Smoking inequalities and tobacco control policies in Europe

Phd thesis, Mirte A. G. Kuipers
Publication: 02-06-2016

Smoking is the worlds’ leading avoidable cause of mortality and kills 6 million people each year. Individuals of lower socioeconomic status are more likely to initiate smoking and less likely to quit smoking. Tobacco control policies have been implemented in the last decades, but although smoking prevalence decreased, smoking inequalities increased over time. This thesis aimed at assessing socioeconomic inequalities in smoking in Europe and the effects of tobacco control policies on smoking and smoking inequalities.

The findings show that adolescents’ own educational performance is more predictive of smoking than their parents’ socioeconomic status. The level of adolescent smoking changed over time and varied between European countries. More strongly developed tobacco control policies were related to lower smoking rates. In general, this effect was observed in high as well as low educational groups. However, inequalities in smoking between these groups remain undiminished.

This thesis concludes that future socioeconomic inequalities in smoking may be reduced if youth access to tobacco is further constrained, students who perform more poorly in school are provided with individual support, and tobacco is de-normalised in such ways that smokers are not stigmatised or considered rebels.

Read the thesis here.