
Where the U.S. tobacco epidemic still rages: Most remaining smokers have lower socioeconomic status
Levinson, A. H. (2017) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2017.0012 · Cited by 24
Nutrient deficiency and obstetrical outcomes in pregnant women following Roux-en-Y gastric bypass: A retrospective Danish cohort study with a matched comparison group
Hammeken, L. H., Betsagoo, R., Jensen, A. N., Sørensen, A., & Overgaard, C. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.07.016 · Cited by 24
Systematic review of the influence of socioeconomic deprivation on mortality after colorectal surgery
Poulton, T. E., Salih, T., Martin, P., Rojas‐García, A., Raine, R., & Moonesinghe, R. (2018) · British journal of surgery · doi:10.1002/bjs.10848 · Cited by 24
Socio-demographic characteristics are related to the advanced clinical stage of oral cancer
Lins, L. A. N., Bezerra, N., Freire, A. R., Almeida, L., de Lucena, E. H. G., & Cavalcanti, Y. W. (2019) · Medicina oral, patología oral y cirugía bucal · doi:10.4317/medoral.23105 · Cited by 24
Socio‐economic differentials in cannabis use trends in Australia
Chan, G., Leung, J., Quinn, C. A., Weier, M., & Hall, W. (2017) · Addiction · doi:10.1111/add.14010 · Cited by 23
Socioeconomic disparities in smoking are partially explained by chronic financial stress: marginal structural model of older US adults
Parnia, A., & Siddiqi, A. (2019) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2019-213357 · Cited by 23
Silica Dust Exposure Increases Risk for Rheumatoid Arthritis
Wrangel, O., Graff, P., Bryngelsson, I., Fornander, L., Wiebert, P., & Vihlborg, P. (2021) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002281 · Cited by 23
Elevated coffee consumption is associated with a lower risk of elevated liver fibrosis biomarkers in patients treated for chronic hepatitis B (ANRS CO22 Hepather cohort)
Barré, T., Fontaine, H., Ramier, C., Beo, V. D., Pol, S., Carrieri, P., Marcellin, F., Cagnot, C., Dorival, C., Zucman‐Rossi, J., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.016 · Cited by 23
Smoking remains associated with education after controlling for social background and genetic factors in a study of 18 twin cohorts
Silventoinen, K., Piirtola, M., Jelenkovic, A., Sund, R., Tárnoki, Á. D., Tárnoki, D. L., Medda, E., Nisticò, L., Toccaceli, V., Honda, C., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-17536-x · Cited by 24
Factors Associated with Successful Smoking Cessation in Korean Adult Males: Findings from a National Survey.
Kim, Y., & Cho, W. (2014) · PubMed Central · Cited by 23
Tobacco control approaches and inequity—how far have we come and where are we going?
Purcell, K. R., OʼRourke, K., & Rivis, M. (2015) · Health Promotion International · doi:10.1093/heapro/dav075 · Cited by 23
An Argument for Change in Tobacco Treatment Options Guided by the ASAM Criteria for Patient Placement
Williams, J. M., Steinberg, M. L., Kenefake, A., & Burke, M. V. (2016) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000239 · Cited by 23
“Economically disadvantaged individuals are less likely to live in a smoke-free home and are more likely to have friends who smoke (Hiscock et al., 2012).”
Background
Improving Medical Education Using a Sex- and Gender-Based Medicine Lens
Rojek, M. K., & Jenkins, M. (2016) · Journal of Women s Health · doi:10.1089/jwh.2016.5948 · Cited by 23
“20 On a behavioral level, smoking cessation is more difﬁcult for women 21 and physicians have been shown to be less likely to recommend smoking cessation to women.”
Beyond education and income: Identifying novel socioeconomic correlates of cigarette use in U.S. young adults
Villanti, A. C., Johnson, A. L., & Rath, J. M. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.06.019 · Cited by 23
Quality of life and associated factors in patients with chronic Chagas disease
Santos‐Filho, J. C. L., Vieira, M. C., Xavier, I. G. G., Maciel, E. R., Rodrigues, L. F., Curvo, E. O., Pereira, I. M., Quintana, M. D. S. B., da Silva, G. M. S., Veloso, H. H., et al. (2018) · Tropical Medicine & International Health · doi:10.1111/tmi.13144 · Cited by 23
“The negative association between smoking and QoL perception in the environment domain may be related to socioeconomic issues, since smoking prevalence and cigarette consumption are higher among populations with low socioeconomic status [37].”
Background
Behavior analysts in the war on poverty: Developing an operant antipoverty program.
Silverman, K., Holtyn, A. F., & Subramaniam, S. (2018) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000230 · Cited by 23
Sociodemographic Factors in Neovascular Age-Related Macular Degeneration
PATEL, S. N., Wu, C., Obeid, A., Sivalingam, M. D., Gervasio, K. A., Wibbelsman, T. D., Levin, H., Xu, D. N., Regillo, C. D., Hsu, J., et al. (2019) · Ophthalmology · doi:10.1016/j.ophtha.2019.09.038 · Cited by 23
Dietary patterns within educational groups and their association with CHD and stroke in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort
Biesbroek, S., Kneepkens, M., van den Berg, S. W., Fransen, H. P., Beulens, J. W. J., Peeters, P. H. M., & Boer, J. M. A. (2018) · British Journal Of Nutrition · doi:10.1017/s0007114518000569 · Cited by 24
“These were chosen based on their known association with both CVD and SES (28 – 30) .”
12-Month Evaluation of an EHR-Supported Staff Role Change for Provision of Tobacco Cessation Care in 8 Primary Care Safety-Net Clinics
Flocke, S. A., Seeholzer, E. L., Lewis, S., Gill, I. J., Rose, J. C., Albert, E. L., Love, T. E., & Kaelber, D. C. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06030-7 · Cited by 22
Smoking mediates the relationship between SES and brain volume: The CARDIA study
Dougherty, R. J., Moonen, J. E. F., Yaffe, K. S., Sidney, S., Davatzikos, C. A., Habes, M., & Launer, L. J. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239548 · Cited by 23
“A multitude of factors may contribute to the observed SES smoking disparity including access to treatment, social support, motivation, and life stressors [54].”
Background
Social inequalities in tobacco-attributable mortality in Spain. The intersection between age, sex and educational level
Haeberer, M., León-Gómez, I., Pérez‐Gómez, B., Téllez-Plaza, M., Pérez‐Ríos, M., Schiaffino, A., Rodríguez‐Artalejo, F., & Galán, I. (2020) · PLoS ONE · doi:10.1371/journal.pone.0239866 · Cited by 24
“Although smoking rates have been declining in many high-income countries, including Spain, declines have been slower or nonexistent among lower socioeconomic groups so that inequalities in smoking have increased [16].”
BackgroundInfluential
Understanding the consequences of educational inequalities on periodontitis: A Mendelian randomization study
Baumeister, S., Freuer, D., Baurecht, H., Reckelkamm, S. L., Ehmke, B., Holtfreter, B., & Nolde, M. (2021) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13581 · Cited by 25
The Impact of the Covid-19 Pandemic on Smoking Among Vulnerable Populations
Wiley, R. C., Oliver, A. C., Snow, M. B., Bunn, J. Y., Barrows, A. J., Tidey, J. W., Lee, D. C., Sigmon, S. C., Gaalema, D. E., Heil, S. H., et al. (2022) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntac135 · Cited by 22
Socioeconomic determinants of periodontitis
Khajavi, A., Radvar, M., & Moeintaghavi, A. (2022) · Periodontology 2000 · doi:10.1111/prd.12448 · Cited by 24
Intelligence, education level, and risk of Parkinson’s disease in European populations: A Mendelian randomization study
Shi, J., Tian, J., Fan, Y., Hao, X., Li, M., Li, J., Ma, D., Guo, M., Li, S., Xu, Y., et al. (2022) · Frontiers in Genetics · doi:10.3389/fgene.2022.963163 · Cited by 23
“The main reasons they have more difficulty quitting may be that they lack motivation, social support, and adequate resources to purchase nicotine replacement products (McEwen et al., 1997; Hiscock et al., 2012).”
Background
Psychosocial and Demographic Correlates of Drug Use in a Sample of HIV-Positive Adults Ages 50 and Older
Siconolfi, D. E., Halkitis, P. N., Barton, S. C., Kingdon, M. J., Pérez‐Figueroa, R., Arias-Martinez, V., Karpiak, S. E., & Brennan‐Ing, M. (2013) · Prevention Science · doi:10.1007/s11121-012-0338-6 · Cited by 22
“Or, this finding may be attributable to confounding with regard to socioeconomic disparity across the gender/orientation analytic groups we used in analyses (Hiscock et al. 2012; New York State Department of Health 2007).”
Smoking Prevalence and the Association between Smoking and Sociodemographic Factors Using the Korea National Health and Nutrition Examination Survey Data, 2008 to 2010
Kim, S. (2012) · Tobacco Use Insights · doi:10.4137/tui.s9841 · Cited by 22
A pre-post pilot study of a brief, web-based intervention to engage disadvantaged smokers into cessation treatment
Brunette, M. F., Gunn, W. B., Alvarez, H., Finn, P. C., Geiger, P., Ferron, J. C., & McHugo, G. J. (2015) · Addiction Science & Clinical Practice · doi:10.1186/s13722-015-0026-5 · Cited by 23
“likely to smoke than others [4-10], and they experience early morbidity and mortality due to smoking-related diseases [6].”
Background
The relationship between pregnancy intention and change in perinatal cigarette smoking: An analysis of PRAMS data
Chisolm, M. S., Cheng, D., & Terplan, M. (2013) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2013.07.010 · Cited by 22
Cumulative social risk exposure and risk of cancer mortality in adulthood
Caleyachetty, R., Tehranifar, P., Genkinger, J. M., Echouffo-Tcheugui, J. B., & Muennig, P. A. (2015) · BMC Cancer · doi:10.1186/s12885-015-1997-z · Cited by 22
“motivational factors, nicotine dependence) [29].”
Background
The influence of sleep quality on smoking cessation in socioeconomically disadvantaged adults
Peltier, M. R., LEE, J., Ma, P., Businelle, M. S., & Kendzor, D. E. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.11.004 · Cited by 22
The Relationship between Multiple Substance Use, Perceived Academic Achievements, and Selected Socio-Demographic Factors in a Polish Adolescent Sample
Mazur, J., Tabak, I., Dzielska, A., Wąż, K., & Oblacińska, A. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13121264 · Cited by 22
“The expected negative correlation between substance use and family socioeconomic status has been confirmed in adult studies [12].”
Background
Inequalities in smoking prevalence: a missed opportunity for tobacco control in Pakistan
Masud, H., & Oyebode, O. O. (2017) · Journal of Public Health · doi:10.1093/pubmed/fdx044 · Cited by 22
Effect of life‐course family income trajectories on periodontitis: Birth cohort study
Schuch, H. S., Peres, K. G., Demarco, F. F., Horta, B. L., Gigante, D. P., Peres, M. A., & Do, L. (2017) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12845 · Cited by 22
Socio-economic factors associated with an increase in fruit and vegetable consumption: a 12-year study in women from the E3N-EPIC study
Affret, A., Severi, G., Dow, C., Mancini, F. R., Rey, G., Delpierre, C., Clavel‐Chapelon, F., Boutron‐Ruault, M., & Fagherazzi, G. (2017) · Public Health Nutrition · doi:10.1017/s1368980017003196 · Cited by 22
Momentary smoking context as a mediator of the relationship between SES and smoking
Jahnel, T., Ferguson, S. G., Shiffman, S. M., Thrul, J., & Schüz, B. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.12.014 · Cited by 23
Socioeconomic position over the life course from childhood and smoking status in mid-adulthood: results from a 25-year follow-up study
Tian, J., Gall, S., Patterson, K. A. E., Otáhal, P., Blizzard, L., Patton, G. C., Dwyer, T., & Venn, A. (2019) · BMC Public Health · doi:10.1186/s12889-019-6483-0 · Cited by 22
Using a nominal group technique to approach consensus on a resilience intervention for smoking cessation in a lower socioeconomic population
Tsourtos, G., Foley, K. M., Ward, P., Miller, E. R., Wilson, C. J., Barton, C., & Lawn, S. (2019) · BMC Public Health · doi:10.1186/s12889-019-7939-y · Cited by 27
An analysis of the disparity in smoking prevalence between urban and non-urban areas in Japan (2004–2019)
Okui, T. (2020) · Epidemiology and Health · doi:10.4178/epih.e2020072 · Cited by 24
“Furthermore, a lack of social support is also considered to be a causal factor for a lower likelihood of smoking cessation in low-SES groups [10].”
Liquid biopsy-based multi-cancer early detection: an exploration road from evidence to implementation
Xu, Y., Zhu, S., Xia, C., Yu, H., Shi, S., Chen, K., He, Y., Deng, C., Jin, H., Liu, J., et al. (2025) · 中国科学通报：英文版 · doi:10.1016/j.scib.2025.06.030 · Cited by 27
Community-based navigators for tobacco cessation treatment: a proof-of-concept pilot study among low-income smokers
Levinson, A. H., Valverde, P., Garrett, K. M., Kimminau, M., Burns, E. K., Albright, K., & Flynn, D. (2015) · BMC Public Health · doi:10.1186/s12889-015-1962-4 · Cited by 21
“Leading suspected factors include underuse of evidencebased treatment (EBT) [22, 24–27], and chronic exposure to psychosocial stressors without adequate social support or healthy coping strategies.”
Background

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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