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CONFERENCE PROCEEDING
Socioeconomic differential effect of tobacco control policies on smoking prevalence and quit ratios in the European Union (2009-2020)
1
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
2
Center for Biomedical Research in Respiratory Diseases, CIBERES, CIBER, Madrid, Spain
3
Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d’Oncologia-ICO, L’Hospitalet de Llobregat, Spain
4
School of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet del Llobregat, Spain
5
Secretariat for Public Health, Department of Health, Government of Catalonia, Barcelona, Spain
6
Department of Epidemiology, School of Public Health, The University of Texas Health Science Center, Houston, United States
7
Tobacco Control Research Group, Institut d’Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Spain
8
School of Nursing, Universitat de Barcelona, L'Hospitalet del Llobregat, Spain
Publication date: 2025-06-23
Tob. Induc. Dis. 2025;23(Suppl 1):A406
KEYWORDS
TOPICS
ABSTRACT
BACKGROUND: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU MS). However, the impact of these policies has been unequal across countries and different income groups. This study evaluates the differential association between tobacco control policy implementation levels and smoking prevalence and quit ratios in 27 EU MS over time (2009-2020) according to population’s socioeconomic status (SES).
METHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the smoking prevalence and quit ratios from the Eurobarometer surveys (2009, n=26582, and 2020, n=28288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (2009-2020) by means Spearman's rank correlation coefficients (rsp).
RESULTS: Large inequalities exist among SES groups in the EU27. High-income residents had lower smoking prevalence (19.0% vs 39.9%) and higher quit ratios (55.0% vs. 32.1%) compared to the most deprived group. Positive changes in smoking indicators from 2009 to 2020 were also higher among the high-income group. There was a strong inverse correlation between policy implementation levels and smoking prevalence in 2020 in high- and moderate-income groups (rsp=-0.615; rsp=-0.498; both p<0.01). A direct correlation was also observed between policy implementation levels and quit ratios in 2020 in high- and moderate-income (rsp=0.580, rsp=0.548, both p<0.01) groups. No significant correlations were found for the low-income group. Regarding relative changes (2009-2020), a strong inverse association was found in high- and low-income groups for smoking prevalence (rsp=-0.478; rsp=-0.450; both p<0.02).
CONCLUSIONS: Declines in smoking prevalence and increases in quit ratios associated with policy implementation levels were considerably lower among the most deprived groups. Tailoring tobacco control policies to make them fairer measures is key if EU27are to achieve their tobacco-free goal.
METHODS: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the smoking prevalence and quit ratios from the Eurobarometer surveys (2009, n=26582, and 2020, n=28288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (2009-2020) by means Spearman's rank correlation coefficients (rsp).
RESULTS: Large inequalities exist among SES groups in the EU27. High-income residents had lower smoking prevalence (19.0% vs 39.9%) and higher quit ratios (55.0% vs. 32.1%) compared to the most deprived group. Positive changes in smoking indicators from 2009 to 2020 were also higher among the high-income group. There was a strong inverse correlation between policy implementation levels and smoking prevalence in 2020 in high- and moderate-income groups (rsp=-0.615; rsp=-0.498; both p<0.01). A direct correlation was also observed between policy implementation levels and quit ratios in 2020 in high- and moderate-income (rsp=0.580, rsp=0.548, both p<0.01) groups. No significant correlations were found for the low-income group. Regarding relative changes (2009-2020), a strong inverse association was found in high- and low-income groups for smoking prevalence (rsp=-0.478; rsp=-0.450; both p<0.02).
CONCLUSIONS: Declines in smoking prevalence and increases in quit ratios associated with policy implementation levels were considerably lower among the most deprived groups. Tailoring tobacco control policies to make them fairer measures is key if EU27are to achieve their tobacco-free goal.
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