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. 2018 Jan;63(1):41-48.
doi: 10.1007/s00038-017-1029-7. Epub 2017 Aug 23.

The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991-2008

Olof Östergren  1 , Pekka Martikainen  2 , Olle Lundberg  3
Affiliations

The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991-2008

Olof Östergren et al. Int J Public Health. 2018 Jan.

Abstract

Objectives: To assess the level and changes in contribution of smoking and alcohol-related mortality to educational differences in life expectancy in Sweden.

Methods: We used register data on the Swedish population at ages 30-74 during 1991-2008. Cause of death was used to identify alcohol-related deaths, while smoking-related mortality was estimated using lung cancer mortality to indirectly assess the impact of smoking on all-cause mortality.

Results: Alcohol consumption and smoking contributed to educational differences in life expectancy. Alcohol-related mortality was higher among men and contributed substantially to inequalities among men and made a small (but increasing) contribution to inequalities among women. Smoking-related mortality decreased among men but increased among women, primarily among the low educated. At the end of the follow-up, smoking-related mortality were at similar levels among men and women. The widening gap in life expectancy among women could largely be attributed to smoking.

Conclusions: Smoking and alcohol consumption contribute to educational differences in life expectancy among men and women. The majority of the widening in the educational gap in mortality among women can be attributed to alcohol and smoking-related mortality.

Keywords: Alcohol; Health inequalities; Mortality; Registers; Smoking.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical permission

The use of data was approved by the KI regional ethics committee (Ref. 02-481).

Funding

This work was supported by the Faculty of Social Sciences, Stockholm University, the Academy of Finland, the Swedish Research Council for Health, Working Life and Welfare (Grant No. 1933006), as well as the Joint Committee for Nordic Research Councils for the Humanities and the Social Sciences (NOS-HS) (Project No. 4.4-2015-61).

Figures

Fig. 1
Fig. 1
Temporary life expectancy (ages 30 and 74) for observed deaths, excluding smoking-related deaths, and excluding alcohol-related deaths by high, intermediate, and low educational attainment, Sweden, 1991–2008. Men and women
Fig. 2
Fig. 2
The contribution of smoking and alcohol-related mortality to the difference in temporary life expectancy (ages 30–74) between high and low educated, Sweden 1991–2008. Men and women
See this image and copyright information in PMC

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