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Ten-year trends in smoking behaviour among adults in southern Germany
Setting:
The city of Augsburg and two adjacent counties, covering a population of 532,987.
Objective:
To provide a detailed description of trends in smoking behaviour among adults according to age, gender and educational status in southern Germany.
Design:
Cross sectional surveys performed 10 years apart (1985 and 1995) in the Augsburg region as part of the WHO MONICA project.
Participants:
Of a total of 9261 eligible subjects, 7938 adults aged 25-64 years (4022 in 1985 and 3916 in 1995) from two separate random samples responded to the survey, giving a response rate of 79% in 1985 and 75% in 1995.
Results:
In both surveys, daily smoking among men showed a clear pattern of reverse association with age and educational status, while women showed only an age-smoking pattern. Between 1985 and 1995, daily smoking showed a general increase among women and a decrease among men, with most of the increase in smoking prevalence as well as in numbers of cigarettes consumed by smokers occurring in women with a low level of education. Smoking cessation generally showed a positive relation to education in each survey for both sexes, and an increasing trend among all educational groups in the 10-year period between 1985 and 1995.
Conclusion:
The 10-year trends in smoking behaviour in southern Germany show features of early stage III of the smoking epidemic, where smoking is decreasing among men and continuing to rise among women, but with signs of levelling off in some social strata. Particular attention should be paid to combating smoking trends among women with low levels of education.