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February 2004, Vol 94, No. 2 | American Journal of Public Health 269-278
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Working Class Matters: Socioeconomic Disadvantage, Race/Ethnicity, Gender, and Smoking in NHIS 2000

Elizabeth M. Barbeau, ScD, MPH, Nancy Krieger, PhD and Mah-Jabeen Soobader, PhD

Elizabeth M. Barbeau is with the Center for Community-Based Research, Dana-Farber Cancer Institute and the Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA. Nancy Krieger and Mah-Jabeen Soobader are with the Department of Society, Human Development and Health, Harvard School of Public Health.

Correspondence: Requests for reprints should be sent to Elizabeth M. Barbeau, ScD, MPH, Center for Community-Based Research, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115 (e-mail: elizabeth_barbeau{at}dfci.harvard.edu).

Objectives. We sought to describe the burden of smoking on the US population, using diverse socioeconomic measures.

Methods. We analyzed data from the 2000 National Health Interview Survey.

Results. Overall, the prevalence of current smoking was greatest among persons in—and independently associated with—working class jobs, low educational level, and low income. Attempts to quit showed no socioeconomic gradient, while success in quitting was greatest among those with the most socioeconomic resources. These patterns held in most but not all race/ethnicity–gender groups. Finer resolution of smoking patterns was obtained using a relational UK occupational measure, compared to the skill-based measure commonly used in US studies.

Conclusions. Reducing social disparities in smoking requires attention to the complexities of class along with race/ethnicity and gender.




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