The evolution of social inequalities in smoking over the life cycle: an analysis by gender and generation.

Summary How do social inequalities in tobacco consumption in France change with age and generation? In order to answer this question, data from the Baromètre santé collected in 2010 from 27,653 people were used to retrospectively reconstruct the smoking history of three birth cohorts (1941-1955, 1956-1970 and 1971-1985). The evolution of smoking inequalities is studied by comparing smoking prevalences calculated at each age by level of education, sex and generation and then using a relative inequality index estimated with logistic regressions. The results show that, after having been more frequent among the most educated, smoking has declined in these groups, while it continues to increase among the less educated. This analysis also confirms the generation gap between women and men in the spread of smoking, even though prevalence levels are now high for both sexes. The importance of social inequalities in smoking is evident at younger ages, for all cohorts and for both sexes. For the oldest cohorts, the inequalities diminish over the course of life until they are reversed for women. For the most recent cohort, inequalities remain at a high level throughout the life cycle and tend to increase after age 25 for women. Based on this finding, it may be effective to target smoking prevention policies by social group and life stage, and in particular to focus efforts on preventing entry into smoking in less educated settings.