Accordingtodatafromthe1995MicrocensusStudypublishedin1998,adeinitesocial differentiationforsmokersofbothsexescanalsobeidentiiedinGermany.Smokingwas
2–3timesmoreprevalentamongmenandwomenwithaloweducationallevelthanamong thosewithahighereducationallevelorinthegraduateprofessionsFig.
2.3
[73] .The
highestsmokingprevalenceswerefoundamongmenwithsimplemanualjobsbuilding sitelabourers,roadconstructionworkers,etc..Thehighestratesamongwomenwerefound
forworkersinthehotelandrestauranttrade,careassistantsfortheelderlyandcleaners,etc. Fig.
2.3 .Theseresultsareconsistentwithindingsfrominternationalsurveys.
Overall,itisconcludedthatcigarettesmokingistakenupinstage1bypeoplewithahigher educationallevelandwhoareinanciallybetteroffasintheUSAintheearlyyearsofthe
3.5 3
2.5 2
1.5 1
0.5 DK
FIN F
I NL
N D
GB P
E S
CH
Odds Ratio
SmMal20-44 SmMal45-74
SmFem20-44 SmFem45-74
Fig. 2.10
OddsratiosORsin12EUcountriesformaleSmMalandfemaleSmFemsmokers, eachintwoagegroups20–44yearsand45–74years
[72] .ORsgreaterthan1.0areindicativeof
anassociationbetweensmokingandloweducationallevel
Stage1 Smokingisanexceptionalbehaviourandismainlyahabitofhighersocio-
economicgroups Stage2
Smokingbecomesevermorecommon.Ratesamongmenpeakat50–80, irrespectiveofsocio-economicgroup.Inwomen,thesepatternsusuallylag
10–20yearsbehindthoseofmen,butsmokingisirstadoptedbywomenfrom highersocio-economicgroupsPortugal
Stage3 Smokingprevalenceratesamongmendecreasetoabout40sincemany
menstopsmoking.Womenreachtheirpeakrate35–40,butattheend ofthisstage,theirratesstarttodeclinetoostartingtohappeninSpain,Italy,
France Stage4
Prevalenceratesdeclinegraduallyforbothmenandwomen,andsmoking becomesprogressivelymoreahabitoflowersocio-economicgroupsnorthern
Europeancountries:Norway,Sweden,GreatBritain
Table 2.5
Stagesofsmokingbehaviourin12EuropeanUnioncountries [72]
twentiethcentury;seeTable 2.5
.Instage2,smokingistakenupbyallstrataofthepopula- tion.Instage3,educationalinitiativescauseadeclineinprevalencerates,irstlyamongmen
andsometimelater,amongwomenemancipation,“equalityproblems”.Instage4,smoking remainsthepreserveofpeoplewithalowlevelofeducationandreducedsocialstatus.These
dataarealsoconirmedbyresearchconductedaspartoftheMicrocensusStudy [42,73]
.
2.8 Concluding Remarks
•
Worldwide,therehasbeenanincreaseinsmokingandhence,intobacco-associated diseasesanddeaths.
•
Inalltheindustrialisedcountries,aswellasinthedevelopingcountries,cigarettecon- sumptionisthedominantformofsmoking.
•
Inmanycountries,smokingprevalenceisdeterminedbyeducationallevelandmonthly income,withsmokingbeingmorecommonamongthesociallydisadvantaged.
•
The growing frequency of smoking among children and women is most alarming, entailingincreasesinratesofmorbidityandmortality.
•
Regardlessofhowtheyareusede.g.inhalation,cigarsandcigarillosalsocarrya greaterriskthanwasthoughtpreviously.
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