Socioeconomic inequality in cigarette smoking: Trends by gender, age, and socioeconomic position in South Korea, 1989–2003
Introduction
It is well known that cigarette smoking causes short- and long-term morbidity and mortality (US Department of Health and Human Services, 1989, International Agency for Research on Cancer, 2004, Doll et al., 2004). Its inverse relation with socioeconomic position (SEP) is also known to be a factor in widening socioeconomic health inequalities (Jarvis and Wardle, 1999). Trends in smoking rates by SEP have been documented in Great Britain (Jarvis and Wardle, 1999, Bartley et al., 2000), northern and southern European countries (Lahelma et al., 1997, Peltonen et al., 1998, Osler et al., 2000, Borrell et al., 2000, Marques-Vidal et al., 2001, Federico et al., 2004), the United States (Pierce et al., 1989) and Australia (Bennett, 1995). In addition, some studies have examined smoking trends in several countries simultaneously (Graham, 1996, Giskes et al., 2005). However, with the exception of one recent report (Cho et al., 2004), studies on smoking trends by SEP in Asian countries, including South Korea, have generally been scarce. This is significant given the fact that many Asian countries not only lead the world in smoking rates by men but have recently experienced enormous economic and social changes that might affect smoking rates.
Generally, trends in socioeconomic differentials in smoking have been documented according to either education (Pierce et al., 1989, Lahelma et al., 1997, Peltonen et al., 1998, Osler et al., 2000, Marques-Vidal et al., 2001) or occupation (Bennett, 1995, Bartley et al., 2000, Borrell et al., 2000). However, prior studies have rarely employed both factors simultaneously as SEP indicators. Because SEP indicators have distinct influences in promoting or damaging an individual's health (Lynch and Kaplan, 2000), it is worth investigating trends in smoking by multiple SEP measures. Furthermore, gender- and age-specific analyses may help prioritize the population groups in which policy efforts to reduce smoking inequalities should be further exercised. In this study, we examined trends of socioeconomic differentials in smoking by gender, age, and SEP indicators (education and occupational class) between 1989 and 2003, using nationally representative samples of South Korea.
Section snippets
Data sources and study subjects
Data analyzed for this study were derived from the Social Statistics Survey (SSS) conducted by Korea National Statistical Office. Five rounds of publicly available SSS data (1989, 1992, 1995, 1999, 2003) were used. Data from survey sections regarding health behaviors were examined for 344,969 subjects (161,378 men, 183,591 women) aged 20 or over. For the analysis on occupational differences in smoking, three rounds of SSS data in 1995, 1999, and 2003 (N = 156,653) were used for consistency in
Changes in the proportion of education and occupational class
As shown in Table 1, educational levels for both genders increased remarkably by age and by year. In 2003, 73.0% of males aged 20–24 entered college, while only 44.9% were in college or higher education in 1989. In addition, less than 20% of males aged 45–64 had college or higher education in 2003. Table 1 also shows an increase in the proportion of non-manual occupations and a decreasing trend of manual occupations in men and women aged 25–44. However, in the 45–64 age groups, the size of the
Trends in smoking rates
In this study, distinct gender differences in smoking trends were seen between men and women, as found in many Asian countries like China (Yang et al., 1999), Vietnam (Jenkins et al., 1997), India (Narayan et al., 1996), Taiwan (Wen et al., 2005), and Japan (Honjo and Kawachi, 2000). Results show that for men, age-standardized smoking rates decreased in all age groups, beginning between 1995 and 1999 and becoming more obvious between 1999 and 2003. For women aged 45+, age-standardized smoking
References (33)
- et al.
Trends in social class inequalities in health status, health-related behaviors, and health services utilization in a southern European urban area (1983–1994)
Prev. Med.
(2000) - et al.
Trends in socioeconomic differentials in cigarette smoking behaviour between 1990–1998: a large prospective study in Korean men
Public Health
(2004) - et al.
Trends in educational inequalities in smoking in northern, mid and southern Italy, 1980–2000
Prev. Med.
(2004) - et al.
Socioeconomic pattern of smoking in Japan: income inequality and gender and age differences
Ann. Epidemiol.
(2005) Smoking prevalence among women in the European Community 1950–90
Soc. Sci. Med.
(1996)- et al.
Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe
Soc. Sci. Med.
(1997) - et al.
Social distribution of cardiovascular disease risk factors: change among men in England 1984–1993
J. Epidemiol. Community Health
(2000) Cardiovascular risk factors in Australia: trends in socioeconomic inequalities
J. Epidemiol. Community Health
(1995)- et al.
Educational differences in smoking: international comparison
BMJ
(2000) - et al.
Mortality in relation to smoking: 50 years' observations on male British doctors
BMJ
(2004)
Trends in smoking behaviour between 1985 and 2000 in nine European countries by education
J. Epidemiol. Community Health
Effects of market liberalization on smoking in Japan
Tobacco Control
Social patterning of individual health behaviours: the case of cigarette smoking
Tobacco use in Vietnam. Prevalence, predictors, and the role of the transnational tobacco corporations
JAMA
Cited by (100)
Prevalence and intensity of cigarette smoking in Iranian households: measurement of socioeconomic inequality
2023, Journal of Substance UseASSOCIATIONS AMONG SOCIAL HEALTH DETERMINANTS AND ORAL-RELATED HEALTH BEHAVIORS AMONG ELDERLY THAIS IN 2015
2022, Southeast Asian Journal of Tropical Medicine and Public HealthThe Real Effect of the Czech Tax Policy for Combating the Tobacco Epidemic
2022, Ekonomicky casopisPattern of Tobacco Smoking Among Egyptian Patients With Bipolar Disorder
2021, Addictive Disorders and their Treatment