Decennial trends of social differentials in smoking habits in Italy

Objective: To present social trends of smoking habits in Italy during the period 1980-1994. Methods: Data from five national health surveys (1980, 1983, 1986-1987, 1990-1991, 1994) were analyzed in order to calculate smoking prevalences. Education attained was used as social class indicator. Main measures: SDPs (prevalence rate standardized on the 1981 Italian population) and PRs (prevalence ratios primary school/degree). Confidence intervals and p-values were calculated as indicators of statistical significance. Results: Among men SDP decreased from 59.5% in 1980 to 37.3% in 1994 and PRs for social classes varied from 1.21 in 1980 to 1.47 in 1994. Corresponding results for women were 17.9% to 20.0% and 0.36 to 0.73. Conclusions: Lower-educated men smoke more than those in higher social categories, and data collected during 1980-1994 in Italy show a tendency to increase such differentials. Among women this pattern was the opposite in 1980, with a tendency to reduce differences over time. Therefore, for both genders data show a progressive disadvantage for the low-educated categories. The greater compliance of better-educated groups with anti-smoking interventions must be taken into account, and should suggest "unequal" interventions that can be more effective among disadvantaged social groups.