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Socioeconomic position and mortality risk of smoking: evidence from the English Longitudinal Study of Ageing (ELSA)

Lewer, D; McKee, M; Gasparrini, A; Reeves, A; de Oliveira, C; (2017) Socioeconomic position and mortality risk of smoking: evidence from the English Longitudinal Study of Ageing (ELSA). European Journal of Public Health , 27 (6) pp. 1068-1073. 10.1093/eurpub/ckx059. Green open access

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Abstract

BACKGROUND: it is not clear whether the harm associated with smoking differs by socioeconomic status. This study tests the hypothesis that smoking confers a greater mortality risk for individuals in low socioeconomic groups, using a cohort of 18 479 adults drawn from the English Longitudinal Study of Ageing. Methods:- Additive hazards models were used to estimate the absolute smoking-related risk of death due to lung cancer or Chronic Obstructive Pulmonary Disease (COPD). Smoking was measured using a continuous index that incorporated the duration of smoking, intensity of smoking and the time since cessation. Attributable death rates were reported for different levels of education, occupational class, income and wealth. RESULTS: Smoking was associated with higher absolute mortality risk in lower socioeconomic groups for all four socioeconomic indicators. For example, smoking 20 cigarettes per day for 40 years was associated with 898 (95% CI 738, 1058) deaths due to lung cancer or COPD per 100 000 person-years among participants in the bottom income tertile, compared to 327 (95% CI 209, 445) among participants in the top tertile. CONCLUSIONS: Smoking is associated with greater absolute mortality risk for individuals in lower socioeconomic groups. This suggests greater public health benefits of smoking prevention or cessation in these groups.

Type: Article
Title: Socioeconomic position and mortality risk of smoking: evidence from the English Longitudinal Study of Ageing (ELSA)
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/eurpub/ckx059
Publisher version: https://doi.org/10.1093/eurpub/ckx059
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: aging, smoking, chronic obstructive airway disease, income, socioeconomic factors, mortality, lung cancer, cigarettes
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10039564
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