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J Epidemiol Community Health. Oct 2003; 57(10): 802–808.
PMCID: PMC1732304

Socioeconomic status over the life course and stages of cigarette use: initiation, regular use, and cessation

Abstract

Study objective: To investigate the association between multiple indicators of socioeconomic status (SES) over the life course and three stages of cigarette use: initiation, regular use, and cessation.

Design: Prospective birth cohort study.

Setting: Providence, Rhode Island.

Participants: Subjects (n=657) aged 30 to 39 were offspring of participants in the Brown University cohort of the United States National Collaborative Perinatal Project started in 1959.

Main results: A significantly increased risk of smoking initiation was observed among people from lower socioeconomic backgrounds. Low SES in childhood also increased the risk for progression to regular smoking, and was associated with a reduced likelihood of smoking cessation. Progression to regular smoking and smoking persistence were also associated with lower adult SES.

Conclusions: Socioeconomic conditions over the life course accumulate to produce increased rates of smoking uptake and reduced rates of cessation among lower SES people. Addressing SES gradients in smoking will require persistent and extended intervention over multiple life stages.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Giovino GA, Henningfield JE, Tomar SL, Escobedo LG, Slade J. Epidemiology of tobacco use and dependence. Epidemiol Rev. 1995;17(1):48–65. [PubMed]
  • Escobedo LG, Anda RF, Smith PF, Remington PL, Mast EE. Sociodemographic characteristics of cigarette smoking initiation in the United States. Implications for smoking prevention policy. JAMA. 1990 Sep 26;264(12):1550–1555. [PubMed]
  • Wagenknecht LE, Perkins LL, Cutter GR, Sidney S, Burke GL, Manolio TA, Jacobs DR, Jr, Liu KA, Friedman GD, Hughes GH, et al. Cigarette smoking behavior is strongly related to educational status: the CARDIA study. Prev Med. 1990 Mar;19(2):158–169. [PubMed]
  • Iribarren C, Luepker RV, McGovern PG, Arnett DK, Blackburn H. Twelve-year trends in cardiovascular disease risk factors in the Minnesota Heart Survey. Are socioeconomic differences widening? Arch Intern Med. 1997 Apr 28;157(8):873–881. [PubMed]
  • Nelson DE, Emont SL, Brackbill RM, Cameron LL, Peddicord J, Fiore MC. Cigarette smoking prevalence by occupation in the United States. A comparison between 1978 to 1980 and 1987 to 1990. J Occup Med. 1994 May;36(5):516–525. [PubMed]
  • Pierce JP, Fiore MC, Novotny TE, Hatziandreu EJ, Davis RM. Trends in cigarette smoking in the United States. Educational differences are increasing. JAMA. 1989 Jan 6;261(1):56–60. [PubMed]
  • Osler M, Gerdes LU, Davidsen M, Brønnum-Hansen H, Madsen M, Jørgensen T, Schroll M. Socioeconomic status and trends in risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992. J Epidemiol Community Health. 2000 Feb;54(2):108–113. [PMC free article] [PubMed]
  • Zhu BP, Liu M, Shelton D, Liu S, Giovino GA. Cigarette smoking and its risk factors among elementary school students in Beijing. Am J Public Health. 1996 Mar;86(3):368–375. [PMC free article] [PubMed]
  • Stanton WR, Oei TP, Silva PA. Sociodemographic characteristics of adolescent smokers. Int J Addict. 1994 May;29(7):913–925. [PubMed]
  • Whitlock G, MacMahon S, Vander Hoorn S, Davis P, Jackson R, Norton R. Socioeconomic distribution of smoking in a population of 10,529 New Zealanders. N Z Med J. 1997 Sep 12;110(1051):327–330. [PubMed]
  • Fernandez E, Garcia M, Schiaffino A, Borras JM, Nebot M, Segura A. Smoking initiation and cessation by gender and educational level in Catalonia, Spain. Prev Med. 2001 Mar;32(3):218–223. [PubMed]
  • Hulshof KF, Wedel M, Löwik MR, Kok FJ, Kistemaker C, Hermus RJ, ten Hoor F, Ockhuizen T. Clustering of dietary variables and other lifestyle factors (Dutch Nutritional Surveillance System). J Epidemiol Community Health. 1992 Aug;46(4):417–424. [PMC free article] [PubMed]
  • Pekkanen J, Tuomilehto J, Uutela A, Vartiainen E, Nissinen A. Social class, health behaviour, and mortality among men and women in eastern Finland. BMJ. 1995 Sep 2;311(7005):589–593. [PMC free article] [PubMed]
  • Cavelaars AE, Kunst AE, Geurts JJ, Crialesi R, Grötvedt L, Helmert U, Lahelma E, Lundberg O, Matheson J, Mielck A, et al. Educational differences in smoking: international comparison. BMJ. 2000 Apr 22;320(7242):1102–1107. [PMC free article] [PubMed]
  • Townsend J, Roderick P, Cooper J. Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity. BMJ. 1994 Oct 8;309(6959):923–927. [PMC free article] [PubMed]
  • Fernandez E, Schiaffino A, García M, Borràs JM. Widening social inequalities in smoking cessation in Spain, 1987-1997. J Epidemiol Community Health. 2001 Oct;55(10):729–730. [PMC free article] [PubMed]
  • Bartley M, Fitzpatrick R, Firth D, Marmot M. Social distribution of cardiovascular disease risk factors: change among men in England 1984-1993. J Epidemiol Community Health. 2000 Nov;54(11):806–814. [PMC free article] [PubMed]
  • Bennett S. Cardiovascular risk factors in Australia: trends in socioeconomic inequalities. J Epidemiol Community Health. 1995 Aug;49(4):363–372. [PMC free article] [PubMed]
  • Fiore MC, Novotny TE, Pierce JP, Hatziandreu EJ, Patel KM, Davis RM. Trends in cigarette smoking in the United States. The changing influence of gender and race. JAMA. 1989 Jan 6;261(1):49–55. [PubMed]
  • Harrell JS, Bangdiwala SI, Deng S, Webb JP, Bradley C. Smoking initiation in youth: the roles of gender, race, socioeconomics, and developmental status. J Adolesc Health. 1998 Nov;23(5):271–279. [PubMed]
  • Wallace JM, Jr, Forman TA, Guthrie BJ, Bachman JG, O'Malley PM, Johnston LD. The epidemiology of alcohol, tobacco and other drug use among black youth. J Stud Alcohol. 1999 Nov;60(6):800–809. [PubMed]
  • Breslau N, Peterson EL. Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Public Health. 1996 Feb;86(2):214–220. [PMC free article] [PubMed]
  • Chassin L, Presson CC, Rose JS, Sherman SJ. The natural history of cigarette smoking from adolescence to adulthood: demographic predictors of continuity and change. Health Psychol. 1996 Nov;15(6):478–484. [PubMed]
  • Pierce JP, Gilpin E. How long will today's new adolescent smoker be addicted to cigarettes? Am J Public Health. 1996 Feb;86(2):253–256. [PMC free article] [PubMed]
  • Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992 Jun;82(6):816–820. [PMC free article] [PubMed]
  • Daly Mary C, Duncan Greg J, McDonough Peggy, Williams David R. Optimal indicators of socioeconomic status for health research. Am J Public Health. 2002 Jul;92(7):1151–1157. [PMC free article] [PubMed]
  • Berkman LF, Macintyre S. The measurement of social class in health studies: old measures and new formulations. IARC Sci Publ. 1997;(138):51–64. [PubMed]
  • Gilman Stephen E, Kawachi Ichiro, Fitzmaurice Garrett M, Buka Stephen L. Socioeconomic status in childhood and the lifetime risk of major depression. Int J Epidemiol. 2002 Apr;31(2):359–367. [PubMed]
  • Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Arch Gen Psychiatry. 1981 Apr;38(4):381–389. [PubMed]
  • Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. [PubMed]
  • Farrer LA, Florio LP, Bruce ML, Leaf PJ, Weissman MM. Reliability of self-reported age at onset of major depression. J Psychiatr Res. 1989;23(1):35–47. [PubMed]
  • Wittchen HU, Burke JD, Semler G, Pfister H, Von Cranach M, Zaudig M. Recall and dating of psychiatric symptoms. Test-retest reliability of time-related symptom questions in a standardized psychiatric interview. Arch Gen Psychiatry. 1989 May;46(5):437–443. [PubMed]
  • Vartiainen E, Seppälä T, Lillsunde P, Puska P. Validation of self reported smoking by serum cotinine measurement in a community-based study. J Epidemiol Community Health. 2002 Mar;56(3):167–170. [PMC free article] [PubMed]
  • Wagenknecht LE, Burke GL, Perkins LL, Haley NJ, Friedman GD. Misclassification of smoking status in the CARDIA study: a comparison of self-report with serum cotinine levels. Am J Public Health. 1992 Jan;82(1):33–36. [PMC free article] [PubMed]
  • Gilpin EA, Pierce JP, Farkas AJ. Duration of smoking abstinence and success in quitting. J Natl Cancer Inst. 1997 Apr 16;89(8):572–576. [PubMed]
  • Osler M, Holstein B, Avlund K, Damsgaard MT, Rasmussen NK. Socioeconomic position and smoking behaviour in Danish adults. Scand J Public Health. 2001 Mar;29(1):32–39. [PubMed]
  • Hyman DJ, Simons-Morton DG, Dunn JK, Ho K. Smoking, smoking cessation, and understanding of the role of multiple cardiac risk factors among the urban poor. Prev Med. 1996 Nov-Dec;25(6):653–659. [PubMed]
  • Monsó E, Campbell J, Tønnesen P, Gustavsson G, Morera J. Sociodemographic predictors of success in smoking intervention. Tob Control. 2001 Jun;10(2):165–169. [PMC free article] [PubMed]
  • Benowitz Neal L. Smoking cessation trials targeted to racial and economic minority groups. JAMA. 2002 Jul 24;288(4):497–499. [PubMed]
  • Niaura Raymond, Abrams David B. Smoking cessation: progress, priorities, and prospectus. J Consult Clin Psychol. 2002 Jun;70(3):494–509. [PubMed]
  • Kawaski I, Lochner K. Socioeconomic status. Cancer Causes Control. 1997 Nov;8 (Suppl 1):S39–S42. [PubMed]
  • Power C, Matthews S. Origins of health inequalities in a national population sample. Lancet. 1997 Nov 29;350(9091):1584–1589. [PubMed]
  • Flint AJ, Novotny TE. Poverty status and cigarette smoking prevalence and cessation in the United States, 1983-1993: the independent risk of being poor. Tob Control. 1997 Spring;6(1):14–18. [PMC free article] [PubMed]
  • Brunner E, Shipley MJ, Blane D, Smith GD, Marmot MG. When does cardiovascular risk start? Past and present socioeconomic circumstances and risk factors in adulthood. J Epidemiol Community Health. 1999 Dec;53(12):757–764. [PMC free article] [PubMed]
  • Greenlund KJ, Liu K, Kiefe CI, Yunis C, Dyer AR, Burke GL. Impact of father's education and parental smoking status on smoking behavior in young adults. The CARDIA study. Coronary Artery Risk Development in Young Adults. Am J Epidemiol. 1995 Nov 15;142(10):1029–1033. [PubMed]
  • van de Mheen H, Stronks K, Looman CW, Mackenbach JP. Does childhood socioeconomic status influence adult health through behavioural factors? Int J Epidemiol. 1998 Jun;27(3):431–437. [PubMed]
  • Lynch JW, Kaplan GA, Salonen JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc Sci Med. 1997 Mar;44(6):809–819. [PubMed]
  • Mayhew KP, Flay BR, Mott JA. Stages in the development of adolescent smoking. Drug Alcohol Depend. 2000 May 1;59 (Suppl 1):S61–S81. [PubMed]
  • Harper Sam, Lynch John, Hsu Wan-Ling, Everson Susan A, Hillemeier Marianne M, Raghunathan Trivellore E, Salonen Jukka T, Kaplan George A. Life course socioeconomic conditions and adult psychosocial functioning. Int J Epidemiol. 2002 Apr;31(2):395–403. [PubMed]
  • Gilman Stephen E. Childhood socioeconomic status, life course pathways and adult mental health. Int J Epidemiol. 2002 Apr;31(2):403–404. [PubMed]
  • Davey Smith G, Hart C, Hole D, MacKinnon P, Gillis C, Watt G, Blane D, Hawthorne V. Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiol Community Health. 1998 Mar;52(3):153–160. [PMC free article] [PubMed]
  • Black D, Morris JN, Smith C, Townsend P. Better benefits for health: plan to implement the central recommendation of the Acheson report. BMJ. 1999 Mar 13;318(7185):724–727. [PMC free article] [PubMed]
  • Abrams DB. Transdisciplinary paradigms for tobacco prevention research. Nicotine Tob Res. 1999;1 (Suppl 1):S15–S23. [PubMed]
  • Abrams DB. Nicotine addiction: paradigms for research in the 21st century. Nicotine Tob Res. 1999;1 (Suppl 2):S211–S215. [PubMed]

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