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The contribution of smoking to socioeconomic differentials in mortality: results from the Melbourne Collaborative Cohort Study, Australia
  1. Mohammad Siahpush1,
  2. Dallas English2,
  3. John Powles3
  1. 1Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Carlton, Melbourne, Australia
  2. 2Cancer Epidemiology Centre, The Cancer Council Victoria, Carlton, Melbourne, Australia
  3. 3Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
  1. Correspondence to:
 M Siahpush
 Centre for Behavioural Research in Cancer, The Cancer Council Victoria, 1 Rathdown St, Carlton 3053, Melbourne, Australia; mohammad.siahpush{at}


Objective: To assess the contribution of smoking to the inverse association of mortality with years of formal education in men in Australia.

Design: Data were obtained from a prospective cohort study that included 17 049 men in Melbourne recruited from 1990 to 1994, most of whom were aged between 40 and 69 years at baseline. The outcome measured was all-cause mortality. The contribution of smoking to socioeconomic status differentials was estimated by including smoking as a variable in a Cox’s proportional hazards model that also included education and other potential confounding variables.

Results: In men, the association between education and mortality was attenuated after adjustment for smoking, and the aetiological fraction for low levels of education was reduced from 16.5% to 10.6%.

Conclusions: In men, smoking contributes substantially to socioeconomic differentials in mortality. Effective policies and interventions that target smoking among socially disadvantaged groups may substantially reduce socioeconomic differentials in health.

  • SES, socioeconomic status

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  • Funding: Cohort recruitment was funded by the Victorian Health Promotion Foundation (VicHealth) and The Cancer Council Victoria. This research was supported in part by grants from VicHealth and the National Health and Medical Research Council (209057). MS is supported by a fellowship from VicHealth.

  • Competing interests: None declared.

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