Smoking prevalence in the UK has fallen steadily over the last two decades. In 2000, 27% of adults aged 16 and over in Great Britain smoked cigarettes compared with 40% in 1978. However, most of this decline occurred in the 1970s and 1980s. In the 1990s the decline in smoking prevalence among adults levelled off (Office for National Statistics, 2001).
The prevalence of smoking is higher among people in manual than non-manual social classes (31% compared with 23% in England in 2000). The widening of this gap over the past 20 years reflects a steeper decline in smoking prevalence among non-manual classes compared with manual classes.
However, between 1998 and 2000, overall prevalence of cigarette smoking among those in manual groups in England fell by two percentage points. Although this is a statistically significant fall, the Office for National Statistics advises caution about a year on year comparison because the data may have been affected by recent changes in assessing socio-economic groups (Office for National Statistics, 2001).
The social class differentials in smoking are reflected in the social gradients of deaths caused by smoking. Among men, smoking accounts for over half of the difference in risk of premature death between social classes (Jarvis and Wardle, 1999). Premature deaths from lung cancer are five times higher among men in unskilled manual work compared to those in professional occupations (DH, 1998a).
Pregnant women
Two data sources are available to estimate smoking among pregnant women in England. The Infant Feeding Survey, which is the main source of information used by the Department of Health to monitor progress towards the tobacco white paper target on smoking in pregnancy, is conducted every five years among women who have recently given birth. The data on smoking are both retrospective and unvalidated by biochemical measures.
The 2000 survey gives prevalence figures for England of 23% for 1995 (the figure used for the baseline of the tobacco white paper target) and 18% for 2000 (DH, 2001c).
From 1992 to 2000, the former Health Education Authority (HEA) conducted annual surveys among pregnant women in England. The proportion of pregnant smokers fluctuated over that time (Owen et al.,1998; Owen and Penn, 1999). In 1999 nearly a third of women (31.5%) smoked during pregnancy compared to 27% in 1992. Smoking was especially prevalent among women who were single, separated or divorced (55.5%), in social groups DE (52.2%), living in rented local authority accommodation (57.3%), or who had left full-time education at 15 and 16 years old (52.9% and 42.7% respectively) (Owen and McNeill, 2001).
When a sample of responses was validated by biochemical measure (saliva cotinine) it revealed an under-reporting of the current smoking status among pregnant women of about 3%. This suggests that government estimates of smoking in pregnancy may be underestimates (Owen and McNeill, 2001).
Young people
In 2000, an estimated 10% of children aged 11-15 were regular smokers, an increase from 9% in 1999 (DH, 2001a). Smoking behaviour in this group has fluctuated considerably over time, showing a low of 8% in 1988 and a high of 13% in 1996 (DH, 2000c). As the majority of smokers take up the habit in their teens, any increases in the rates of young smokers will eventually feed through into adult smoking rates.
Black and minority ethnic groups
Cigarette smoking among minority ethnic groups is generally less than among the UK population as a whole (27%), but a more detailed examination reveals important differences between and within groups. The smoking rate among Bangladeshi men is particularly high (44%). Smoking rates are even higher among middle-aged and older Bangladeshi men (50% and 54% for men aged between 35-54 and 55+ years respectively). This same group of men also has high rates of chewing tobacco products.
Tobacco chewing is particularly high among older Bangladeshi women: 43% of women aged 35-54 years and 56% of women aged over 55 years chew tobacco (DH, 1999a).
Poverty and smoking
Traditional measures of social class tend to underplay the extent to which high smoking rates have not decreased in the poorest sections of society. Recent studies have shown that smoking levels have remained virtually unchanged among those in the poorest groups, and among lone mothers smoking levels have risen (Marsh and McKay, 1994; Dorsett and Marsh 1998; Jarvis, 1998). In a detailed study, lone parents living in rented accommodation and relying on social security benefits were found to have smoking levels in excess of 75% (Dorsett and Marsh, 1998).
HEALTH DEVELOPMENT AGENCY, UK
Source: medicalnewstoday.com
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