Poverty as a smoking trap

Abstract

Background: The relationship between smoking and poverty is a public health issue in many countries, and several studies have shown a link between living in deprived neighbourhoods and smoking. In France the prevalence of smoking has decreased since the year 2000s. We examined whether reduced smoking rates differed by socio-economic status, anticipating reductions to be smaller amongst lower socio-economic groups. We also investigated whether poor housing conditions and/or living in a deprived neighbourhood were significantly associated with smoking.

Methods: Data were collected by telephone surveys conducted between 2000 and 2007 with representative samples of the French population aged 18-75. The data from the last of these surveys (2007, N=6007) were also used to carry out a cluster analysis on various indicators relating to housing conditions and neighbourhood.

Results: Between 2000 and 2007 the social differential in smoking rates increased sharply in France. Specific types of neighbourhood and poor housing conditions (described as cramped housing in a noisy and stressful environment or deprived neighbourhood), which were closely correlated with socio-economic status, were found to be significantly correlated with smoking, even after adjusting for potential key confounders and especially for individual markers of social disadvantage.

Conclusion: Interventions which do not specifically target smoking but which contribute to improving poor smokers' living conditions, are necessary to promote smoking cessation.