Patterns of disparity: age and socioeconomic differences in women's smoking and quitting outcomes in Great Britain

Smoking poses health risks to women across the lifespan. This study aimed to examine age-related differences in smoking, quit attempts, and cessation outcomes among women in Great Britain, overall and by socioeconomic position.

We analysed cross-sectional data from 30,519 women (≥ 16 years) in Great Britain participating in a nationally representative survey between 2023 and 2025. We used logistic regression with restricted cubic splines to obtain age-specific estimates of smoking prevalence, the quit attempt rate, the success rate of quit attempts, and the overall quit rate, among all women and by socioeconomic position (indexed by occupational social grade; ABC1 = more advantaged, C2DE = less advantaged). We calculated prevalence ratios (PR; C2DE/ABC1) to illustrate the extent of socioeconomic disparities.

Overall, smoking prevalence was highest among women in their 20s and 30s and declined with age. However, there were notable differences by socioeconomic position. While it declined steadily with age among more advantaged women, smoking prevalence peaked in the early 40s among less advantaged women and was more than twice that of more advantaged women in mid-life (PR range = 2.02-2.47 between ages 35 and 60). Quit attempts decreased linearly with age, with similar prevalence and trends across socioeconomic groups. The success rate of quit attempts was highest among women in their 20s and 30s, but dropped in mid-life and further in older age. Women from less advantaged backgrounds had lower success rates, particularly between ages 45 and 60 (PR range = 0.70-0.73). The overall quit rate among past-year smokers was highest at age 31 for more advantaged women (23.3%) and at age 25 for less advantaged women (22.9%). Quit rates were substantially lower between ages 40 and 60 among less advantaged women (PR range = 0.65-0.69).

Smoking behaviours and cessation outcomes among women in Great Britain vary by both age and socioeconomic position, with particularly high smoking prevalence and low quit rates among less advantaged women in mid-life, corresponding with perimenopause and the menopausal transition. These disparities highlight the need for tailored smoking cessation strategies to improve quit success and reduce smoking prevalence across the lifespan.