Reducing social disparities in tobacco use: a social-contextual model for reducing tobacco use among blue-collar workers

Am J Public Health. 2004 Feb;94(2):230-9. doi: 10.2105/ajph.94.2.230.


In the United States in 1997, the smoking prevalence among blue-collar workers was nearly double that among white-collar workers, underscoring the need for new approaches to reduce social disparities in tobacco use. These inequalities reflect larger structural forces that shape the social context of workers' lives. Drawing from a range of social and behavioral theories and lessons from social epidemiology, we articulate a social-contextual model for understanding ways in which socioeconomic position, particularly occupation, influences smoking patterns. We present applications of this model to worksite-based smoking cessation interventions among blue-collar workers and provide empirical support for this model. We also propose avenues for future research guided by this model.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Health Behavior
  • Health Promotion / organization & administration*
  • Humans
  • Middle Aged
  • Occupational Health Services / organization & administration*
  • Occupations / classification*
  • Occupations / economics
  • Psychology, Industrial
  • Smoking / economics
  • Smoking / epidemiology
  • Smoking / psychology
  • Smoking Prevention*
  • Social Class*
  • Social Support
  • Sociology, Medical