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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2005 May;59(5):395–401. doi: 10.1136/jech.2004.025684

Trends in smoking behaviour between 1985 and 2000 in nine European countries by education

K Giskes 1, A Kunst 1, J Benach 1, C Borrell 1, G Costa 1, E Dahl 1, J Dalstra 1, B Federico 1, U Helmert 1, K Judge 1, E Lahelma 1, K Moussa 1, P Ostergren 1, S Platt 1, R Prattala 1, N Rasmussen 1, J Mackenbach 1
PMCID: PMC1733079  PMID: 15831689

Abstract

Objective: To examine whether trends in smoking behaviour in Western Europe between 1985 and 2000 differed by education group.

Design: Data of smoking behaviour and education level were obtained from national cross sectional surveys conducted between 1985 and 2000 (a period characterised by intense tobacco control policies) and analysed for countries combined and each country separately. Annual trends in smoking prevalence and the quantity of cigarettes consumed by smokers were summarised for each education level. Education inequalities in smoking were examined at four time points.

Setting: Data were obtained from nine European countries: Norway, Sweden, Denmark, Finland, the United Kingdom, the Netherlands, Germany, Italy, and Spain.

Participants: 451 386 non-institutionalised men and women 25–79 years old.

Main outcome measures: Smoking status, daily quantity of cigarettes consumed by smokers.

Results: Combined country analyses showed greater declines in smoking and tobacco consumption among tertiary educated men and women compared with their less educated counterparts. In country specific analyses, elementary educated British men and women, and elementary educated Italian men showed greater declines in smoking than their more educated counterparts. Among Swedish, Finnish, Danish, German, Italian, and Spanish women, greater declines were seen among more educated groups.

Conclusions: Widening education inequalities in smoking related diseases may be seen in several European countries in the future. More insight into effective strategies specifically targeting the smoking behaviour of low educated groups may be gained from examining the tobacco control policies of the UK and Italy over this period.

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Selected References

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  1. Bartley M., Fitzpatrick R., Firth D., Marmot M. Social distribution of cardiovascular disease risk factors: change among men in England 1984-1993. J Epidemiol Community Health. 2000 Nov;54(11):806–814. doi: 10.1136/jech.54.11.806. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cavelaars A. E., Kunst A. E., Geurts J. J., Crialesi R., Grötvedt L., Helmert U., Lahelma E., Lundberg O., Matheson J., Mielck A. Educational differences in smoking: international comparison. BMJ. 2000 Apr 22;320(7242):1102–1107. doi: 10.1136/bmj.320.7242.1102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cesana G. C., de Vito G., Ferrario M., Sega R., Mocarelli P. Trends of smoking habits in northern Italy (1986-1990). The WHO MONICA Project in Area Brianza, Italy. MONICA Area Brianza Research Group. Eur J Epidemiol. 1995 Jun;11(3):251–258. doi: 10.1007/BF01719428. [DOI] [PubMed] [Google Scholar]
  4. Dalstra J. A. A., Kunst A. E., Geurts J. J. M., Frenken F. J. M., Mackenbach J. P. Trends in socioeconomic health inequalities in the Netherlands, 1981-1999. J Epidemiol Community Health. 2002 Dec;56(12):927–934. doi: 10.1136/jech.56.12.927. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Faggiano F., Versino E., Lemma P. Decennial trends of social differentials in smoking habits in Italy. Cancer Causes Control. 2001 Sep;12(7):665–671. doi: 10.1023/a:1011247024979. [DOI] [PubMed] [Google Scholar]
  6. Ferrario M., Sega R., Chatenoud L., Mancia G., Mocarelli P., Crespi C., Cesana G., MONICA-Brianza Research Group. MONItoring of CArdiovascular diseases Time trends of major coronary risk factors in a northern Italian population (1986-1994). How remarkable are socioeconomic differences in an industrialized low CHD incidence country? Int J Epidemiol. 2001 Apr;30(2):285–297. doi: 10.1093/ije/30.2.285. [DOI] [PubMed] [Google Scholar]
  7. Graham H. Smoking prevalence among women in the European community 1950-1990. Soc Sci Med. 1996 Jul;43(2):243–254. doi: 10.1016/0277-9536(95)00369-x. [DOI] [PubMed] [Google Scholar]
  8. Iribarren C., Luepker R. V., McGovern P. G., Arnett D. K., Blackburn H. Twelve-year trends in cardiovascular disease risk factors in the Minnesota Heart Survey. Are socioeconomic differences widening? Arch Intern Med. 1997 Apr 28;157(8):873–881. [PubMed] [Google Scholar]
  9. Lahelma E., Rahkonen O., Berg M. A., Helakorp S., Prättälä R., Puska P., Uutela A. Changes in health status and health behavior among Finnish adults 1978-1993. Scand J Work Environ Health. 1997;23 (Suppl 3):85–90. [PubMed] [Google Scholar]
  10. Mackenbach J. P., Kunst A. E. Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997 Mar;44(6):757–771. doi: 10.1016/s0277-9536(96)00073-1. [DOI] [PubMed] [Google Scholar]
  11. Maziak W., Hense H. W., Döring A., Keil U. Ten-year trends in smoking behaviour among adults in southern Germany. Int J Tuberc Lung Dis. 2002 Sep;6(9):824–830. [PubMed] [Google Scholar]
  12. Osler M., Kirchhoff M. Smoking behaviour in Danish adults from 1982 to 1992. Public Health. 1995 Jul;109(4):245–250. doi: 10.1016/s0033-3506(95)80201-0. [DOI] [PubMed] [Google Scholar]
  13. Osler M., Prescott E., Gottschau A., Bjerg A., Hein H. O., Sjøl A., Schnohr P. Trends in smoking prevalence in Danish adults, 1964-1994. The influence of gender, age, and education. Scand J Soc Med. 1998 Dec;26(4):293–298. doi: 10.1177/14034948980260041101. [DOI] [PubMed] [Google Scholar]
  14. Peltonen M., Huhtasaari F., Stegmayr B., Lundberg V., Asplund K. Secular trends in social patterning of cardiovascular risk factor levels in Sweden. The Northern Sweden MONICA Study 1986-1994. Multinational Monitoring of Trends and Determinants in Cardiovascular Disease. J Intern Med. 1998 Jul;244(1):1–9. doi: 10.1046/j.1365-2796.1998.00289.x. [DOI] [PubMed] [Google Scholar]
  15. Pierce J. P. International comparisons of trends in cigarette smoking prevalence. Am J Public Health. 1989 Feb;79(2):152–157. doi: 10.2105/ajph.79.2.152. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rohrmann Sabine, Becker Nikolaus, Kroke Anja, Boeing Heiner. Trends in cigarette smoking in the German centers of the European Prospective Investigation into Cancer and Nutrition (EPIC): the influence of the educational level. Prev Med. 2003 Apr;36(4):448–454. doi: 10.1016/s0091-7435(02)00047-6. [DOI] [PubMed] [Google Scholar]
  17. Schiaffino Anna, Fernandez Esteve, Borrell Carme, Salto Esteve, Garcia Montse, Borras Josep Maria. Gender and educational differences in smoking initiation rates in Spain from 1948 to 1992. Eur J Public Health. 2003 Mar;13(1):56–60. doi: 10.1093/eurpub/13.1.56. [DOI] [PubMed] [Google Scholar]
  18. Whitlock G., MacMahon S., Vander Hoorn S., Davis P., Jackson R., Norton R. Association of environmental tobacco smoke exposure with socioeconomic status in a population of 7725 New Zealanders. Tob Control. 1998 Autumn;7(3):276–280. doi: 10.1136/tc.7.3.276. [DOI] [PMC free article] [PubMed] [Google Scholar]

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