Socioeconomic gradients in smoking among young women: A British survey

Marked and increasing socioeconomic gradients in cigarette smoking are well established. Tracking these differentials among women requires appropriate measures of their socioeconomic position (SEP) which are equivalent across older and younger age groups. This study examines socioeconomic gradients in cigarette smoking by age among women aged 20-34, using a standard indicator of SEP (age left full-time education) and alternative indicators which take account of changes in women's educational levels across age cohorts. The study is based on a large cross-sectional British data set (n = 12,398), the Southampton Women's Survey, conducted 1998-2002. Poisson log-linear regression with adjusted variance was used to predict smoking status (ever smoked > or =1 cigarette a day for 1 year, currently smoking > or =1 cigarette a day, and ex-smoker - ever-smoker not currently smoking > or =1 cigarette a day) in models which controlled for SEP, age and year of interview. Socioeconomic gradients in ever-smoking were marked but stable across age groups. With quitting more prevalent in the higher than lower socioeconomic groups, gradients in current smoking steepened across age groups, with significant age/SEP interactions. The socioeconomic patterning of ever, ex and current smoking was similar using both the standard and alternative measures of education, but interactions were less pronounced with the alternative measures. Socioeconomic indicators which take account of the recent and rapid increase in women's educational participation rates may provide a more reliable indication of age-related differentials in smoking status than standard measures. Nonetheless, both conventional and alternative measures point to stable socioeconomic differentials in rates of ever-smoking and widening differentials in current smoking across age groups. Our study confirms that addressing the link between socioeconomic disadvantage and tobacco use remains a major challenge for the tobacco control community.