Smoking Inequalities: Study Shows Why Quitting Remains Harder for Disadvantaged Groups

A large study of more than 195,000 adults in England has found that people experiencing greater socioeconomic disadvantage are consistently more likely to smoke, have higher levels of tobacco addiction and be less motivated to quit smoking. The findings suggest that smoking inequalities remain a significant public health challenge despite ongoing tobacco control efforts.

 

Researchers analysed nationally representative survey data collected between 2014 and 2023. They examined five indicators of socioeconomic position: occupational social grade, employment status, housing tenure, education level and household income. The study explored how these factors were associated with smoking prevalence, nicotine dependence, motivation to quit, quit attempts, quitting success and the use of smoking cessation aids.

 

Outcome	Research Finding
Smoking prevalence	Higher likelihood of smoking
Tobacco addiction	Higher levels of nicotine dependence
Motivation to quit	Lower motivation to stop smoking
Quit attempts	Lower likelihood among several disadvantaged groups
Quitting success	Lower success for people living in disadvantaged housing tenures

Researchers also found that while disadvantaged groups were generally less likely to make a quit attempt according to several socioeconomic measures, the evidence for quitting success varied depending on which measure of disadvantage was used. Housing tenure showed the clearest relationship with lower quit success, whereas other indicators produced less consistent findings.

 

The study reported that e-cigarettes were the most commonly used smoking cessation aid among participants. However, patterns of use varied by socioeconomic circumstances, and researchers did not find a consistent relationship across all measures of disadvantage. Evidence for other cessation aids—including prescription medications, behavioural support and nicotine replacement therapy—was either inconsistent or limited by uncertainty.

Importantly, the researchers cautioned that differences in access, affordability and personal perceptions of cessation aids may contribute to these variations.

 

Smoking continues to place a disproportionate health burden on people experiencing social and economic disadvantage. The researchers suggest that future studies investigating smoking behaviours may not need to measure multiple indicators of socioeconomic position, as overall patterns remain similar regardless of which indicator is used. However, they also emphasise that this does not mean one smoking cessation strategy will work equally well for every disadvantaged group. Tailored support may still be necessary depending on an individual’s circumstances.

 

Although this study was conducted in England, its findings reinforce an important public health message that is relevant in Australia: people facing financial or social disadvantage may encounter additional barriers when trying to quit smoking.

If you’re planning to quit, support is available. Speaking with your GP, pharmacist, or another qualified healthcare professional can help you understand evidence-based smoking cessation options appropriate to your individual circumstances. Every quit attempt is an opportunity to improve your health, and seeking support can make that journey easier.

 

Authors: Annika Theodoulou, Jamie Hartmann-Boyce, Nicola Lindson, Thomas R. Fanshawe and Sarah Jackson.

Journal: Nicotine & Tobacco Research (Oxford University Press)

Original research examined smoking behaviours among 195,543 adults in England between 2014 and 2023.