Socioeconomic status and smoking: a review
01 Feb 2012-Annals of the New York Academy of Sciences (Wiley-Blackwell)-Vol. 1248, Iss: 1, pp 107-123
TL;DR: 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.
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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TL;DR: Effective actions to reduce NCD inequalities include equitable early childhood development programmes and education; removal of barriers to secure employment in disadvantaged groups; comprehensive strategies for tobacco and alcohol control and for dietary salt reduction that target low socioeconomic status groups.
544 citations
01 Jan 2016
TL;DR: Findings from the 2013/2014 survey are presented, which collected data from almost 220 000 young people in 42 countries in Europe and North America and focuses on social context, health outcomes, health behaviours and risk behaviours relevant to young people’s health and well-being.
Abstract: Health Behaviour in School-aged Children (HBSC), a WHO collaborative cross-national study, has provided information about the health, well-being, social environment and health behaviour of 11-, 13and 15-year-old boys and girls for over 30 years. This latest international report from the study presents findings from the 2013/2014 survey, which collected data from almost 220 000 young people in 42 countries in Europe and North America. The data focus on social context (relations with family, peers and school), health outcomes (subjective health, injuries, obesity and mental health), health behaviours (patterns of eating, toothbrushing and physical activity) and risk behaviours (use of tobacco, alcohol and cannabis, sexual behaviour, fighting and bullying) relevant to young people’s health and well-being. New items on family and peer support, migration, cyberbullying and serious injuries are also reflected in the report.
461 citations
TL;DR: The main priority to reduce the burden of lung cancer is to implement or enforce effective tobacco control policies in all countries and prevent an increase in smoking in sub-Saharan Africa and women in low- and middle-income countries (LMICs).
Abstract: Lung cancer killed approximately 1,590,000 persons in 2012 and currently is the leading cause of cancer death worldwide. There is large variation in mortality rates across the world in both males and females. This variation follows trend of smoking, as tobacco smoking is responsible for the majority of lung cancer cases. In this article, we present estimated worldwide lung cancer mortality rates in 2012 using the World Health Organization (WHO) GLOBOCAN 2012 and changes in the rates during recent decades in select countries using WHO Mortality Database. We also show smoking prevalence and trends globally and at the regional level. By region, the highest lung cancer mortality rates (per 100,000) in 2012 were in Central and Eastern Europe (47.6) and Eastern Asia (44.8) among males and in Northern America (23.5) and Northern Europe (19.1) among females; the lowest rates were in sub-Saharan Africa in both males (4.4) and females (2.2). The highest smoking prevalence among males is generally in Eastern and South-Eastern Asia and Eastern Europe, and among females is in European countries, followed by Oceania and Northern and Southern America. Many countries, notably high-income countries, have seen a considerable decrease in smoking prevalence in both males and females, but in many other countries there has been little decrease or even an increase in smoking prevalence. Consequently, depending on whether or when smoking prevalence has started to decline, the lung cancer mortality trend is a mixture of decreasing, stable, or increasing. Despite major achievements in tobacco control, with current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. The main priority to reduce the burden of lung cancer is to implement or enforce effective tobacco control policies in order to reduce smoking prevalence in all countries and prevent an increase in smoking in sub-Saharan Africa and women in low- and middle-income countries (LMICs).
361 citations
Cites background from "Socioeconomic status and smoking: a..."
...In LMICs, similar changing patterns of smoking prevalence by socioeconomic status have been reported (33-35)....
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TL;DR: Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups, which are priority areas for future smoking cessation interventions within vulnerable groups.
Abstract: Objectives To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. Design A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. Data sources MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database9s inception published prior to March 2014. Study selection Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Data extraction Two authors independently assessed studies for inclusion and extracted data. Results 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Conclusions Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. Trial registration number: A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761).
327 citations
TL;DR: In the United States, lung cancer is the second most common diagnosed cancer and the leading cause of cancer-related death and the major risk factor is tobacco smoking.
Abstract: In the United States, lung cancer is the second most common diagnosed cancer and the leading cause of cancer-related death. Although tobacco smoking is the major risk factor accounting for 80% to 90% of all lung cancer diagnoses, there are numerous other risk factors that have been identified as
308 citations
Cites background from "Socioeconomic status and smoking: a..."
...SES is strongly associated with some lung cancer risk factors, including tobacco smoking behavior, whereby uptake may be higher among those with low SES and quit attempts are less likely to be successful (20)....
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References
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TL;DR: A revision of the FTQ: the Fagerström Test for Nicotine Dependence (FTND), which found that a revised scoring of time to the first cigarette of the day (TTF) and number of cigarettes smoked per day (CPD) improved the scale.
Abstract: We examine and refine the Fagerstrom Tolerance Questionnaire (FTQ: Fagerstrom, 1978). The relation between each FTQ item and biochemical measures of heaviness of smoking was examined in 254 smokers. We found that the nicotine rating item and the inhalation item were unrelated to any of our biochemical measures and these two items were primary contributors to psychometric deficiencies in the FTQ. We also found that a revised scoring of time to the first cigarette of the day (TTF) and number of cigarettes smoked per day (CPD) improved the scale. We present a revision of the FTQ: the Fagerstrom Test for Nicotine Dependence (FTND).
9,766 citations
TL;DR: In this paper, a comprehensive report entitled Adherence to Long-Term Therapies: Evidence for Action w1x was published, focusing on nine chronic conditions and their risk factors.
Abstract: The World Health Organization(WHO) has recently published a comprehensive report entitled Adherence to Long-Term Therapies: Evidence for Action w1x. This report focuses on nine chronic conditions and their riskfactors. The conditions reviewed are hypertension, tobacco smoking cessation, asthma, cancer (palliative care), depression, diabetes, epilepsy, HIV yAIDS and tuberculosis. The report reviewed the available literature on the epidemiology of nonadherence worldwide; it stressed the multi-factorial nature of nonadherence, it identified health systems and health care teams as significant determinants to good adherence and discussed the health and economic consequences of nonadherence as well as some strategies for improving it. This report has major relevance for cardiovascular nurses. Cardiovascular disease is and will remain a major challenge for health care professionals and health care systems, and it contributes significantly to the global burden of disease in both developed and developing countriesw2x. Nonadherence to treatment recommendations in patients with cardiovascular risk-factors as well as patients with cardiovascular disease is widespread, and it is a major factor contributing to poor outcome. Nurses are excellently positioned to target the behavioral dimension of chronic disease management. They can improve outcomes by developing and implementing adherence-enhancing strategies to reduce cardiovascular risk-factors, and to enhance adherence with non-smoking, diet, exercise and medication regimens w3x. The value of this WHO report is not only that it comprehensively reviews the current state of the literature including hypertension and tobacco smoking cessation, but also it highlights the need for a multi-disciplinary approach to adherence, emphasizes system factors that need to be addressed in successfully implementing adherence-enhancing strategies. Moreover, it also provides illustrative examples of the ways in which professionals have contributed in their own fields of expertise including cardiovascular care among other fields. This report, therefore, provides an instrument to cardiovascular nurses to expand the behavioral dimension of their patient management strategies, to teach students at undergraduate and graduate level, to guide their research endeavors, to guide policy makers, ultimately with the goal to improve outcomes of populations.
4,049 citations
TL;DR: Following a cohort of 1,000 children from birth to the age of 32 y, it is shown that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self- control.
Abstract: Policy-makers are considering large-scale programs aimed at self-control to improve citizens’ health and wealth and reduce crime. Experimental and economic studies suggest such programs could reap benefits. Yet, is self-control important for the health, wealth, and public safety of the population? Following a cohort of 1,000 children from birth to the age of 32 y, we show that childhood self-control predicts physical health, substance dependence, personal finances, and criminal offending outcomes, following a gradient of self-control. Effects of children's self-control could be disentangled from their intelligence and social class as well as from mistakes they made as adolescents. In another cohort of 500 sibling-pairs, the sibling with lower self-control had poorer outcomes, despite shared family background. Interventions addressing self-control might reduce a panoply of societal costs, save taxpayers money, and promote prosperity.
3,622 citations
TL;DR: This glossary presents a comprehensive list of indicators of socioeconomic position used in health research, with a description of what they intend to measure and how data are elicited and the advantages and limitation of the indicators.
Abstract: This glossary presents a comprehensive list of indicators of socioeconomic position used in health research. A description of what they intend to measure is given together with how data are elicited and the advantages and limitation of the indicators. The glossary is divided into two parts for journal publication but the intention is that it should be used as one piece. The second part highlights a life course approach and will be published in the next issue of the journal.
2,271 citations
TL;DR: From the model it is clear that, during certain periods of evolution of this epidemic, it is to be expected that smoking-attributable mortality will rise at the same time that smoking prevalence might be decreasing.
Abstract: It has been estimated that cigarettes are the cause of the deaths of one in two of their persistent users, and that approxi mately half a billion people currently alive-8% of the world's population could eventually be killed by tobacco if current smoking patterns persist. De spite this pandemic, tobacco consump tion continues and is increasing in many countries, especially in Asia and in Southern and Eastern Europe. A major factor affecting public awareness of the substantial health hazards of tobacco use is the three- to four-decade lag between the peak in smoking prevalence and the subsequent peak in smoking-related mortality. Based on nearly 100 years of observations in countries with the longest history of widespread cigarette use, a four-stage model of cigarette consump tion and subsequent mortality among men and women is proposed. From the model it is clear that, during certain periods of evolution of this epidemic, it is to be expected that smoking-attributable mortality will rise at the same time that smoking prevalence might be decreasing. This is because current mortality is most closely related to previous, not current, levels of cigarette consumption. Broad geographic classifications of regions are given, according to the stage of the epidemic that they are currently ex periencing. Tobacco control policy im plications for countries at each of the four stages of the cigarette epidemic are also discussed.
1,156 citations