Social class, education, and smoking cessation: Long-term follow-up of patients treated at a smoking cessation unit

Esteve Fernández, Anna Schiaffino, Carme Borrell, Joan Benach, Carles Ariza, Josep Maria Ramon, Jorge Twose, Manel Nebot, Anton Kunst

Research output: Contribution to journalArticle

Abstract

Our objective was to examine social class and educational differences in long-term smoking cessation success among a cohort of smokers attending a specialized smoking clinic. We studied sustained abstinence after cessation among 1,516 smokers (895 men and 621 women) treated for smoking cessation between 1995 and 2001 at a university teaching hospital in the metropolitan area of Barcelona, Spain. We calculated 1-year and long-term (up to 8-year) abstinence probabilities by means of Kaplan-Meier curves and the hazard ratio of relapse by means of Cox regression, after adjusting for other predictors of relapse. Overall abstinence probability was .277 (95% CI = .254-.301). Men and women in social classes IV-V had significant hazard ratios of relapse after long-term follow-up (men: 1.36, 95% CI = 1.07-1.72; women: 1.60, 95% CI = 1.24-2.06), as compared with patients in social classes I-II. The same independent effect was bserved for education: Men and women with primary or less than primary studies had higher hazard ratios of relapse (men: 1.75, 95% CI = 1.35-2.25; women: 1.92, 95% CI = 1.51-2.46), as compared with patients with a university degree. Similar estimates were obtained after adjustment for stage of change, Fagerström score for nicotine dependence, and type of treatment. Patients of lower socioeconomic status are at higher risk of relapse, and this association is independent of other well-known predictors of relapse. Social differences have to be taken into account in the clinical setting when tailoring specific actions to treat smoking dependence.

Original languageEnglish (US)
Pages (from-to)29-36
Number of pages8
JournalNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
Volume8
Issue number1
DOIs
StatePublished - Feb 2006
Externally publishedYes

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Smoking Cessation
Social Class
Education
Recurrence
Smoking
Tobacco Use Disorder
Teaching Hospitals
Spain

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Social class, education, and smoking cessation : Long-term follow-up of patients treated at a smoking cessation unit. / Fernández, Esteve; Schiaffino, Anna; Borrell, Carme; Benach, Joan; Ariza, Carles; Ramon, Josep Maria; Twose, Jorge; Nebot, Manel; Kunst, Anton.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, Vol. 8, No. 1, 02.2006, p. 29-36.

Research output: Contribution to journalArticle

Fernández, Esteve ; Schiaffino, Anna ; Borrell, Carme ; Benach, Joan ; Ariza, Carles ; Ramon, Josep Maria ; Twose, Jorge ; Nebot, Manel ; Kunst, Anton. / Social class, education, and smoking cessation : Long-term follow-up of patients treated at a smoking cessation unit. In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2006 ; Vol. 8, No. 1. pp. 29-36.
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