Smoking Linked to Higher Death Rate Among Poorer Men

Quitting could reduce gap in mortality rates between rich and poor, study says

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By Steven Reinberg
HealthDay Reporter

THURSDAY, July 13, 2006 (HealthDay News) -- Poorer, less-educated men are more than twice as likely to die as their wealthier, better-educated counterparts, and smoking is to blame for more than half the difference in those mortality rates.

It has been known that poorer and poorly educated men have higher death rates than those who are richer and more educated, although the reason why had not been well documented, said study co-author Dr. Prabhat Jha, an adjunct professor at the University of Toronto and director of the university's Centre for Global Health Research.

But, the new study found that "the key reason is that poorer and less educated men smoke more. They have higher smoking-related deaths and are less likely to quit," Jha said.

"If you look at differences in the social inequalities between rich and poor men and their risk of death, more than half the risk is attributable to smoking-related diseases," he said.

Reporting in the July 15 issue of The Lancet, Jha and his colleagues based their finding on data collected on the deaths of 564,626 men, ages 35 to 69, in Canada, the United States, the United Kingdom and Poland.

Jha believes the findings hold true for other countries as well. "Poor men and less educated men are more likely to smoke," he said. "That's true in China, Brazil, India and many places. The consequences of smoking are contributing to deaths worldwide," Jha added.

One of the reasons for the higher death rate among poorer men is that they're not quitting smoking at the same rates as richer, more educated men, Jha said. To solve this problem, Jha thinks cigarette taxes should be raised.

"Taxing cigarettes more aggressively would lead to higher quitting rates among the poor," Jha said. "We know that quitting smoking works. To extend these benefits to the poorest segments of society, we need even more widespread control, particularly with taxes, which would be most effective in reducing the inequalities between rich and poor."

One expert thinks that smoking is only one sign of the health inequities between rich and poor.

"These findings are that much more compelling, following on the heels of a World Health Organization projection that tobacco will kill more than a billion people in the 21st Century," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

Taken together, these reports establish tobacco both as a modern plague and a cause of profound health disparities, Katz said. "But it is also a symptom of disadvantages in everything from education to recreational opportunity. Tobacco may be a singularly important cause of the health hazards of poverty, but it is certainly not the only one," he said.

More information

The American Cancer Society can tell you more about the health dangers of smoking.

SOURCES: Prabhat Jha, M.D., Ph.D., adjunct professor, University of Toronto, director, Centre for Global Health Research, Canada; David L. Katz, M.D., M.P.H., associate professor of public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; July 15, 2006, The Lancet

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