Leaving nobody behind? Widening socio-economic inequalities in smoking as Ireland moves towards being tobacco-free
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Tobacco Free Ireland Programme, Health Service Executive, Ireland
Health Intelligence, Health Service Executive, Ireland
Publication date: 2023-04-25
Corresponding author
Aishling Sheridan   

Tobacco Free Ireland Programme, Health Service Executive, Ireland
Tob. Prev. Cessation 2023;9(Supplement):A87
Despite progress, smoking remains the leading preventable cause of disease in Ireland. Recent studies show a two-fold difference in standardized mortality across socio-economic groups in Ireland and international studies suggest at least half this gap is attributable to smoking. Ireland has committed to a tobacco-free goal and an assessment of this challenge across society is urgently required. This study measures differences in smoking prevalence across socio-economic groups in Ireland to inform priorities for equitable tobacco-endgame planning.

Material and Methods:
Secondary analysis of Healthy Ireland Surveys 2015 to 2021 was conducted. Trends in crude smoking prevalence were measured by socio-economic group. Logistic regression compared the odds of smoking in lower socioeconomic groups relative to higher socioeconomic groups across the period, adjusted for differences in age and gender across groups.

The gap in crude smoking prevalence across socioeconomic groups was 12.5% in 2015; the gap increased to 20.1% in 2021. After adjustment for age and gender, in 2015, compared to those in the higher socioeconomic groups, those in lower socioeconomic groups were 2.1 times more likely to currently smoke (aOR 2.1, 95% CI 1.9–2.5, P<0.0001); in 2021, compared to the higher socioeconomic group, those in lower socio-economic groups were 3.7 times more likely to currently smoke (aOR 3.7, 95% CI 3.0–4.4, P<0.0001). A significant reduction in adjusted odds of smoking across the period was observed only for those in higher managerial, administrative and professional occupations; no difference was observed for those in other occupational groups.

People in lower socio-economic groups risk being left behind as Ireland moves to become smoke-free. Tailored and targeted stop-smoking support, reduced inequalities in exposure to tobacco retail, and higher tobacco taxation are urgently needed.

See The State of Tobacco Control in Ireland (2022)

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