TY - JOUR

T1 - Gender-specific modifying effect on the educational disparities in the impact of smoking on health expectancy

AU - Brønnum-Hansen, Henrik

AU - Jeune, Bernard

N1 - © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - BACKGROUND: Smoking reduces life years in good health but it is unclear how education modifies the impact of smoking. We hypothesize that the vulnerability of the effect of smoking on health expectancy decreases with educational level in both genders and examine the contributions of mortality and health effects.METHODS: Life tables by educational level and smoking category were constructed from registers and survey data. For each educational level, difference in expected lifetime in self-rated good and poor health between 30-year-old never smokers and smokers were estimated and decomposed into contributions from mortality and health status.RESULTS: Difference in expected lifetime in good health between never smokers and smokers decreased with educational level for women but increased for men. Thus, the differences between never smokers and heavy smokers among 30-year-old women with a low, medium and high educational level were 12.9, 8.9 and 4.1 years, respectively. In contrast, the differences between male never smokers and heavy smokers with a low, medium and high educational level were 10.3, 11.4 and 14.3 years, respectively. Regardless of educational level, the mortality effect increased by exposure to smoking but the effect of health status increased by educational level for men and decreased for women.CONCLUSION: The social differential vulnerability to the effect of smoking differed between genders. Thus, whereas smoking had a substantial effect on health among women with a low educational level the pattern for men was opposite because the health gain for never smokers was greatest for men with a high education.

AB - BACKGROUND: Smoking reduces life years in good health but it is unclear how education modifies the impact of smoking. We hypothesize that the vulnerability of the effect of smoking on health expectancy decreases with educational level in both genders and examine the contributions of mortality and health effects.METHODS: Life tables by educational level and smoking category were constructed from registers and survey data. For each educational level, difference in expected lifetime in self-rated good and poor health between 30-year-old never smokers and smokers were estimated and decomposed into contributions from mortality and health status.RESULTS: Difference in expected lifetime in good health between never smokers and smokers decreased with educational level for women but increased for men. Thus, the differences between never smokers and heavy smokers among 30-year-old women with a low, medium and high educational level were 12.9, 8.9 and 4.1 years, respectively. In contrast, the differences between male never smokers and heavy smokers with a low, medium and high educational level were 10.3, 11.4 and 14.3 years, respectively. Regardless of educational level, the mortality effect increased by exposure to smoking but the effect of health status increased by educational level for men and decreased for women.CONCLUSION: The social differential vulnerability to the effect of smoking differed between genders. Thus, whereas smoking had a substantial effect on health among women with a low educational level the pattern for men was opposite because the health gain for never smokers was greatest for men with a high education.

U2 - 10.1093/eurpub/cku185

DO - 10.1093/eurpub/cku185

M3 - Journal article

C2 - 25395399

VL - 25

SP - 477

EP - 481

JO - European Journal of Public Health

JF - European Journal of Public Health

SN - 1101-1262

IS - 3

ER -