Study Links Economic Disadvantage to Higher Smoking Rates, Addiction

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Jamie Hartmann-Boyce

People experiencing greater economic disadvantage are more likely to smoke cigarettes, be more addicted to tobacco and have more difficulty quitting, according to a new study co-authored by Jamie Hartmann-Boyce, assistant professor of health policy and management.

The study, published in Nicotine and Tobacco Research, found that socioeconomic inequalities in smoking persist despite decades of tobacco control policies and overall declines in smoking rates.

Hartmann-Boyce and researchers from the University of Oxford and University College London analyzed data from nearly 200,000 adults participating in the Smoking Toolkit Study, an ongoing national survey in England. They examined how smoking behavior relates to multiple indicators of disadvantage, including occupational social grade, employment status, housing tenure, education level and household income.

“There is often a perception that smoking isn’t a problem anymore,” Hartmann-Boyce says. “That’s wrong. Instead, smoking is focused more and more in specific communities, typically those facing multiple forms of disadvantage. We hope this work serves as a timely reminder of the need to continue investing in tobacco control programs that reduce smoking in populations carrying the heaviest burden of tobacco-related health harms.”

People in lower occupational grades, with less education, lower incomes or living in more disadvantaged housing were more likely to smoke than those in more advantaged groups. 

The study also found stronger urges to smoke among participants facing greater disadvantage, particularly when measured by occupation, education and income.

In addition, disadvantaged participants were less likely to attempt quitting in the past year. Among those who did try, renters and people in public housing had lower quit success rates than homeowners. E-cigarettes were the most popular quit aid.

The study adds to a growing body of evidence that while smoking rates have declined overall, the burden of tobacco use remains disproportionately concentrated among society’s most disadvantaged groups.