The Association Between Education and Smoking Prevalence, Independent of Occupation: A Nationally Representative Survey in Japan.

BACKGROUND

Higher smoking prevalence in less educated persons and manual workers is well known. This study examines the independent relationship of education and occupation with tobacco use.

METHODS

We used anonymized data from a nationwide population survey (30,617 men and 33,934 women). Education was divided into junior high school, high school, or university attainment. Occupation was grouped into upper non-manual, lower non-manual, and manual. Poisson regression models stratified by age and gender were used to estimate adjusted prevalence ratio (PR) and 95% confidence interval (CI) for current smoking.

RESULTS

After adjustment for covariates, education, and occupation, education was significantly related to current smoking in both genders; compared to university graduates, PRs of junior high school graduates aged 20-39, 40-64, and ≥65 were 1.74 (95% CI, 1.53-1.98), 1.50 (95% CI, 1.36-1.65), and 1.28 (95% CI, 1.08-1.50) among men, and 3.54 (95% CI, 2.92-4.30), 2.72 (95% CI, 2.29-3.23), and 1.74 (95% CI, 1.14-2.66) among women, respectively. However, significantly higher smoking prevalence in manual than in upper non-manual was found only in men aged 20-64; compared to upper non-manual, the PRs of manual workers aged 20-39, 40-64, and ≥65 were 1.11 (95% CI, 1.02-1.22), 1.18 (95% CI, 1.10-1.27), and 1.10 (95% CI, 0.89-1.37) among men, and 0.95 (95% CI, 0.75-1.20), 0.92 (95% CI, 0.75-1.12), and 0.46 (95% CI, 0.22-0.95) among women, respectively.

CONCLUSIONS

Independent of occupation, educational disparities in smoking existed, regardless of age and gender. Occupation-smoking relationship varied with age and gender. Our study suggests that we should pay attention to social inequality in smoking as well as national smoking prevalence.