Socioeconomic position and smoking behaviour in Danish adults

Abstract

Aims: The associations between smoking and various socioeconomic indicators may have different implications and causes, which may also vary according to sex and birth cohort. This study analyses how two dimensions of socioeconomic position, an individual ( education) and a structural ( occupation) indicator, are associated with ever, current and ex-smoking. Methods: Data on smoking behaviour were collected in five cross-sectional surveys of random samples of the general Danish population aged 20 years or more at intervals between 1982 and 1994. In total, 8,054 men and 8,281 women participated. Logistic regression was used to analyse the infl uence of education and occupation on smoking behaviour controlling for sex and birth cohort. Results: In cohorts born after 1930 ever and current smoking were related to years of school education and current occupation. The prevalences of ever and current smoking were highest among the least educated, unskilled workers, unemployed persons and persons who received welfare benefits. A significant interaction between birth cohort and education indicated that the educational difference in ever and current smoking increased significantly with increasing year of birth. In multivariate analysis controlling for sex and birth cohort, ex-smoking seemed to be more strongly associated with education than occupation .Those with 12 or more years of school education had twice as high a chance of being ex-smokers as those with 7 years of school or less. Conclusion: Smoking behaviour is strongly associated with both individual and structural indicators of socioeconomic position in Danish adults in all cohorts except for those born before 1930.

Keywords

birth cohort education occupation smoking socioeconomic position.

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References

Acheson D. Independent inquiry into inequalities in health. London , Stationery Office, 1998 .

Cavelaars AEJM. Cross-national comparisons of socioeconomic differences in health indicators. Dissertation , Erasmus University, Rotterdam , 1997.

Blaxter M. Health and lifestyles. London, Routledge, 1990.

Mheen PJM , Smith GD , Hart CL The health impact of smoking in manual and non-manual social class men and women: a test of the Blaxter hypothesis. Soc Sci Med 1999; 48: 1851-6.

Currie CE , Elton RA , Todd J. , Platt S. Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in school-aged children survey. Health Educ Res 1997; 12: 385- 97.

Gerdes LU , Brø nnum-Hansen H. , Madsen M. , et al. Trends in selected biological risk factors for cardiovascular diseases in the Danish MONICA population 1982-1992. J Clin Epidemiol 2000; 53: 427- 34.

Rasmussen NK , Groth MV , Bredkjër SR , Madsen M. , Jørgensen FK Health and morbidity in Denmark 1987. Copenhagen, Danish Institute of Clinical Epidemiology , 1988.

Osler M. , Kirchhoff M. Smoking behaviour in Danish adults from 1982 to 1992. Public Health 1995; 109: 245- 50.

Osler M. , Prescott E. Psycho-social, behavioural, and health determinants of successful smoking cessation: a longitudinal study of Danish adults. Tobacco Control 1998; 7: 262-7.

10.

Osler M. Unemployment and change in smoking behaviour among Danish adults. Tobacco Control 1995; 4: 53-6.

11.

Hamtoft H. , Lindhardt M. Tobacco consumption in Denmark II. The Danish National Morbidity Survey of 1950. Dan Med Bull 1955; 2: 188-94.

12.

Osler M. , Prescott E. , Gottschau A. , et al. Trends in smoking prevalence in Danish adults, 1964-1994. The infl uence of gender, age and education. Scand J Soc Med 1998; 26: 293-8.

13.

Prescott E. Tobacco related diseases: the role of gender. Dissertation, Lëgeforeningens Forlag, 2000.

14.

Liberatos P. , Link BG , Kelsey JL The measurement of social class in epidemiology . Epidemiol Rev 1988; 10: 87- 120.

15.

Kirchhoff M. Cardiovascular diseases. Social and psychosocial differences in the distribution of risk factors. Dissertation, Copenhagen, Glostrup Population Studies, 1986.

16.

Suadicani P. , Hein HO , Gyntelberg F. Serum validated tobacco use and social inequalities in risk of ischaemic heart disease. Int J Epidemiol 1994; 23: 293-300.