SMOKING and quitting behaviors in England 2014 to 2023 show clear socioeconomic disadvantage tied to smoking and addiction overall.
Study Snapshot
Researchers analyzed nationally representative, cross-sectional survey data from 195,543 adults aged 18 years and older in England, collected between January 2014 and December 2023. Five indicators of socioeconomic position were assessed: occupational social grade, employment status, housing tenure, educational level, and household income. Outcomes included smoking prevalence, motivation to stop smoking, level of tobacco addiction, past-year quit attempts, use of cessation aids, and quitting success.
Smoking And Quitting Behaviors Track with Socioeconomic Position
Across every socioeconomic position indicator, increasing disadvantage was associated with higher odds of smoking, higher tobacco addiction, and lower motivation to stop smoking. Among people who smoked in the past year, those in more disadvantaged occupational social grades, with lower household incomes, and with less education were less likely to have made a quit attempt in the previous year compared with the most advantaged groups.
Quitting success also showed an inequity signal. Odds of quitting success were lower among people in more disadvantaged housing tenures, although the pattern was less clear across the other socioeconomic position measures evaluated.
Cessation Aids Show Limited, Mixed Signals
The study also explored whether use of cessation aids differed by socioeconomic position. For e-cigarettes, differences were observed, but results either varied substantially depending on which socioeconomic position indicator was used or were inconclusive. For other cessation aids, the analysis found a lack of clear evidence for socioeconomic patterning.
Clinical Takeaway
These findings reinforce that inequalities in smoking persist across multiple forms and degrees of disadvantage. The authors suggest that when studying smoking prevalence, tobacco addiction, motivation, quit attempts, and quitting success, results may be broadly similar regardless of the socioeconomic position indicator chosen. However, they caution that this does not imply a single tailored smoking cessation approach will address all socioeconomic inequalities equally well across different types, or degrees, of disadvantage.
Reference: Theodoulou A et al. Smoking and quitting behaviors by different indicators of socioeconomic position in England: a population study, 2014 to 2023. Nicotine & Tobacco Research. 2026; DOI:10.1093/ntr/ntag003.
