Socio-economic disadvantage at the area level poses few direct barriers to smoking cessation for Australian smokers: findings from the International Tobacco Control Australian cohort survey

Drug Alcohol Rev. 2012 Jul;31(5):653-63. doi: 10.1111/j.1465-3362.2012.00427.x. Epub 2012 Mar 4.


Introduction: Area-level indicators of socio-economic variation are frequently included in models of individual health outcomes. Area disadvantage is linearly related to smoking prevalence, but its relation to cessation outcomes is less well understood.

Aims: To explore the relationship between area-level disadvantage and prospective data on smoking cessation.

Design and methods: The Australian cohort of the International Tobacco Control Four-Country Survey (N = 3503) was used to prospectively examine the contribution of area-level socio-economic disadvantage to predicting three important smoking-cessation outcomes: making a quit attempt, achieving 1 month abstinence and achieving 6 month abstinence from smoking, while controlling for individual-level socio-economic indicators and other individual-level covariates related to smoking cessation.

Results: Only two independent associations were observed between socio-economic disadvantage and cessation outcomes. Area-level disadvantage was related to 1 month abstinence in a non-linear fashion, and the individual experience of smoking-induced deprivation was associated with a lower likelihood of making quit attempts.

Discussion: Despite the documented higher prevalence of smoking among the more disadvantaged and in more disadvantaged areas, socio-economic disadvantage was not consistently related to making quit attempts, nor to medium-term success. Nevertheless, indirect effects of disadvantage, like its impact on psychological distress, cannot be ruled out, and considering smokers' individual psychosocial circumstances is likely to aid cessation efforts.

Conclusion: Socio-economic disadvantage, particularly at the area level, poses few direct barriers to smoking cessation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Cohort Studies
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Nonlinear Dynamics
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Smoking / epidemiology*
  • Smoking Cessation / statistics & numerical data*
  • Socioeconomic Factors
  • Tobacco Use Disorder / rehabilitation*
  • Young Adult