Thirty-eight-year trends of educational differences in smoking in Finland

Oona Pentala-Nikulainen,Pekka Jousilahti,Pekka Puska,Antero Heloma,Jouni Lahti,Ossi Rahkonen,Otto Ruokolainen

doi:10.1007/s00038-019-01228-x

Abstract

ObjectivesSmoking is declining, but it is unevenly distributed among population groups. Our aim was to examine the socio-economic differences in smoking during 1978–2016 in Finland, a country with a history of strict tobacco control policy.MethodsAnnual population-based random sample data of 25–64-year-olds from 1978 to 2016 (N = 104,315) were used. Response rate varied between 84 and 40%. In addition to logistic regression analysis, absolute and relative educational differences in smoking were examined.ResultsSmoking was more prevalent among the less educated but declined in all educational groups during the study period. Both absolute and relative differences in smoking between the less and highly educated were larger at the end of the study period than at the beginning. Cigarette price seemed to have a larger effect on the smoking among the less educated.ConclusionsSocio-economic differences in smoking among the Finnish adult population have increased since the 1970s until 2016. Further actions are needed, especially focusing on lower socio-economic positions, to tackle inequalities in health. They should include support for smoking cessation and larger cigarette tax increases.

Highlights

The detrimental effects of smoking on health are well known and reported (USDHHS 2014)
Cigarette price seemed to have a larger effect on the smoking among the less educated
Socio-economic differences in smoking among the Finnish adult population have increased since the 1970s until 2016

Summary

Introduction

The detrimental effects of smoking on health are well known and reported (USDHHS 2014). Smoking has declined in Europe since the 1980s, but it is differently distributed among the population 1996; European Commission 2003, 2017). Men and lower socio-economic groups generally smoke more than women and the higher socio-economic groups, and the differences. National Institute for Health and Welfare, Po Box 30, Helsinki, Finland. A central aim of Finnish health policy, in addition to improving public health, is to reduce inequalities in health (Melkas 2013). Legislation has a history of four decades, as the first Tobacco Control Act (TCA)

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