Widening inequalities in smoking rates in the Republic of Ireland?

Abstract

Objectives: To assess patterns in adult smoking rates in Ireland across two main socio-economic indicators: level of education and social class (SC), using national cross-sectional survey data from 1998 and 2007.

Methods: Complete smoking-related information on adults (≥18 years) for 1998 [n=6,293] and 2007 [n=10,251] were analysed. Age-standardized smoking rates for each of the two main indicators were computed overall and by sex using 2002 Census as the standard population. Relative index of inequality (RII) in age-standardized smoking rates was computed (comparing the lowest with the highest socio-economic groups) for each calendar year based on relative ranking (0=highest; 1=lowest) and then regressing the cumulative percentile distribution of the sub-classes within each year. 95% confidence intervals (CI) for RII were generated.

Results: Overall, sample-weighted smoking rates declined from 33% (in 1998) to 29% (in 2007). However, the lowest SC groups recorded 51% higher smoking rates compared to the highest SC smoking rates in 1998 and this widened relatively by 37% to 70% in 2007. Smoking rates among those with lowest education widened relatively by 40% (from 35% to 49%) between the two time-periods compared to the highest groups. Female smoking rates have increased more relative to their male counterparts in lower SC groups.

Conclusions: Overall, smoking rates have declined in Ireland over a 10-year period but using “a” relative index of inequality measure, social inequalities in smoking rates have significantly widened in lower socio-economic groups, worsening further among disadvantaged females.Tobacco control policies combined with socio-economic interventions are imperative to address these inequalities.