Occupational disparities in smoking: An essential area for surveillance

Objectives: We examined the disparities in smoking prevalence, physician advice for smoking cessation, and quit attempts among occupational groups in Ontario, Canada. Methods: We used data on Ontario adults (18 years or older) from the 1998-2006 Centre for Addiction and Mental Health Monitor (n=21882). Results: Blue-collar workers had more than twice the smoking prevalence than professionals (32% vs. 15%, p>0.01). Respondents who were exposed to secondhand smoke (SHS) at work were 28% more likely to smoke than all other workers. Outdoor workers were 20% more likely to be exposed to SHS at work than indoor workers. Compared to professionals, the adjusted odds ratio (OR) for smoking was 6.47 (95% confidence interval (CI) =2.68-15.65) for semi-skilled manual workers and 3.26 (95% CI=1.37-7.75) for unskilled manual workers. Even after controlling for gender, age, income, and occupation, outdoor workers had 1.8 higher odds (95% CI=1.09-3.04) for exposure to SHS at work than indoor workers. Blue-collar workers had 2.09 higher odds (95% CI=1.22-3.58) for exposure to SHS at work than professionals. The odds of receiving physician advice for smoking cessation was higher for blue-collar workers (OR=1.42, 95% CI 1.11-1.81) and sales/service workers (OR=1.52, 95% CI 1.19-1.95) than professionals. Quit attempts in the past year among smokers were similar across all occupations. Conclusions: Physicians were providing cessation advice to occupations with high smoking prevalence. Smoking prevalence and exposure to SHS at work differ across occupations.