Educational inequalities in smoking cessation trends in Italy, 1982-2002
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Background/aim: 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. Methods: 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. Results: 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. Conclusion: 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.