Study: smoking increases social inequality

BUENOS AIRES – Smoking causes more than 5 million deaths per year and 80% of smokers live in developing countries, according to a study conducted at the request of the World Health Organization (WHO) and involved 31 million people worldwide.

“This study shows that there is an inverse relationship between income level and consumption of tobacco: the lower classes consume more than higher classes. In the Americas, for example, smoking among the poorer citizens is 50% higher than in the higher income classes,” explains Dr. Augustine Ciapponi, lead author and specialist in medical clinic, family medicine and coordinator of the Cochrane Centre IECS.

If cigarette consumption continues at the same rate by 2030 it will be responsible for 8 million deaths, the study “Systematic review of the relationship between tobacco and poverty”, which was commissioned by WHO to the Institute for Clinical Effectiveness and Health Policy (IECS) , a non-profit organization in Argentina dedicated to research, education and technical cooperation in health.

“The lower income groups and young people aged between 15 and 44 years are most affected by the tobacco pandemic, which widens the gap between rich and poor,” the study said, noting that the most accepted explanation for this phenomenon known as the Four Stages Model.

“Smoking spread rapidly among the upper classes, which are those that are more open to innovation. Then spreads to the rest of the population (in a second and a third stage). Then the upper classes stop smoking because they are in contact with the culture of health care and because they receive information regarding the damage it causes. And in a fourth and final stage, smoking decreases in the upper classes and is transfered and consolidated in the lower classes, “explains Ciapponi.

“In low-income households, the purchase of tobacco accounts for 10.7% of their spending,” states the study, so it’s also clear that the proportion of income that is spent on tobacco is highest in the lower classes (with less income) than in the higher income group. “So the tobacco contributes to impoverishment,” it concludes.

But this is not the only cause explored regarding the vulnerability of those with fewer resources, who also “can not afford the consequences of smoking as more affluent groups can.”

“Chronic obstructive pulmonary disease (COPD), lung cancer and heart attacks affect the poor more than rich because the most humble citizens have less access to health insurance. Smoking emphasizes inequalities in different societies and widens the gap between the rich and the poor,” emphasizes Ciapponi.

The specialist also states that the inverse relationship between income level and tobacco consumption (at higher income, less consumption) has increased over the past 20 years. During this period, tobacco consumption among women has also increased strongly.”

“To reduce the scope of this pandemic that affects everyone diverse strategies must be implemented specially those that have proven to be effective in curbing smoking: smoke-free policies, increasing taxes on cigarettes (this measure is proven to discourage consumption) and even stricter legislation regarding advertising,” says Ciapponi.

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