Tobacco use is now concentrated among the least advantaged socioeconomic groups in society, according to a new study at the Colorado School of Public Health at University of Colorado (CU) Anschutz. The findings show that most remaining smokers in the United States have low income, no college education, a disability or no health insurance.
After decades of declining smoking rates overall, about 15 percent of U.S. adults — more than 36 million — continue to smoke cigarettes. About 50 to 75 percent of smokers have one or more low-socioeconomic disadvantages, and the lowest socioeconomic categories have the highest smoking rates.
The researchers say that quitting methods that have been working for smokers in higher economic brackets aren’t working for the disadvantaged and that new strategies are needed.
“It’s unusual to find part of the population experiencing high rates of a health problem and also representing the majority of affected people,” said study author Dr. Arnold Levinson, associate professor of community and behavioral health at the Colorado School of Public Health at CU Anschutz.
“But with smoking, we have this unusual situation: Americans with lower socioeconomic status today are suffering from epidemic smoking rates, and they make up nearly three-fourths of all our remaining smokers.”
The study, published in the Journal of Health Care for the Poor and Underserved, used data from a national survey which the University of Colorado conducted in 2012.
The continued epidemic can’t be blamed on lack of desire to quit or efforts to quit. In fact, several studies have found no socioeconomic differences in smokers’ desires to quit or attempts to quit. Instead, the disparities continue and have gotten worse because lower socioeconomic smokers who try to quit are less likely to succeed.
“In the last half-century, public health efforts helped cut the smoking rate by more than half, but we probably need to change our strategies for helping smokers quit,” Levinson said. “The methods that worked for the upper half of society don’t seem to be working well for the other half.”
“Now the nation’s public health system has a dual moral obligation toward smokers of low socioeconomic class. We must eliminate the disparity in smoking rates, and we must provide cessation-supporting services to the new majority of smokers,” said Levinson.
According to the Centers for Disease Control, cigarette smoking remains the leading cause of preventable disease and death in the US, causing more than 480,000 premature deaths every year, or one of every five deaths.