Social gradients in current smoking in Argentina: Traits of an epidemic

Globally, tobacco is the number one preventable cause of death, killing one in ten adults. In addition, it is projected that 80% of all tobacco deaths will occur in developing countries by 2030. Social factors drive the adoption and cessation of smoking in populations, but few studies have examined the social patterning of smoking in developing countries. We investigated the social patterning of current smoking status in Argentina and heterogeneity in this patterning by age using cross-sectional survey data from 2005. Higher socioeconomic status (SES) was associated with a decreased odds of current smoking status for men but not women. However, this relationship varied by age in both genders (P for interaction <0.0001 in men and women). At younger ages, higher SES was associated with less smoking, but the opposite relationship was observed at older ages, particularly for women. Men ages 18-34 had a decreased odds of current smoking with increasing education (OR=0.80, 95% CI 0.73-0.87), whereas men aged 65 and older showed no patterning by education (OR=0.94, 95% CI 0.82-1.08). Younger women showed evidence for inverse social gradients with education (OR=0.91, 95% CI 0.84-0.98 for women 18-34 years old), while older women had an increased odds of current smoking with increasing education (OR=1.19, 95% CI 1.05-1.36 for women 65 and older). These cross-sectional results provide evidence for the complexity of the social patterning of current smoking status in Argentina according to gender and age group. The increased burden of current smoking among those of lower socioeconomic status within younger cohorts is a troubling pattern that is certain to impact future disparities in chronic disease outcomes unless major interventions are undertaken.