Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
Popul Health Metr. 2021 Jan 30;19(1):3. doi: 10.1186/s12963-021-00247-2.
To study the trends of smoking-attributable mortality among the low and high educated in consecutive birth cohorts in 11 European countries.
Register-based mortality data were collected among adults aged 30 to 79 years in 11 European countries between 1971 and 2012. Smoking-attributable deaths were estimated indirectly from lung cancer mortality rates using the Preston-Glei-Wilmoth method. Rate ratios and rate differences among the low and high-educated were estimated and used to estimate the contribution of inequality in smoking-attributable mortality to inequality in total mortality.
In most countries, smoking-attributable mortality decreased in consecutive birth cohorts born between 1906 and 1961 among low- and high-educated men and high-educated women, but not among low-educated women among whom it increased. Relative educational inequalities in smoking-attributable mortality increased among both men and women with no signs of turning points. Absolute inequalities were stable among men but slightly increased among women. The contribution of inequality in smoking-attributable mortality to inequality in total mortality decreased in consecutive generations among men but increased among women.
Smoking might become less important as a driver of inequalities in total mortality among men in the future. However, among women, smoking threatens to further widen inequalities in total mortality.
研究 11 个欧洲国家连续出生队列中低学历和高学历人群中与吸烟相关的死亡率趋势。
在 1971 年至 2012 年间，在 11 个欧洲国家收集了 30 至 79 岁成年人的登记死亡率数据。通过使用 Preston-Glei-Wilmoth 方法从肺癌死亡率间接估计吸烟相关死亡人数。估计了低学历和高学历人群之间的比率比和差异，并用于估计吸烟相关死亡率不平等对总死亡率不平等的贡献。
在大多数国家，1906 年至 1961 年出生的连续出生队列中，低学历和高学历男性以及高学历女性的吸烟相关死亡率均有所下降，但低学历女性的死亡率却有所上升。男性和女性的吸烟相关死亡率的相对教育不平等呈上升趋势，没有转折点的迹象。男性的绝对不平等保持稳定，但女性略有增加。吸烟相关死亡率不平等对总死亡率不平等的贡献在男性中逐代减少，但在女性中增加。
在未来，吸烟可能不再是男性总死亡率不平等的主要驱动因素。然而，对于女性来说，吸烟有可能进一步扩大总死亡率的不平等。
