[Socioeconomic differences in smoking cessation among adults]

We wanted to investigate variations among socioeconomic groups with regard to smoking cessation, attempts at quitting, intention to quit, future smoking identity and knowledge about help available for smoking cessation.

Data were drawn from the Directorate for Health and Social Affairs' population-based smoking surveys. A total of 5125 subjects aged 25-74 were included for analysis.

Quit rates increased with social status and was higher among persons living with a spouse or partner than among singles. The relationship between smoking cessation and social status was stronger for women than for men. There was a significant bivariate association between social status and intention to quit, future smoking identity and lack of knowledge about support for smoking cessation. Type of tobacco and number of cigarettes smoked per day were significantly related to intention to quit, but in this model the adjusted odds ratio did not relate to social status.

Several explanations could account for the low quit rates among persons with low socioeconomic status. There are positive values associated with smoking in their environment, and they have a local rather than a cosmopolitan value orientation. The strong anti-smoking social norm is perceived as a threat to personal freedom, hence continued smoking may be an expression of psychological reactance. Weak future orientations, external locus of control, stress and depression have also been found to predict low smoking cessation. These conditions are reported to be more common among lower socioeconomic groups, together with high levels of nicotine addiction.