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Socioeconomic inequalities in smoking cessation in 11 European countries from 1987 to 2012
  1. Jizzo R Bosdriesz1,
  2. Marc C Willemsen2,3,
  3. Karien Stronks1,
  4. Anton E Kunst1
  1. 1Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  2. 2Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
  3. 3Alliance Smokefree Holland, The Hague, The Netherlands
  1. Correspondence to Jizzo R Bosdriesz, Department of Public Health, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, Amsterdam 1100DD, The Netherlands; j.bosdriesz{at}


Background During the 1990s, inequalities in smoking prevalence by socioeconomic status (SES) have widened in Europe. Since then, many tobacco control policies have been implemented. Yet, European overviews of recent trends in smoking inequalities are lacking. This paper aims to provide an overview of long-term trends of socioeconomic inequalities in smoking cessation in Europe.

Methods We used data for 11 countries taken from Eurobarometer surveys from 1987 to 1995 and 2002–2012, with a total study sample of 63 737 respondents. We performed multilevel logistic regression to model associations of the quit ratio (proportion former smokers of ever smokers) with SES, measured by education and occupation separately, with adjustments for age, sex and time.

Results We found a significant, positive association for education and occupation with the quit ratio. The strength of the association decreased slightly from 1987 to 1995 and increased again from 2002 to 2012. Inequalities increased between the two periods in most countries and decreased in only one country. While in 1987–1995, the quit ratio increased among all SES groups and most strongly among the low SES group, in 2002–2012 it increased only among the high-education group (OR=1.38, 95% CI 1.02 to 1.87), and non-manual occupation group (OR=1.59, 95% CI 1.19 to 2.12).

Conclusions Socioeconomic inequalities in smoking cessation rates have strongly increased since the 1990s and during the 2000s. This suggests that the tobacco control policies implemented during the 2000s have not been able to counter the trend in increasing inequalities.


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