Social class and period influences on smoking transitions in early adolescence

Michael J Green, MRC/CSO Social & Public Health Sciences Unit

Michael J Green

Co Authors
Alastair H Leyland, Helen Sweeting & Michaela Benzeval

Smoking, Social Class, Period Effects, Adolescence

Background: Smoking development is often conceptualised in stages from initiation, through occasional use to daily smoking. Previous research suggests that adolescents from a disadvantaged background are more likely to become daily smokers at early ages than their more affluent peers. Recent years have seen increasing efforts in the UK to reduce smoking, but it is unclear how this has affected socioeconomic inequalities in early adolescent smoking development. Methods: Smoking histories from ages 11 to 15 were constructed using data spanning 1991-2009 from the British Household Panel Survey youth sample. 4,500 adolescents had valid data. Discrete-time survival analyses examined associations with household social class and time period (measured in years since 1991) for progression from never to having tried smoking (n=1,917), from trying to occasional use (n=861), and from occasional use to either daily smoking or quitting (n=293 and n=390 respectively), adjusting for respondents’ gender and age. Results: Adolescents from manual compared to non-manual households were more likely to try smoking, and to progress from occasional to daily use, but did not differ in progression from trying to occasional use, or in quitting after occasional use. For time period there was a non-linear decrease in the risk of trying smoking which remained relatively flat up to 2001, decreasing more sharply thereafter, and the risk of progression to occasional use initially increased with passing years but then decreased again. Transitions to daily smoking or quitting were independent of time period. There were no interactions between household class and time period. Conclusion: Smoking initiation among early adolescents has decreased across the socioeconomic spectrum in recent years. However socioeconomic inequalities in early adolescent uptake persist. Social class is most strongly associated with initial trying and progression from occasional to daily use. Interventions need to address these stages if they are to reduce inequalities.