Environmental and Occupational Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy.
Cancer Causes Control. 2013 Jul;24(7):1385-91. doi: 10.1007/s10552-013-0218-9. Epub 2013 May 3.
To update educational inequalities in smoking in Italy up to 2009, with an in-depth analysis of female prevalence.
Data from 15 national health surveys (1980, 1983, 1986-1987, 1990, 1994, 1999-2003, 2005-2009) were analyzed. The overall sample size was representative of the population older than 25 years of age (3,300,000 men and 3,620,000 women). Main measures smoking prevalence rates standardized to the 2,000 European population, prevalence ratios by educational level (high: university degree or high school diploma; low: primary or middle school diploma), area (north, center, south and islands), and age-group (25-44, 45-59, >=60 years). Trends in tobacco prevalence were also analyzed with a multivariate approach using the negative binomial distribution.
Although male prevalence steadily declined of about 2% annually from 56.1% in 1980 to 30.2% in 2009, educational inequalities slightly widened, recording in 2009 a 53% higher prevalence in men with low educational level compared to graduates. Even though female prevalence stalled around 18% in the last three decades, this was the result of opposite trends by educational group. In fact, highly educated women, with the highest prevalence during 1980s, decreased their tobacco use, determining a reversal similar to men in educational inequalities in smoking. This reversal occurred from the 1980s onwards with a time gradient starting from north to south and from younger to older women.
To achieve a fairer reduction in smoking habits, tobacco control policies focusing on lower social groups are needed.
更新截至 2009 年意大利吸烟教育不平等情况，并深入分析女性吸烟率。
分析了 15 项全国健康调查的数据（1980 年、1983 年、1986-1987 年、1990 年、1994 年、1999-2003 年、2005-2009 年）。总体样本量代表了年龄在 25 岁以上的人群（330 万男性和 362 万女性）。主要措施为根据 2000 年欧洲人口标准化的吸烟率、按教育程度（高：大学学位或高中文凭；低：小学或中学文凭）、地区（北部、中部、南部和岛屿）和年龄组（25-44 岁、45-59 岁、>=60 岁）划分的流行率比。还使用负二项分布的多变量方法分析了烟草流行趋势。
尽管男性吸烟率从 1980 年的 56.1%稳步下降，每年下降约 2%，到 2009 年降至 30.2%，但教育不平等略有扩大，2009 年低教育程度男性的吸烟率比毕业生高 53%。尽管过去三十年女性吸烟率在 18%左右停滞不前，但这是由于不同教育群体的趋势相反。事实上，受教育程度较高的女性在 20 世纪 80 年代吸烟率最高，她们减少了吸烟，这导致了与男性在吸烟教育不平等方面类似的逆转。这种逆转从 20 世纪 80 年代开始，从北部到南部，从年轻女性到老年女性，时间梯度逐渐出现。
为了实现更公平的吸烟习惯减少，需要针对社会较低阶层制定烟草控制政策。
