Abstract
This study aimed to measure changes in socioeconomic inequalities in smoking and smoking cessation due to the 2006 smoking ban in Luxembourg. Data were derived from the PSELL3/EU-SILC (Panel Socio-Economique Liewen Zu Letzebuerg/European Union—Statistic on Income and Living Conditions) survey, which was a representative survey of the general population aged ≥16 years conducted in Luxembourg in 2005, 2007, and 2008. Smoking prevalence and smoking cessation due to the 2006 smoking ban were used as the main smoking outcomes. Two inequality measures were calculated to assess the magnitude and temporal trends of socioeconomic inequalities in smoking: the prevalence ratio and the disparity index. Smoking cessation due to the smoking ban was considered as a positive outcome. Three multiple logistic regression models were used to assess social inequalities in smoking cessation due to the 2006 smoking ban. Education level, income, and employment status served as proxies for socioeconomic status. The prevalence of smoking decreased by 22.5% between 2005 and 2008 (from 23.1% in 2005 to 17.9% in 2008), but socioeconomic inequalities in smoking persisted. Smoking prevalence decreased by 24.2% and 20.2% in men and women, respectively; this difference was not statistically significant. Smoking cessation in daily smokers due to the 2006 smoking ban was associated with education level, employment status, and income, with higher percentages of quitters among those with a lower socioeconomic status. The decrease in smoking prevalence after the 2006 law was also associated with a reduction in socioeconomic inequalities, including differences in education level, income, and employment status. Although the smoking ban contributed to a reduction of such inequalities, they still persist, indicating the need for a more targeted approach of smoke-free policies directed toward lower socioeconomic groups.
Highlights
Smoking is a major cause of premature mortality and morbidity and is a global public health issue
Our results showed that socioeconomic inequalities in smoking persisted over the study period, regardless of measurement by education level, household equivalent income, or employment status
As this study only focused on the potential impact of the 2006 smoke-free law, the proportion of smokers who ceased smoking as a result of the 2006 smoking ban is probably lower than the general smoking cessation rate
Summary
Smoking is a major cause of premature mortality and morbidity and is a global public health issue. To address the harmful effects of smoking on population health, the Government of the Grand Duchy of Luxembourg adopted a smoke-free law on September 5, 2006 that was intended to "protect everyone against the harmful effects of passive smoking" and was aimed at "restricting advertising of tobacco and its products, banning smoking in certain places and prohibition of placing on the market of tobacco for oral use" [16] These places included public areas, such as restaurants, bars, hospitals, schools, museums, theatres, modes of public transportation (trains, buses, and airplanes), nursing homes and accommodations for the elderly, and the workplace. Tobacco consumption volumes per capita in Luxembourg are artificially high and do not reflect the actual consumption of tobacco by its residents
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