Complex inequalities of gender and social class in daily smoking among Swedish men and women

• Published in: European journal of public health 2018-11, Vol.28 (suppl_4), p.325
• Main Authors: Landstedt, E, San Sebastian, M
• Format: Article
• Language: English
• Subjects: Folkhälsovetenskap; gender; Gender inequality; Public Health Science; Smoking; social class; Social classes; Social inequality; Social Work; Socialt arbete
• ISSN: 1101-1262; 1464-360X; 1464-360X
• DOI: 10.1093/eurpub/cky214.048

Background: Cigarette smoking is a major public health threat. In high income countries, smoking is most prevalent in disadvantaged groups. Little is known about complex inequalitites in smoking based on multiple axes of social positions which would be necessary in designing interventions aiming at reducing smoking rates. The study aimed to describe the prevalence of daily smoking in the adult Swedish population across combinations of the social positions gender and occupational class, and to examine smoking differences attributed to the intersection of gender/occupational class Methods: The study sample (N = 61 316, age 26 – 84) was pooled from seven years of the annual cross sectional Swedish national public health surveys (2010 to 2016). The outcome was current daily smoking. Binary variables of gender (man/woman) and occupational class (blue collar/white collar) were used to construct the four category intersection meausure of gender/class. Complex inequalities in daily smoking were estimated by joint-, referent- and excess disparities. Survey year and age were used as covariates. Results: The overall daily smoking prevalence was 10.21%. The smoking rates in the categories of gender and occupational class were as follows: white collar men: 6.70%; white collar women: 7.79%; blue collar men: 13.75% and blue collar women: 16.63%. The absolute joint disparity was 9.96 percentage points (CI: 9.14 – 10.79) and that the main contributor to this inequality was occupational class (70.66%). The results of excess disparity further showed that blue collar women were particularly exposed regarding smoking. Conclusions: Acknowledging the complexity of disadvantage and privilege regarding daily smoking contributes to an understanding of the situation for multiply marginalised groups, for example blue collar women. The findings may inform future public health interventions to reduce smoking habits. Key messages: Acknowledging the complexity of disadvantage and privilege contributes to an understanding of daily smoking across multiply marginalised groups. Blue collar women is a particularly important group to consider in public health efforts to reduce smoking.