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western european countries
lung cancer
discrepancy
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Class Differences And Smoking Rates
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Decline in Smoking Rates

Smoking rates have decreased in the developed world over the past three decades. In the heyday of smoking, in the mid 60's, over 40% of men smoked, this has now declined to the low 20's in most Western European countries. A decline in smoking rates coincided with medical studies consistently linking smoking with lung cancer, and other diseases. Lately, government tax hikes have made smoking an expensive luxury, inspiring those not convinced by the health benefits, to finally quit.

What is noticeable however is that not all social groups have experienced the same reduction in smoking rates. It is the educated professional classes that have seen the greatest drop in smoking rates while manual workers have experienced the least. Should we be surprised? And what underlies these clear class differences in smoking rates?

Several hypotheses have been put forward to explain these statistically significant smoking rates between the social classes and it useful to look at just a couple of those often cited.

The Education Question and Smoking Rates

Despite improvements in health, for all social classes over the years, the class discrepancy, for all aspects of health, still remains. Class differences often reflect educational status. Thus manual workers, on the whole, are relatively poorly educated and the professional classes, by definition, are well educated. The argument goes that well educated people tend to make good choices in many aspects of their lives. These 'good choices' extend into their life style preferences. Thus not only will this group as a whole tend to smoke less but they will also tend to eat healthier and to exercise more. Could this be the whole answer or are there other factors at work? Perhaps smokers with a poor educational status are not fully aware of the dangers of long term smoking and fail to view their habit as a particularly hazardous one.

The Environmental Connection and Smoking Rates

It is undoubtedly the case that people belonging to lower social classes tend to live in poorer environments than those from higher social classes. Their income may mean that they live in undesirable neighbourhoods and experience poor and cramped living conditions. Relaxation and recreational outlets may be limited. Smoking in these situations may be viewed as a release and a means of coping with difficult and stressful conditions. Nicotine is a psychoactive drug acting as both a relaxant and a stimulant. As one British ex health Secretary, John Reid, aptly put it: "Smoking is one of the few pleasures left for the poor on the sink estates and the working men's clubs". The irony of course, is that the most disadvantaged in society are also the least able to fund their increasingly expensive habit.

The Whole Story?

The two possibilities outlined here are not mutually exclusive and both are likely to play a major part in explaining the observed difference in smoking rates between the social classes. Other factors may also play a part. As with many things in life, simple correlations may reflect the effect of a number of different and sometimes interacting factors. Perhaps the association of social class and smoking is a particularly complex one that ultimately defies discrete and simple explanations.

No Easy Explanations but No Surprises Either

Few would deny that all societies tend to stratify into classes and that these classes exhibit marked social, economic and behavioural characteristics. It should therefore come as no surprise that differences in smoking prevalence amongst the different social classes exist. Egalitarians would like everyone to be created equal but as everyone else knows, this is really not the case.


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