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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Socio‐Economic Position and the Prevalence of Ten Chronic Diseases in Australia, 2021: A Whole of Population Census Data Analysis
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“13 Smoking could mediate the influence of socio-economic position on the prevalence of several chronic diseases, including lung disease, for which the increase in prevalence with decreasing IRSD decile was particularly large.”
The impact of oral health disparities on smoking prevalence
Carneiro, P. H., Zhang, A., Zhao, W., Ojcius, D. M., Daly, L., & Almeida-da-Silva, C. L. C. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1667261 · Cited by 7
From cigarettes to symptoms: the association between smoking and depression in the German National Cohort (NAKO)
Völker, M. P., Callies, C., Frank, J., Foo, J. C., Reinhard, I., Zillich, L., Klinger-König, J., Grabe, H. J., Beule, A. G., Erhardt, A., et al. (2025) · BMC Public Health · doi:10.1186/s12889-025-25959-0 · Cited by 6
The effects of hardcore smokers' depression and self-esteem on daily smoking amount
Han, J., & Lee, H. (2020) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2020.02.006 · Cited by 6
Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort
Kang, J., Kim, T., Han, K., Jung, J.-H., Jeong, S.-M., Yeo, Y., Jung, K., Lee, H., Cho, J. H., & Shin, D. W. (2023) · Epidemiology and Health · doi:10.4178/epih.e2023101 · Cited by 6
“Because income depends on occupational status, which is closely tied to health behaviors [31,32], low-income participants are more likely to smoke tobacco, consume unhealthy diets, be exposed to occupational carcinogens, and have limited access to health care.”
Background
Uptake and 4-week outcomes of an ‘opt-out’ smoking cessation referral strategy in a London-based lung cancer screening setting
Bhamani, A., Katsampouris, E., Bojang, F., Verghese, P., Creamer, A. W., Prendecki, R., Khaw, C. R., Dickson, J. L., Horst, C., Tisi, S., et al. (2025) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2024-002337 · Cited by 6
“Providing on-site specialist smoking cessation services is likely to boost uptake further and should be considered for future LCS programmes.”
Association of the p53 codon 72 polymorphism with clinicopathological characteristics of colorectal cancer through mRNA analysis
Oliveira, L. P., López, I., Santos, É. M. M., Tucci, P., Marı́n, M., Soares, F. A., ROSSI, B. M., & Coudry, R. D. A. (2013) · Oncology Reports · doi:10.3892/or.2013.2940 · Cited by 6
Social differences in who receives questions and advice about smoking habits when visiting primary care – Results from a population based study in Sweden in 2012
Molarius, A., Hellstrand, M., & Engström, S. (2016) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2016.12.016 · Cited by 6
“Previous studies have shown that persons with low socioeconomic status havemore difficulties to quit smoking than personswith high socioeconomic status (Pisinger et al., 2011; Hiscock et al., 2015; Reid et al., 2010) which is pertinent for designing smoking cessation programs.”
BackgroundMethod
The Impact of Insurance Gain and Discussions with Healthcare Providers on Quitting Smoking
Brown, C. C., & Wei, F. (2017) · Behavioral Medicine · doi:10.1080/08964289.2017.1375455 · Cited by 6
“likely to smoke than individuals with higher incomes.(37) This study provides valuable information about the relationship between gaining insurance and smoking cessation, which may be particularly useful for policies regarding the lowincome population and Medicaid expansion.”
Background
Social Determinants of Health and Attempt to Change Unhealthy Lifestyle: A Population-based Study
Danaei, M., Palenik, C. J., Abdollahifard, G., & Askarian, M. (2017) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_106_17 · Cited by 6
“[21] Another study reported that low socioeconomic status individuals were less likely to quit smoking and their chances of being unsuccessful were higher.[22]”
Perfil e fatores associados ao sucesso terapêutico de tabagistas atendidos em um serviço público especializado [Profile and factors associated with successful treatment of smokers in a specialized public service] [Perfil y factores asociados al éxito terapéutico de tabaquistas atendidos en un servicio público especializado]
dos Santos, S. R., Bittencourt, A. R. D. C., Silva, M. H. D. C., Stacciarini, T. S. G., Engel, R. H., & Cordeiro, A. L. P. D. C. (2018) · Revista Enfermagem UERJ · doi:10.12957/reuerj.2018.17381 · Cited by 6
The Fundamental Role of Socioeconomic Resources for Health and Health Behaviors
Siddiqi, A., Hertzman, C., & Smith, B. T. (2018) · Springer eBooks · doi:10.1007/978-0-387-93826-4_14 · Cited by 6
Associations Between Maternal Nutrition in Pregnancy and Child Blood Pressure at 4–6 Years: A Prospective Study in a Community-Based Pregnancy Cohort
Ni, Y., Szpiro, A. A., Loftus, C. T., Tylavsky, F. A., Kratz, M., Bush, N. R., LeWinn, K. Z., Sathyanarayana, S., Enquobahrie, D. A., Davis, R. L., et al. (2020) · Journal of Nutrition · doi:10.1093/jn/nxaa395 · Cited by 6
Smoking in early adulthood is prospectively associated with prescriptions of antipsychotics, mood stabilizers, antidepressants and anxiolytics
Rognli, E. B., Bramness, J. G., & von Soest, T. (2021) · Psychological Medicine · doi:10.1017/s0033291720005401 · Cited by 6
EGFR mutation profile in Australian patients with non-small cell lung cancer
Mead, S., Lucas, M., Pang, J., FELLOWES, A. P., Harraway, J. R., Svobodová, S., Amanuel, B., & Fox, S. B. (2021) · Pathology · doi:10.1016/j.pathol.2021.01.017 · Cited by 6
Tobacco smoking and HIV-related immunologic and virologic response among individuals of the Canadian HIV Observational Cohort (CANOC)
McClean, A. R., Kooij, K. W., Trigg, J., Ye, M., Sereda, P., McLinden, T., Bacani, N., Aran, N., Thomas, R., Wong, A., et al. (2021) · AIDS Care · doi:10.1080/09540121.2021.1929813 · Cited by 6
“Further, we cannot exclude the possibility that higher intensity smoking may affect immunologic and virologic response to cART (Feldman et al., 2006; Hile et al., 2016; Hiscock et al., 2012; Nagelhout et al., 2012).”
Background
How do educational disparities in smoking develop during early life? A Swedish longitudinal study
Wells, L., & Östberg, V. (2021) · SSM - Population Health · doi:10.1016/j.ssmph.2021.100859 · Cited by 6
“…position in the social structure tends to confer a greater risk of: smoking initiation, a higher rate of dependence, nonadherence to cessation treatment and a lower rate of cessation, and smoking-related mortality (Hiscock et al., 2012; Jarvis & Wardle, 1999; Swedish Public Health Agency, 2018).”
Background
Investigating the association between smoking, environmental tobacco smoke exposure and reward‐related brain activity in adolescent experimental smokers
Dieleman, J., Sescousse, G., Kleinjan, M., Otten, R., & Luijten, M. (2021) · Addiction Biology · doi:10.1111/adb.13070 · Cited by 6
Inpatient admissions and outpatient appointments in the first year post cancer diagnosis: A population based study from England
Pethick, J., Chen, C., Charnock, J., Bowden, R., & Tzala, E. (2021) · Cancer Epidemiology · doi:10.1016/j.canep.2021.102003 · Cited by 6
Factors associated with initiation and use of snus among adolescents
Ansteinsson, V. E., Mdala, I., Becher, R., Grøtvedt, L., Kopperud, S. E., & Valen, H. R. (2021) · Scandinavian Journal of Public Health · doi:10.1177/14034948211062311 · Cited by 6
“1007/s10865007-9098-3 [8] Hiscock R, Bauld L, Amos A, et al.”
Background
A cross-sectional survey of smoking and cessation support policies in a sample of homeless services in the United Kingdom
Cox, S., Murray, J., Ford, A., Holmes, L., Robson, D., & Dawkins, L. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08038-7 · Cited by 5
Association Between Place of Secondhand Smoke Exposure and Depression Among Nonsmoking Children and Adolescents: A Systematic Review
Christian, F., & Kim, Y. (2022) · Asia Pacific Journal of Public Health · doi:10.1177/10105395221099418 · Cited by 6
Smoking in the workplace: A study of female call center employees in South Korea
Oh, H., & Boo, S. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267685 · Cited by 6
“In this study, female smokers generally had poor health and lower levels of education, and our finding proves their vulnerable status [33, 35].”
Background
Accessibility of smoking cessation clinics in Turkey: a descriptive study among a population of smokers in İstanbul
Bayram, T., Karaketir, Ş. G., ÖZER, F., Tatar, Y., KILINCKIRAN, M., Nur, C. A. N., & Save, D. (2022) · Türkiye Halk Sağlığı Dergisi · doi:10.20518/tjph.916741 · Cited by 6
Identifying the barriers of smoking cessation and predictors of nicotine dependence among adult Malaysian smokers: A cross-sectional study
Marzo, R. R., El-Fass, K. A., Osman, N. A., Kyaw, T. M., Arivanandan, P., Morgan, L., Latchumana, K., Arasu, K., Obaromi, D. A., & Lin, Y. (2022) · Tobacco Induced Diseases · doi:10.18332/tid/154964 · Cited by 6
Race and Ethnic Differences in the Protective Effect of Parental Educational Attainment on Subsequent Perceived Tobacco Norms among US Youth
Adinkrah, E. K., Najand, B., & Young‐Brinn, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20032517 · Cited by 5
“However, socioeconomic status (SES) indicators such as parental educational attainment may lower youth risk-taking behaviors such as tobacco use [2].”
Background
Impact of the cost-of-living crisis on the nature of attempts to stop smoking and to reduce alcohol consumption in Great Britain: A representative population survey, 2021–2022
Jackson, S. E., Cox, S., Shahab, L., & Brown, J. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286183 · Cited by 6
“There is a social gradient in smoking, whereby low-income earners and those who have access to state support and live in social housing are more likely to smoke and have higher levels of dependence than those who are more affluent [17, 18].”
Background
Gene–environment interaction: why genetic enhancement might never be distributed fairly
Prince, S. (2023) · Journal of Medical Ethics · doi:10.1136/jme-2023-109101 · Cited by 7
Socioeconomic Inequalities in Functional Outcome After Reperfusion-Treated Ischemic Stroke
Buus, S. M. Ø., Schmitz, M. L., Cordsen, P., Johnsen, S. P., Andersen, G., & Simonsen, C. Z. (2023) · Stroke · doi:10.1161/strokeaha.123.043547 · Cited by 6
Targeting in a population health approach
Roberts‐Thomson, K. (2012) · Community Dentistry And Oral Epidemiology · doi:10.1111/j.1600-0528.2012.00715.x · Cited by 6
Risky Single-Occasion Drinking and Disadvantaged Men: Will Recruitment Through Primary Care Miss Hazardous Drinkers?
Crombie, I. K., Falconer, D. W., Irvine, L. A., Norrie, J. D., Williams, B., & Slane, P. W. (2013) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.12123 · Cited by 6
Prevalence and Correlates of Cigarette Smoking Among Operation Iraqi Freedom-era and Operation Enduring Freedom-era Women From the Active Component Military and Reserve/National Guard
Weg, M. W. V., Mengeling, M. A., Booth, B. M., Torner, J. C., & Sadler, A. G. (2015) · Medical Care · doi:10.1097/mlr.0000000000000285 · Cited by 6
Socio-behavioral risk factors among older adults living with HIV in Thailand
Musumari, P. M., Tangmunkongvorakul, A., Srithanavibooncha, K., Feldman, M. D., Sitthi, W., Rerkasem, K., Techasrivichien, T., Suguimoto, S. P., Ono‐Kihara, M., & Kihara, M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188088 · Cited by 6
Impacts of smoke-free public places legislation on inequalities in youth smoking uptake: study protocol for a secondary analysis of UK survey data
Anyanwu, P. E., Craig, P., Katikireddi, S. V., & Green, M. J. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022490 · Cited by 7
Characterizing Employees’ Preferences for Incentives for Healthy Behaviors: Examples to Improve Interest in Wellness Programs
Jenkins, K. R., Fakhoury, N., Richardson, C. R., Segar, M., Krupka, E. L., & Kullgren, J. T. (2018) · Health Promotion Practice · doi:10.1177/1524839918776642 · Cited by 7
Exposure to second-hand smoke in the context of tobacco policy changes in Estonia, 1996–2016
Reile, R., & Pärna, K. (2019) · European Journal of Public Health · doi:10.1093/eurpub/ckz027 · Cited by 6
Youth Perceptions of Parental Involvement and Monitoring, Discrepancies With Parental Perceptions, and Their Associations With First Cigarette Use in Black and White Girls
Sartor, C. E., Ye, F., Simon, P., Zhai, Z. W., Hipwell, A. E., & Chung, T. A. (2020) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2020.81.180 · Cited by 6
“(a) Socioeconomic StatuS: Given the association of low socioeconomic status with elevated risk for cigarette smoking (Hiscock et al., 2012) and the potential links between socioeconomic status and parenting behaviors (e.g., more limited availability of parents in single-parent–headed households,…”
Background
Social deprivation and secondhand smoke exposure among urban male residents: A nationwide study in China
Yang, Y., Yang, X. Y., Yang, T., He, W., Peng, S., & Rockett, I. R. H. (2021) · Tobacco Induced Diseases · doi:10.18332/tid/132290 · Cited by 6
Correlates of e-cigarette use among adults initiating smoking cessation treatment
Boozary, L. K., Frank-Pearce, S. G., Alexander, A. C., Waring, J. J. C., Ehlke, S. J., Businelle, M. S., Cohn, A. M., & Kendzor, D. E. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108724 · Cited by 7
Associations between Second-Hand Tobacco Smoke Exposure and Cardiorespiratory Fitness, Physical Activity, and Respiratory Health in Children
Parnell, M., Foweather, L., Whyte, G. P., Dickinson, J. W., & Gee, I. L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111445 · Cited by 6
Parental awareness and attitude towards environmental tobacco smoke exposure in children with respiratory illnesses
Hasniah, A. L., Tan, Y., Buhairah, M. A. N., Chan, T. W., Nabil, T. I. M., & Zulkifli, S. Z. S. (2016) · Public Health · doi:10.1016/j.puhe.2015.10.028 · Cited by 6
Perceived feasibility of a primary care intervention for Tobacco Cessation on Prescription targeting disadvantaged groups in Sweden: a qualitative study
Leppänen, A., Biermann, O., Sundberg, C. J., & Tomson, T. (2016) · BMC Research Notes · doi:10.1186/s13104-016-1949-y · Cited by 6
“Difficulties in reaching disadvantaged groups with tobacco cessation interventions could be explained by a lack of motivation, low self-efficacy, reduced social support for quitting and understanding of the harmful effects of tobacco use, a stronger addiction to tobacco, targeted marketing by the tobacco industry and…”
Background
Smoking and finances: baseline characteristics of low income daily smokers in the FISCALS cohort
Martire, K. A., Clare, P. J., Courtney, R. J., Bonevski, B., Boland, V. C., Borland, R., Doran, C. M., Farrell, M., Hall, W., Iredale, J. M., et al. (2017) · International Journal for Equity in Health · doi:10.1186/s12939-017-0643-6 · Cited by 6
“Even so we know that the cessation success rate for low SES smokers is generally low [3].”
BackgroundInfluential

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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