CULTURAL, MATERIAL, AND PSYCHOSOCIAL CORRELATES OF THE SOCIOECONOMIC GRADIENT IN SMOKING-BEHAVIOR AMONG ADULTS

Background. The aim was to identify the correlates of educational diff erences in smoking among adults. Methods. We used data from the baseli ne of a Dutch longitudinal study, relating to a population of 2,462 re spondents, ages 25-74. Logistic regression was used to assess the educ ational gradient in smoking. Current smokers were compared with former and never smokers, respectively. Results. The risk of being a current smoker compared with being a former/never smoker was higher among low er educational groups. For example, the odds of being a current smoker compared with never smoker among persons in the lowest level was more than five times as high as that for persons in the highest level. A s ubstantial part (20-40%) of the increased risk of being a smoker among lower groups appeared to be associated with adverse material conditio ns. The financial situation especially accounted for that effect. One of the cultural factors, i.e., locus of control, was found to account for approximately 30% of the educational gradient in the case in which smokers were compared with former smokers. Psychosocial factors, i.e. , neuroticism and coping styles, accounted for less of the gradient in smoking than cultural and material factors. Conclusions. On the basis of the results, we hypothesize that both cultural and material factor s contribute to the higher smoking rates among lower socioeconomic gro ups. Psychosocial factors seem to be less important. If our results ar e confirmed in more powerful studies, this would indicate, first, that possibilities for a reduction of smoking differences may be found in tailoring smoking cessation programs to the more externally oriented l ocus of control and the coping styles that are common among lower educ ational groups, and second, that a reduction of smoking differences ma y follow from an improvement of the material living conditions of lowe r socioeconomic groups. (C) 1997 Academic Press.