Social determinants of ever initiating smoking differ from those of quitting: a cross-sectional study in Estonia

Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis

Background

In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH.

Methods

A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I² statistics.

Results

This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics.

Conclusions

To the best of our knowledge, this is the first systematic review on the relationship between participants’ socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.

Economic fluctuations and urban-rural differences in educational inequalities in mortality in the Baltic countries and Finland in 2000-2015: a register-based study

We examined urban-rural differences in educational inequalities in mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in the context of macroeconomic changes. Educational inequalities among 30–74 year olds were examined in 2000–2003, 2004–2007, 2008–2011 and 2012–2015 using census-linked longitudinal mortality data. We estimated age-standardized mortality rates and the relative and slope index of inequality. Overall mortality rates were larger in rural areas except among Finnish women. Relative educational inequalities in mortality were often larger in urban areas among men but in rural areas among women. Absolute inequalities were mostly larger in rural areas excepting Finnish men. Between 2000–2003 and 2012–2015 relative inequalities increased in most countries while absolute inequalities decreased except in Lithuania. In the Baltic countries the changes in both relative and absolute inequalities tended to be more favorable in urban areas; in Finland they were more favorable in rural areas. The overall pattern changed during the reccessionary period from 2004–2007 to 2008–2011 when relative inequalities often diminished or the increase slowed, while the decrease in absolute inequalities accelerated with larger improvements observed in urban areas. Despite substantial progress in reducing overall mortality rates in both urban and rural areas in all countries, low educated men and women in rural areas in the Baltic countries are becoming increasingly disadvantaged in terms of mortality reduction.

Socioeconomic factors associated with tobacco smoking among adult males in Sri Lanka

Background

Tobacco smoking is considered as a major public health issue worldwide. Reduction of tobacco usage has been one of the main government policies in Sri Lanka and the price of cigarettes has been raised several times in the last few years. The purpose of this study was to evaluate the socioeconomic factors associated with tobacco smoking among adult males in Sri Lanka.

Methods

A study was conducted in Gampaha district in Sri Lanka recruiting 365 tobacco smoking people and their spouses. Data regarding tobacco smoking were obtained using an interviewer administrated questionnaire.

Results

Frequency of tobacco smoking was negatively associated with the improvement of educational levels. Employment, monthly income, influence of friends, smoking frequency before price increment, weekly expenditure for smoking, low educational level and the age of first smoking exposure was significantly associated with tobacco smoking among smokers. According to the spouses, smoking frequency before price increment, weekly expenditure of the husbands of smoking and influence of friends, number on smoking friends, spouse’s employment and husband’s monthly income were factors associated with tobacco smoking of their husbands. In addition, smoking at home, at work places and at friend’s houses was significant with the frequency of daily smoking.

Conclusions

Increasing the price of tobacco products has no significant impact on smoking behaviors in Sri Lanka. The need for essential strategies to educate and motivate the smokers to stop smoking is required. Primary care health workers might play a major role in motivating smokers to quit smoking.

Income-related inequality in smoking cessation among adult patients with cardiovascular disease: a 5-year follow-up of an angiography intervention in Luxembourg

BACKGROUND

Smoking contributes to cardiovascular diseases (CVD), a leading cause of death and a large source of healthcare costs in Western countries. We examined the association between income and smoking cessation among smokers who underwent coronary angiography at the National Institute for Cardiac Surgery and Interventional Cardiology in Luxembourg.

METHODS

Data were derived from a follow-up study conducted in 2013/2014 among 4391 patients (of which 1001 patients were smokers) at the time of coronary angiography in 2008/2009. Four logistic regression models were applied. In three models, the predictor was income and the covariates were sex, age, nationality, marital status, diagnosis, body mass, physical activity, and awareness of tobacco as a cardiovascular (CV) risk factor. In the other model, the predictor was an interaction term composed of income and awareness of tobacco as a CV risk factor; the other variables were covariates.

RESULTS

Among patients who were current smokers at baseline, 43.2% were current smokers at follow-up and 56.8% had quit smoking. In the multivariate logistic models, quitting smoking was associated with income even after controlling for socio-demographic, diagnostic, and behavioural risk factors. In the full model, the odds of quitting smoking among patients in the two highest income categories remained significant when compared to patients in the lowest income category: odds ratio (OR) = 2.8; 95% confidence interval (CI), 1.3-6.1 and OR = 2.8; 95% CI, 1.2-6.5, respectively. In the full model with an interaction term, quitting smoking was only associated with income when patients knew tobacco was a CV risk factor. The odds of smoking cessation were 5.62 (95% CI: 2.13-14.86) and 3.65 (95% CI: 1.51-8.86) times for patients with annual incomes of 36,000-53,999€ and ≥54,000€, respectively), compared to those for patients with an annual income of <36,000€.

CONCLUSIONS

This study highlights the influence of income on behaviours regarding CVD risk factors after a major CVD event. Patients in the highest income groups were more likely to quit smoking, although only when they were aware of tobacco as a CV risk factor. Therefore, intervention strategies targeting lower income groups should be implemented in major health facilities.

Contribution of smoking-attributable mortality to life expectancy differences by marital status among Finnish men and women, 1971-2010

BACKGROUND

Smoking is known to vary by marital status, but little is known about its contribution to marital status differences in longevity. We examined the changing contribution of smoking to mortality differences between married and never married, divorced or widowed Finnish men and women aged 50 years and above in 1971-2010.

DATA AND METHODS

The data sets cover all persons permanently living in Finland in the census years 1970, 1975 through 2000 and 2005 with a five-year mortality follow-up. Smoking-attributable mortality was estimated using an indirect method that uses lung cancer mortality as an indicator for the impact of smoking on mortality from all other causes.

RESULTS

Life expectancy differences between the married and the other marital status groups increased rapidly over the 40-year study period because of the particularly rapid decline in mortality among married individuals. In 1971-1975 37-48% of life expectancy differences between married and divorced or widowed men were attributable to smoking, and this contribution declined to 11-18% by 2006-2010. Among women, in 1971-1975 up to 16% of life expectancy differences by marital status were due to smoking, and the contribution of smoking increased over time to 10-29% in 2006-2010.

CONCLUSIONS

In recent decades smoking has left large but decreasing imprints on marital status differences in longevity between married and previously married men, and small but increasing imprints on these differences among women. Over time the contribution of other factors, such as increasing material disadvantage or alcohol use, may have increased.

Perfil Sócio-demográfico e Clínico de uma Amostra de Fumantes Portugueses: Implicações do Sexo para a Intervenção na Cessação Tabágica

RESUMO As medidas de cessação tabágica mostram resultados positivos na diminuição da morbidade e mortalidade associadas ao consumo do tabaco. Esses programas possuem maior eficácia quando se adequam às especificidades dos tabagistas. Este estudo teve como objetivo analisar as diferenças de sexo em uma amostra de 100 fumantes portugueses, através da administração de um questionário sócio-demográfico e clínico. Observaram-se diferenças de sexo no número de cigarros consumidos por dia, no momento do dia e no contexto social de maior consumo, no residir com fumantes, na pressão social para deixar de fumar e no sono. As implicações clínicas dos resultados foram discutidas no sentido de otimizar a prestação dos serviços de saúde em contexto de cessação tabágica.

Educational differences in cigarette smoking among adult population in Estonia, 1990-2010: does the trend fit the model of tobacco epidemic?

BACKGROUND

In developed countries, smoking spreads through society like an epidemic in which adults from higher socioeconomic groups are the first to adopt and earlier to quit smoking, and in which exists a lag in adoption of smoking between men and women. The objective of this study was to describe trends in daily and occasional smoking, to investigate association between smoking status and education, and to examine if the associations in 1990-2010 in Estonia fit the pattern predicted by the model of tobacco epidemic.

METHODS

The study was based on a 20-64-year-old subsample (n = 18740) of nationally representative postal cross-sectional surveys conducted every second year in Estonia during 1990-2010. Cigarette smoking and education were examined. χ2 test for trend was used to determine daily and occasional smoking trends over study years. Multinomial logistic regression model was used to test educational differences in daily and occasional smoking for every study year. Adjusted relative risk ratios (RRRs) with 95% confidence intervals were calculated.

RESULTS

In 1990-2010, daily smoking varied largely between genders showing decreasing trend among men, but not among women. In 2010, one third of men and one fifth of women were daily smokers. Daily smoking was not clearly associated with education among men in 1990-1994 and among women in 1990-2000. Men revealed inverse relationship between daily smoking and education since 1996, but women since 2002. In 2010, compared to men and women with higher education, relative risk ratio of daily smoking was 2.92 (95% CI = 2.01-4.25) among men and 2.29 (95% CI = 1.65-3.17) among women with secondary education, but 4.98 (95% CI 3.12-7.94) among men and 6.62 (95% CI = 4.07-10.76) among women with basic education.In 1990-2010, occasional smoking was stable and similar (varying between 7-10%) among men and women, no association with education was found.

CONCLUSIONS

Daily smoking patterns in Estonia fit the model of tobacco epidemic in developed countries. Educational differences in daily smoking highlight the importance of addressing smoking behaviour in the general population by educational subgroups in Estonia.

Surveillance of social and geographic inequalities in housing-related issues: the case of the Eastern Townships, Quebec (Canada)

Even though health inequalities are conditioned by many aspects of the environment, much of the existing research focuses on the social environment. This emphasis has the effect to neglect other environmental aspects such as its physical dimension. The physical environment, which is linked to housing conditions, may contribute to the uneven distribution of health. In this study, we examined 19 housing-related issues among a representative sample of 2,000 adults residing in a Quebec (Canada) health region characterized by a mix of rural, semi-rural, and urban areas. The distribution of these issues was examined according to socioeconomic and geographic indicators of social position. Summary measures of inequalities were assessed. Our results showed that the prevalence of nearly all housing-related issues was higher among low-income households compared to more affluent ones. Highly educated individuals showed better housing conditions, whereas different issues tended to cluster in deprived or densely populated areas. To conclude, we observed steep gradients between social class and poor housing conditions. This may explain a substantial part of health inequality on the regional scale. The surveillance of housing-related issues is therefore essential to properly inform and mobilize local stakeholders and to develop interventions that target vulnerable groups on this level.

Workplace social capital and smoking among Chinese male employees: a multi-level, cross-sectional study

OBJECTIVES

The present study sought to investigate the associations between workplace social capital and smoking status among Chinese male employees.

METHODS

A cross sectional study with a two-stage stratified sampling procedure was conducted in Shanghai in 2012. In total, 1603 male workers from 35 workplaces were involved. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure. Multilevel logistic regression analysis was conducted to explore whether individual-level social capital and aggregated workplace-level social capital were associated with smoking.

RESULTS

Overall, 54.2% of the subjects smoked currently. After controlling for individual covariates (age, education level, marital status, occupational status and job stress), compared to workers in the highest quartile of individual-level social capital, the prevalence ratios of smoking for workers in the third quartile, second quartile and lowest quartile were 1.26 (95% CI: 1.11-1.38), 1.35 (95% CI: 1.19-1.50) and 1.39 (95% CI: 1.24-1.51) respectively. However, there was no relationship between workplace-level social capital and smoking status.

CONCLUSIONS

Higher individual-level social capital was associated with a lower likelihood of smoking among Chinese male employees. By contrast, no clear association was found between workplace-level social capital and smoking. Further longitudinal studies are warranted to examine the possible link between workplace social capital and smoking cessation in Chinese workplaces.

Relationship between Work Hours and Smoking Behaviors in Korean Male Wage Workers

Objectives

The purposes of this study are 1) to measure the prevalence of smoking according to weekly work hours by using data from the Korean Labor and Income Panel Study (KLIPS), and 2) to explain the cause of high smoking prevalence among those with short or long work hours by relative explanatory fraction.

Methods

Data from a total of 2,044 male subjects who responded to the questionnaire in the 10th year (2007) and 11th year (2008) of the Korean Labor and Income Panel Study were used for analysis. Current smoking, smoking cessation, continuous smoking, start of smoking, weekly work hours, occupational characteristics, sociodemographic and work-related factors, and health behavior-related variables were analyzed. Log-binomial regression analysis was used to study the relationship between weekly work hours and smoking behaviors in terms of the prevalence ratio.

Results

The 2008 age-adjusted smoking prevalence was 64.9% in the short work hours group, 54.7% in the reference work hours group, and 60.6% in the long work hours group. The smoking prevalence of the short work hours group was 1.39 times higher than that of the reference work hours group (95% confidence interval of 1.17-1.65), and this was explained by demographic variables and occupational characteristics. The smoking prevalence of the long work hours group was 1.11 times higher than that of the reference work hours group when the age was standardized (95% confidence interval of 1.03-1.19). This was explained by demographic variables. No independent effects of short or long work hours were found when the variables were adjusted.

Conclusion

Any intervention program to decrease the smoking prevalence in the short work hours group must take into account employment type, job satisfaction, and work-related factors.

Alcohol consumption, smoking and overweight as a burden for health care services utilization: a cross-sectional study in Estonia

BACKGROUND

Alcohol consumption, smoking and weight problems are common risk factors for different health problems. We examine how these risk factors are associated with the use of health care services.

METHODS

Data for 6500 individuals in the 25-64 age group came from three cross-sectional postal surveys conducted in 2004, 2006, and 2008 in Estonia. The effect of alcohol consumption, smoking and weight problems on the use of primary and specialist care services, hospitalizations and ambulance calls was analysed separately for men and women by using binary logistic regression.

RESULTS

Overweight and/or obesity were strongly related to the use of primary care and out-patient specialist services for both genders, and to hospitalizations and ambulance calls for women. Current smoking was related to ambulance calls for both genders, whereas smoking in the past was related to the use of primary care and specialist services among men and to hospitalizations among women. Beer drinking was negatively associated with all types of health care services and similar association was found between wine drinking and hospitalizations. Wine drinking was positively related to specialist visits. The frequent drinking of strong alcohol led to an increased risk for ambulance calls. Drinking light alcoholic drinks was positively associated with all types of health care services (except ambulance calls) among men and with the use of specialist services among women.

CONCLUSIONS

Overweight and smoking had the largest impact on health care utilization in Estonia. Considering the high prevalence of these behavioural risk factors, health policies should prioritize preventive programs that promote healthy lifestyles in order to decrease the disease burden and to reduce health care costs.

Socioeconomic Indicators Associated with Initiation and Cessation of Smoking among Women in Seoul

Background

While smoking prevalence in Korean men has been decreasing, it is increasing in Korean women. Little is known about women's smoking inequalities in Korea. This study was conducted to investigate the association of socioeconomic indicators with the initiation and cessation of smoking among Korean women.

Methods

This was a cross-sectional study on 9,089 women aged 25-64 years from the 2008 Seoul Community Health Survey. The data on smoking and socioeconomic status were obtained through face-to-face interviews. Smoking initiation rate was defined as the proportion of the individuals who had started smoking at least one cigarette among all subjects. Smoking cessation rate was calculated by dividing the number of individuals who had quit smoking by the number of ever smokers. Education level, total family income and occupation were investigated as socioeconomic indicators.

Results

Education level was significantly associated with both initiation and cessation of smoking. Lower educated women had a higher likelihood of smoking initiation (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.17 to 2.51) but lower likelihood of smoking cessation (OR, 0.38; 95% CI, 0.22 to 0.66) than higher educated women. Smoking initiation rate was higher in manual workers (OR, 1.65; 95% CI, 1.20 to 2.27) than in non-manual workers. However, there were no significant differences of both initiation and cessation of smoking according to total household income.

Conclusion

This study shows that there are smoking inequalities among Korean women. It is thought that education level and occupation are important determinants of women's smoking status.

Avoidable mortality in Estonia: exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007

OBJECTIVES

A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia.

STUDY DESIGN

Descriptive study.

METHODS

Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable).

RESULTS

The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death.

CONCLUSIONS

Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures.

Regional surveillance of social and geographic inequalities in smoking: the case of Montréal, Canada

Surveillance of social inequalities in health is a platform for action. We examined the trends in smoking behaviours (current and ever smoking, quit ratios) according to education and place of residence and we quantified the observed inequalities. Data were from repeated cross-sectional surveys (2003-2009) of Montreal (Canada) residents ≥15 years (n=12,053). Trends in smoking behaviours according to education were measured with logistic and log-binomial regressions. Spatial distribution of smoking behaviours across local areas was assessed with Morans' Index. Observed inequalities were quantified with prevalence ratio and difference, population attributable risk, and slope index of inequality. Results showed that ever smoking rose among low-educated individuals. Among their high-educated fellow-citizens, current smoking decreased and quit ratios increased. Adverse smoking behaviours (current and ever smoking) were clustered in south-central areas. We conclude that smoking inequalities in Montreal are growing. We thus encourage a closer monitoring of smoking social differentials.

Nicotine dependence and psychological distress: outcomes and clinical implications in smoking cessation

Nicotine dependence is characteristically a chronic and relapsing disease. Although 75%-85% of smokers would like to quit, and one-third make at least three serious lifetime attempts, less than 50% of smokers succeed in stopping before the age of 60. Relevant and complex factors contributing to sustained cigarette consumption, and strongly implicated in the clinical management of smokers, are the level of nicotine dependence and psychological distress. In this review of the literature, these two factors will be examined in detail to show how they may affect smoking cessation outcome and to encourage clinicians to assess patients so they can offer tailored support in quitting smoking.

Is income or employment a stronger predictor of smoking than education in economically less developed countries? A cross-sectional study in Hungary

Background

In developed European countries in the last phase of the smoking epidemic, education is a stronger predictor of smoking than income or employment. We examine whether this also applies in economically less developed countries.

Methods

Data from 7218 respondents in the 25-64 age group came from two National Health Interview Surveys conducted in 2000 and 2003 in Hungary. Independent effects of educational level, income and employment status were studied in relation to smoking prevalence, initiation and continuation for all age groups combined and separately for 25-34, 35-49 and 50-64 years old. Absolute levels were evaluated by using age-standardized prevalence rates. Relative differences were assessed by means of logistic regression.

Results

Education and income, but not employment, were associated with equally large differences in smoking prevalence in Hungary in the 25-64 age group. Among men, smoking initiation was related to low educational level, whereas smoking continuation was related to low income. Among women, low education and low income were associated with both high initiation and high continuation rates. Considerable differences were found between the age groups. Inverse social gradients were generally strongest in the youngest age groups. However, smoking continuation among men had the strongest association with low income for the middle-aged group.

Conclusions

Patterns of inequalities in smoking in Hungary can be best understood in relation to two processes: the smoking epidemic, and the additional effects of poverty. Equity orientated tobacco control measures should target the low educated to prevent their smoking initiation, and the poor to improve their cessation rates.

Smoking, sociodemographic determinants, and stress in the Alabama Black Belt

PURPOSE

In the Alabama Black Belt, poverty is high, and the educational level is low. Studies have found increased tobacco use among individuals exposed to high levels of stress. Few studies have been conducted in this region to measure smoking status, its sociodemographic determinants, and how smoking status relates to stressful environmental conditions.

METHODS

A cross-sectional questionnaire survey of 1,387 individuals.

FINDINGS

Approximately 25% of the respondents currently smoked cigarettes. Females were less likely to smoke compared to males (OR, 0.29; 95% CI, 0.23-0.38). Blacks were less likely to smoke cigarettes compared to whites (OR, 0.64; 95% CI, 0.43-0.95). Compared to individuals who were employed, participants who were unemployed or retired had increased odds of smoking (OR, 1.68; 95% CI, 1.15-2.20). The odds of being a current smoker were increased in the presence of moderate level stress (OR, 2.06; 95% CI, 1.38-3.07) or when there was a high level of stress (OR, 2.21; 95% CI, 1.47-3.31). Smoking was associated with increased odds of having a moderate level (OR, 2.06; 95% CI, 1.38-3.08) and a high level of stress (OR, 2.21; 95% CI, 1.47-3.32). Females who reported moderate to high levels of stress had increased odds of being smokers compared to males. Interaction between gender and stress showed deviation from additivity.

CONCLUSION

Our findings suggest a high rate of cigarette use in the area. Increased stress levels appear to predispose females more than males to cigarette smoking. The implications of this association may guide interventions targeted at reducing smoking and its complications.

Comparison of socioeconomic differences in self-perceived health in Estonia and Finland

Aim: To compare self-perceived health in relation to socioeconomic factors in Estonia and Finland. Methods: This study was based on the 25—69 year old adult population of the European Social Survey, conducted in Estonia and in Finland in 2006. Self-perceived health was rated on the five-point scale as very good, good, fair, poor, and very poor. The socioeconomic position was measured by the level of education, economic activity, and self-rated financial situation. Logistic regression analysis was applied to assess the association between self-perceived health and the socioeconomic factors. Results: The prevalence of less-than-good health was significantly higher in Estonia than in Finland. Significant associations with less-than-good self-perceived health were found for less educated, economically non-active respondents with poorer self-rated financial situation in both countries. After adjustment, economic non-activity among women and self-rated financial situation among men appeared not to be associated with less-than-good self-perceived health in Finland. Conclusions: Self-perceived health was poorer in Estonia than in Finland, but Estonia shares with Finland a similar socioeconomic pattern of health. Further research is needed to monitor socioeconomic variations in health behaviour and mortality in both countries.

Work-place social capital and smoking cessation: the Finnish Public Sector Study

AIMS

To examine whether high social capital at work is associated with an increased likelihood of smoking cessation in baseline smokers.

DESIGN

Prospective cohort study.

SETTING

Finland.

PARTICIPANTS

A total of 4853 employees who reported to be smokers in the baseline survey in 2000-2002 (response rate 68%) and responded to a follow-up survey on smoking status in 2004-2005 (response rate 77%).

MEASUREMENTS

Work-place social capital was assessed using a validated and psychometrically tested eight-item measure. Control variables included sex, age, socio-economic position, marital status, place of work, heavy drinking, physical activity, body mass index and physician-diagnosed depression.

FINDINGS

In multi-level logistic regression models adjusted for all the covariates, the odds for being a non-smoker at follow-up were 1.26 [95% confidence interval (CI)=1.03-1.55] times higher for baseline smokers who reported high individual-level social capital than for their counterparts with low social capital. In an analysis stratified by socio-economic position, a significant association between individual-level social capital and smoking cessation was observed in the high socio-economic group [odds ratio (OR) (95% CI)=1.63 (1.01-2.63)], but not in intermediate [(OR=1.10 (0.83-1.47)] or low socio-economic groups [(OR=1.28 (0.86-1.91)]. Work unit-level social capital was not associated with smoking cessation.

CONCLUSIONS

If the observed associations are causal, these findings suggest that high perceived social capital at work may facilitate smoking cessation among smokers in higher-status jobs.