Educational inequalities in smoking cessation trends in Italy, 1982-2002

Smoking prevalence rates are declining in most industrialised countries, partly because of growing cessation rates. However, little is known on recent time-trends in smoking cessation by socioeconomic position. This study aims to estimate educational inequalities in smoking cessation trends in Italy between 1982 and 2002.

Data were derived from two national health interview surveys carried out in Italy in 1999-2000 (n = 34 789) and in 2004-2005 (n = 33 135). On the basis of respondents' age at starting and age at quitting smoking, we computed age-standardised smoking cessation rates at ages 20-44 years for subjects who were current smokers between 1982 and 2002.

Smoking quit rates were approximately constant at a figure of about 2 per 100 person-years until the period 2000-2002, when they rapidly increased up to 3-4 per 100 person-years. Higher educated smokers constantly showed higher cessation rates than lower educated subjects (rate ratio 1.33; 95% CI 1.25 to 1.41 for men and 1.41; 95% CI 1.30 to 1.53 for women). The relative size of educational difference in smoking cessation did not significantly vary by period. However, in absolute terms, the increase in cessation rates in 2000-2002 was larger among higher educated smokers.

Educational inequalities in smoking cessation persisted in both relative and absolute terms. The increase in smoking cessation rates in 2000-2002 suggests that tobacco control policies may have reached more disadvantaged smokers, although smokers of higher socioeconomic groups seem to have benefited the most.