Half of social inequalities in male mortality due to smoking
Men of lower social class, income, or education have a two-fold increased risk of dying than men in higher strata, and half of this difference is attributable to smoking, reveals a paper published online today by The Lancet.
There are substantial social inequalities in adult male mortality in many countries. Prabhat Jha (University of Toronto, Canada) and colleagues looked at the contribution of smoking to these social inequalities in men aged 35-69 years. The investigators estimated male deaths attributed to smoking and those not attributed to smoking in three social bands in four countries using mortality data from 1996. They compared deaths in the highest and lowest strata for social class in England and Wales, neighbourhood income in Canada, and completed years of education in the USA and Poland. They found on average a 19% difference between the highest and lowest social strata in the risk of dying in each country (England and Wales 21% vs 43%, USA 20% vs 37%, Canada 21% vs 34%, and Poland 26% vs 50%) and around half of the difference (12% on average) was due to the risk of being killed by smoking (England and Wales 4% vs 19%, USA 4% vs 15%, Canada 6% vs 13%, and Poland 5% vs 22%).
Professor Sir Richard Peto, co-author from the University of Oxford, concludes: "In these populations, most, but not all, of the substantial social inequalities in adult male mortality during the 1990s were due to the effects of smoking. Widespread cessation of smoking could eventually halve the absolute differences between these social strata in the risk of premature death."
"Higher taxes, warning labels, and other tobacco control interventions have already been shown to help increase smoking cessation rates, with higher taxes being particularly effective at raising cessation rates among less educated or poorer groups," Dr Jha adds.
See also accompanying Comment.
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