Low Socioeconomic Status a Common Thread Among US Smokers

According to the CDC, the smoking rate in the United States has been on the decline over a decade since 2005, and according to research conducted at the Colorado School of Public Health at CU Anschutz, a majority of those who continue to smoke have a low socioeconomic status.

For this study, the authors gathered 2012 data from the national supplement to The Attitudes and Behaviors Surveys (TABS) on Health for adults in the state of Colorado. The authors were particularly interested in establishing smoking prevalence in the state and ascertaining the impact of education, poverty level, occupation, and health insurance status on smoking.

TABS is a population-level survey of Colorado adults to identify and understand influential factors that public health programs can address to improve the health of people in the state. The objective is to document the extent of chronic diseases and health risks and to support planning, implementation, and evaluation of state and local programs to address them.

“In the last half-century, public health efforts helped cut the smoking rate by more than half, but we probably need to change our strategies for helping smokers quit,” said study author Arnold Levinson, PhD, MJ, in a press release.

Their analysis found that smoking ranged between 24.2% to 42.6% among those with a low socioeconomic status. When the analysis combined highest prevalence with low socioeconomic status, prevalence accounted for 31.1% of US adults but only 50% of smokers.

Levinson said that it’s hard to find part of the population experiencing high rates of a health problem and simultaneously representing many affected people. “But with smoking, we have this unusual situation: Americans with lower socioeconomic status today are suffering from epidemic smoking rates, and they make up nearly three-fourths of all our remaining smokers,” he said.

When all the low socioeconomic status categories were combined, it made up about 53% of adults and about 72% of smokers. These are startling data.

Do these numbers represent a difference in smokers' attempts to quit or a need for distinct programs based on the target population? The authors believe that lower socioeconomic smokers who try to quit are less likely to succeed. “The methods that worked for the upper half of society don’t seem to be working well for the other half,” Levinson said.

“Further progress against the US cigarette epidemic depends on focusing tobacco research and program initiatives on reaching and engaging these smokers in cessation strategies that work for them,” the paper concludes.

The study has been published in the Journal of Health Care for the Poor and Undeserved.