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Socioeconomic status and smoking: a review
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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“More disadvantaged clients were less likely to remain abstinent from smoking at 1 year, as our previous work and that of others has shown.18,91,92”
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“37 Those who live at or below the poverty line may benefit from targeted approaches that address the emotional, financial, and social stressors of poverty.”
Skýbová, D., Šlachtová, H., Tomášková, H., Dalecká, A., & Maďar, R. (2021) · Medycyna Pracy · doi:10.13075/mp.5893.01139 · Cited by 18
“In terms of prevalence, higher prevalence was observed in disadvantaged groups whose smokers may face higher risk [10].”
BackgroundSreeramareddy, C. T., & Manoharan, A. (2021) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntab269 · Cited by 18
Steinberg, N., Parisi, J. M., Feger, D. M., Clay, O. J., Willis, S. L., Ball, K., Marsiske, M., Harrell, E. R., Sisco, S. M., & Rebok, G. W. (2022) · Journal of Aging and Health · doi:10.1177/08982643221102718 · Cited by 18
“This is further supported by less access to resources (e.g., gym facilities, community centers) necessary to maintain good health and prevent the adoption of harmful health behaviors within rural communities (Haq & Penning, 2020; Hiscock et al., 2012; Smith & Goldman, 2007; Wister, 1996).”
BackgroundWang, Y., Wen, X., Liang, W., & Lin, X. (2022) · Food Quality and Preference · doi:10.1016/j.foodqual.2022.104766 · Cited by 18
Vogel, E. A., Barrington‐Trimis, J. L., Harlow, A. F., Wong, M. K., Cho, J., Han, D., Leventhal, A. M., & Tackett, A. P. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107387 · Cited by 19
Getz, V., Munkhaugen, J., Lie, H. C., & Dammen, T. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1060701 · Cited by 20
“Research has suggested that the smoking population today is largely an underserved group characterized by low socioeconomic status and with limited personal resources to facilitate cessation (Cavelaars et al., 2000; Laaksonen et al., 2005; Hiscock et al., 2012).”
BackgroundTrends in cross-border and illicit tobacco purchases among people who smoke in England, 2019–2022
Jackson, S. E., Cox, S., & Brown, J. (2023) · Tobacco Control · doi:10.1136/tc-2023-057991 · Cited by 18
Zhang, J., Wurzel, D. F., Perret, J. L., Lodge, C., Walters, E. H., & Dharmage, S. C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082413 · Cited by 25
Moore, K., Borland, R., Yong, H., Siahpush, M., Cummings, K. M., Thrasher, J. F., & Fong, G. T. (2012) · International Journal of Public Health · doi:10.1007/s00038-012-0378-5 · Cited by 18
“There are also suggestions that they have lower levels of support to quit from friends and relatives, and in some cases health providers (Hiscock et al. 2012) and that the choice to continue to smoke may reflect a perception among disadvantaged populations of poorer life chances (Lawlor et al.…”
Evaluating the Postpartum Maternal Health Clinic: How Patient Characteristics Predict Follow-Up
Nowik, C. M., Pudwell, J., & Smith, G. N. (2016) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2016.05.005 · Cited by 20
Geographical Variations and Trends in Major Cancer Incidences throughout Korea during 1999-2013
Won, Y., Jung, K., Oh, C., Park, E., Kong, H., Lee, D. H., Lee, K. H., & Registries, T. C. O. P.-B. R. C. (2018) · Cancer Research and Treatment · doi:10.4143/crt.2017.411 · Cited by 18
Adolescent Tobacco Uptake and Other Substance Use: A Latent Class Analysis
Delk, J., Carey, F. R., Case, K. R., Creamer, M. R., Wilkinson, A. V., Perry, C. L., & Harrell, M. B. (2018) · American Journal of Health Behavior · doi:10.5993/ajhb.43.1.1 · Cited by 18
Tobacco Smoking, Substance Use, and Mental Health Symptoms in People with HIV in an Urban HIV Clinic
Miles, D. R. B., Bilal, U., Hutton, H. E., Lau, B. M., Lesko, C. R., Fojo, A. T., McCaul, M. E., Keruly, J. C., Moore, R. D., & Chander, G. (2019) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2019.0075 · Cited by 18
“…tobacco smoking with excess morbidity and mortality among PWH, it is essential to develop cessation interventions that are tailored for low-income and minority PWH. 17,29 Ideally, these interventions would also account for sex differences in initiation/ re-initiation and cessation of tobacco use.”
InfluentialFlocke, S. A., Seeholzer, E. L., Lewis, S. A., Gill, I. J., Ordillas, E., Rose, J. C., Albert, E. L., Love, T. E., & Kaelber, D. C. (2019) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/j.jcjq.2019.09.003 · Cited by 18
Explaining the social gradient in smoking and cessation: the peril and promise of social mobility
Thirlway, F. (2019) · Sociology of Health & Illness · doi:10.1111/1467-9566.13039 · Cited by 22
Attention-deficit/hyperactivity disorder and smoking habits in pregnant women
Andersson, A., Hegvik, T., Chen, Q., Rosenqvist, M. A., Kvalvik, L. G., Almqvist, C., D'Onofrio, B. M., Hartman, C. A., Klungsøyr, K., Haavik, J., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0234561 · Cited by 19
“Socioeconomic Status (SES) has been shown to be associated with both smoking [28] and ADHD [29] with lower SES being associated with higher smoking rates [30], and smoking cessation less likely to be successful [31].”
BackgroundFervaha, G., Izard, J., Tripp, D. A., Aghel, N., Shayegan, B., Klotz, L. H., Niazi, T. M., Fradet, V., Taussky, D., Lavallée, L. T., et al. (2020) · Canadian Urological Association Journal · doi:10.5489/cuaj.6912 · Cited by 18
Ye, X., Zhu, D., & He, P. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1935459 · Cited by 18
The impact of smoke-free legislation on educational differences in birth outcomes
McKinnon, B., Auger, N., & Kaufman, J. S. (2015) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2015-205779 · Cited by 18
Acculturation and smoking in North Americans of Chinese ancestry: A systematic review
Gotay, C. C., Reid, M. S., Dawson, M. Y., & Wang, S. (2015) · Canadian Journal of Public Health · doi:10.17269/cjph.106.4762 · Cited by 18
Clare, P. J., Slade, T. N., Courtney, R. J., Martire, K. A., & Mattick, R. P. (2014) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntu119 · Cited by 18
Bhattacharya, A., Vilardaga, R., Kientz, J. A., & Munson, S. A. (2017) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3025453.3025725 · Cited by 21
“Unemployment, homelessness, lack of insurance, and lack of access to healthcare are some socio-economic barriers individuals face in accessing resources to quit smoking [28].”
BackgroundLee, Y., & Lee, K.-S. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220241 · Cited by 18
Eick, S. M., Meeker, J. D., Brown, P., Swartzendruber, A. L., Rios-McConnell, R. E., Shen, Y., Milne, G. L., Vega, C. V., Rosario, Z., Alshawabkeh, A. N., et al. (2019) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2019.07.032 · Cited by 19
Martinez, O. P., Storo, K. E., Provenzano, Z., Murphy, E., Tomita, T. M., & Cox, S. (2023) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2023.08.130 · Cited by 18
Borrelli, B., Rueras, N., & Jurasic, M. M. (2019) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz144 · Cited by 17
Tjora, T., Skogen, J. C., & Sivertsen, B. (2020) · BMC Public Health · doi:10.1186/s12889-020-09604-6 · Cited by 22
“Now, the trend of smoking cessation seems to be spreading in a similar manner [13], meaning that the “early adopters” have taken on the cessation trend first, as they did the smoking trend decades ago, further reinforcing the widely documented social gradient in smoking [10].”
BackgroundResultPublic opinion on implementing the National Lung Cancer Screening Program in Korea
Park, J., Lee, J., & Kim, Y. (2021) · Translational Lung Cancer Research · doi:10.21037/tlcr-20-865 · Cited by 17
“This is in line with data from other countries, reporting that smoking rates are higher among people with lower socioeconomic status (14,15).”
ResultVoci, S. C., Veldhuizen, S., Tien, S., Barker, M., Minian, N., Selby, P. L., & Zawertailo, L. A. (2021) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntab082 · Cited by 17
Metadata
- 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
- 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
- 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
- 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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