Affluent professionals who smoke have higher death rates than low-paid nonsmokers of the same sex, according to British researchers.
They conclude that smoking may be a greater cause of health disparities than social class.
The study also found that smoking cancels out the survival advantage women normally have over men. The findings show that "in essence, neither affluence nor being female offers a defense against the toxicity of tobacco", noted the study authors, from NHS Health Scotland and the University of Glasgow.
The researchers analysed how smoking affected the survival rates of 15 000 residents in the West of Scotland who were recruited in 1972-76. The participants were grouped by gender and social class, and then further divided into smokers, never-smokers and ex-smokers.
What the study revealed
When the death rates of the participants were assessed after 14 and 28 years, smokers had much higher death rates than never-smokers in every social class.
After 28 years, 56% of female never-smokers and 36% of male never-smokers in the lowest social classes were still alive, compared with 41% of female smokers and 24% of male smokers in the top social classes. Death rates for smokers in the lowest social classes were even higher.
Death rates of ex-smokers were much closer to those of never-smokers than smokers, which shows that quitting smoking does make a difference regardless of social class, the researchers said. The findings appear in the British Medical Journal.
"This study reinforces current policies in the United Kingdom and other countries aimed at helping smokers stop smoking," said study author Dr Laurence Gruer, director of public health science at NHS Scotland. "Accessible and effective smoking cessation advice and services, as well as strong action to discourage young people from starting to smoke, are key to reducing health inequalities. With over 23% of adults in the UK still smoking, rising to well over 40% in some places and groups, it's crucial we continue to make smoking cessation a top priority." – (HealthDay News, February 2009)
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