Abstract
IntroductionSmoking among those who live with children is an important influence on smoking initiation among children. This study assessed socioeconomic inequalities in smoking and quitting-related outcomes among all adults with and without children in the household.Aims and MethodsMonthly repeat cross-sectional household survey of adults (16+) from 2013–2019 in England (N = 138 583). We assessed the association between cigarette smoking and quitting-related outcomes and having children in the household, and whether these relationships were moderated by occupational social grade (categories AB–E from most to least advantaged). Trends in smoking prevalence among adults with and without children in the household were explored.ResultsIn adjusted analysis, the association of having children in the household with smoking prevalence depended on social grade: smoking prevalence was between 0.71 (95% confidence interval 0.66–0.77) and 0.93 (0.88–0.98) times lower among social grades AB–D with children in the household relative to those without. Conversely, it was 1.11 (1.05–1.16) times higher among social grade E. Yearly prevalence declined similarly among those with and without children (both prevalence ratio: 0.98, 95% confidence interval 0.97–0.99). Motivation to stop smoking was higher among those with children than those without, but lower among disadvantaged than more advantaged groups. Social grades D–E had greater heavy smoking, but higher prevalence of past-month quit attempts.ConclusionsAmong the most disadvantaged social grade in England, smoking prevalence was higher in those with children in the household than without. To attenuate future smoking-related inequalities, there is an urgent need to target support and address barriers to quitting and promote longer-term quit success.ImplicationsIn the most disadvantaged occupational social grade, having children in the household was associated with higher smoking prevalence compared with not having children. This contrasts with all other social grades in which there was lower comparative smoking prevalence among those with than without children in the household. Without attention this disparity could exacerbate existing and future health inequalities related to smoking.
Highlights
Smoking among those who live with children is an important influence on smoking initiation among children
We aimed to explore trends in smoking prevalence between 2013 and 2019 according to socio-economic position (SEP) among adults with and without children in the household, respectively
Comparisons with sales data and other national surveys show that the Smoking Toolkit Study (STS) recruits a representative sample of the population in England u with regards to key demographic variables and smoking indicators [23]. n The sample dataset consisted of STS respondents from March 2013 to December 2019 inclusive
Summary
Smoking among those who live with children is an important influence on smoking initiation among children. Progress in reducing current smoking prevalence among 11-15 year olds in England (22% in 1996 to 5% in 2018 [4]) is t likely partially reflective of the declines in adult smoking seen over a period of major rip tobacco control legislation (namely the 2007 smokefree law, 2012 and 2015 tobacco retail display bans, 2015 ban on smoking in cars with children, 2016 standardised packaging and ongoing tobacco taxation) [5,6,7,8] Despite this overall reduction, in recent years there is some c evidence that the decline in smoking among youth is stalling across the UK nations [4,9,10], and a socio-economic gradient in adult smoking remains [11]. Those of more disadvantaged s socio-economic position (SEP) exhibit persistently higher smoking rates (25% in routine and u manual occupations smoke versus 10% in managerial and professional occupations) and bear a disproportionate burden of the associated morbidity and mortality [12]
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More From: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
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