The influence of gender, social circumstances and smoking on survival: theRenfrew and Paisley study

The present study aimed to compare survival to age 75 between men and women , by social circumstances and smoking behaviour. A 20 year follow up was ca rried out of a large representative cohort of Scottish men and women in the Renfrew and Paisley study, and was combined with Scottish mortality statis tics. 6831 men and 7993 women aged 45-64 y at time of examination (between 1972 and 1976) were considered. Combining the estimates from the Renfrew an d Paisley study with those from Scottish mortality statistics for men and w omen younger than 45 y of age, it was calculated that 28% of the male smoke rs and 44% of the male never smokers in disadvantaged social circumstances will have survived to age 75 y, compared with 46% and 56% of the female smo kers and never smokers respectively. In more privileged social circumstance s, 41% of the male smelters and 62% of the male never smokers will have sur vived to age 75 y, compared with 56% and 70% of the female smokers and neve r smokers respectively. The difference between male smokers in low social c lasses and female never smokers in high social classes is 42% in absolute t erms (28% vs 70%), which gives an indication of the combined influence of g ender, social circumstances and smoking on survival. These results show tha t gender, social circumstances and smoking are important determinants of mo rtality which have led to substantial differences ill survival. The influen ce of additional factors related to mortality could usefully be compared to these to put their effects into perspective.