Association of Cumulative Socioeconomic and Health-Related Disadvantage With Disparities in Smoking Prevalence in the United States, 2008 to 2017

Summary of Study

Bottom Line: Results of this study demonstrate that US disparities in smoking prevalence from 2008 to 2017 were successively larger with each additional disadvantage faced, were expressed in higher smoking initiation odds and lower smoking cessation odds, and widened over time. Understanding emerging patterns of smoking disparities among disadvantaged populations can guide tobacco control policy.

Cigarette smoking is unduly common in those facing socioeconomic or health-related disadvantages, such as poverty or behavioral health conditions, which contributes to inequities in morbidity and mortality. Understanding emerging patterns of disparities in smoking prevalence can guide priorities for tobacco control.

In this study, the mean current smoking prevalence collapsed across the 10-year period was successively higher among populations facing 0 (13.8%), 1 (21.4%), 2 (26.6%), 3 (35.1%), 4 (45.7%), or 5 or 6 (58.2%) disadvantages.

The accumulation of the following 6 different socioeconomic or health-related disadvantages that are linked with smoking and designated by US public health organizations as tobacco use disparity populations are unemployment, poverty, low education, disability/limitation, serious psychological distress, and heavy alcohol consumption.

This study reveals an emerging pattern of smoking disparities in the United States among populations facing multiple forms of disadvantage. The probability of smoking successively increases as the cumulative number of disadvantages faced by a population rises, without leveling off at any threshold of disadvantage.

Successful prevention of smoking initiation and promotion of smoking cessation in multi-disadvantaged populations would substantially reduce the smoking-related public health burden in the United States.

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Feature Charticle

Proportion of Current Smokers by Year by Cumulative DisadvantageJAMA

 

Findings:

  • Cigarette smoking is unduly common in those facing socioeconomic or health-related disadvantages, such as poverty or behavioral health conditions, which contributes to inequities in morbidity and mortality. 
  • In this study, the mean current smoking prevalence collapsed across the 10-year period was successively higher among populations facing 0 (13.8%), 1 (21.4%), 2 (26.6%), 3 (35.1%), 4 (45.7%), or 5 or 6 (58.2%) disadvantages.
  • Understanding emerging patterns of disparities in smoking prevalence can guide priorities for tobacco control.