Neighbourhood deprivation and smoking cessation: a survival analysis using the French constances cohort

Socioeconomic disparity in smoking prevalence is increasing in France, which may be partially related to lower rates of smoking cessation in lower socioeconomic groups. Research suggests that this socioeconomic gradient may extend to the neighbourhood level, as deprived neighbourhoods present characteristics that reduce the likelihood of quitting. However, longitudinal studies are limited; therefore, this study aims to investigate the effect of neighbourhood deprivation on smoking cessation.

Data from Constances, a French national population-based cohort collecting annual data from adults aged 18 to 69 at inception, were used. Participants who enrolled between 2012 and 2018 with at least one follow-up wave and with information on smoking status before 2020 were included. The hazard of quitting was estimated by the decile of the French Deprivation Index (FDEP) using a Cox model on a cohort of 21,110 smokers at baseline.

After adjustment for relevant demographic and individual-level socioeconomic factors, individuals in the highest deprivation decile were less likely to quit smoking compared to those in the lowest, with a hazard ratio of 0.89 (95% CI 0.81, 0.98). Stratified analyses indicated that this effect was present for those with the least education.

In a large representative cohort, we found that smokers living in highly deprived neighbourhoods are less likely to quit. These smokers may be facing multiple barriers to cessation, underscoring the importance of targeting such neighbourhoods in smoking cessation interventions.