BACKGROUND: Traditional cigarette (TC) smoking is a leading cause of preventable death, contributing to chronic health issues worldwide. The rise of electronic cigarettes (EC) has introduced new smoking behaviours, including exclusive TC, EC, and dual use. While socioeconomic position (SEP) disparities in TC use are well-documented, less is known about their impact on EC and dual use. This study examines sex-specific associations between SEP and smoking-related behaviours in young adults.
METHODS: Data were drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort in southwest England. SEP indicators (maternal/paternal education, household social class, composite SEP) were collected at or near offspring birth. At age 24 years, participants reported their smoking behaviours, categorized as never-users, exclusive EC, exclusive TC, or dual users. Logistic regression models examined associations between SEP and smoking categories, stratified by sex.
RESULTS: Among participants, 33.0% were never-users, 2.2% exclusive EC users, 33.7% exclusive TC users, and 30.2% dual users. Mean initiation age was 15.75 years for TC and 22.39 years for EC. Lower SEP was associated with higher odds of TC and dual use, particularly among females. Higher maternal and paternal education was linked to lower dual use odds for both sexes but higher TC use among males. Professional household's females had higher odds of never-use, while males in the same class had higher odds of TC use. No significant SEP association with EC use was found, except males with degree-holding fathers had 71% reduced odds of EC use.
CONCLUSIONS: This study highlights the complex relationship between SEP and smoking-related behaviours, with significant sex-specific disparities. These findings underscore the need for targeted public health interventions that consider both socioeconomic and sex differences in smoking-related behaviours. Public health policies must address the growing challenge of dual use and tailor interventions to the unique needs of different demographic groups.