Abstract：
BACKGROUND: While smoking prevalence in high income countries has declined over time, socioeconomic inequalities in smoking have widened. This study is one of the few studies to examine the longitudinal pattern of income-related smoking inequalities and only the second using concentration indices in its analysis.
METHODS: Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups.
RESULTS: Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period.
CONCLUSIONS: Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.
METHODS: Income-related smoking inequalities were measured using concentration indices using the Northern Ireland Continuous Household Survey data. Smoking inequalities were compared quantitatively and visually across three periods: 1985-1995, 1997-2005 and 2007-2015. Joinpoint analysis was used to measure the overall time trend of smoking inequalities. Subgroup analysis was used to examine the nature of change in smoking inequalities across population sub-groups.
RESULTS: Throughout 1985-2015, smoking was more concentrated among the poor (standard concentration index of-0·131, p < 0·001). While prevalence declined sharply across population, income-related inequalities increased sharply in general and within subgroups. Income-related smoking inequalities were significantly larger among high educated group and those who were employed. No structural break was observed with respect to the adoption of any specific policy measures over the period.
CONCLUSIONS: Current approaches to tobacco control may be ill-suited to addressing smoking inequalities and may indeed be counterproductive. More tailored approaches that address the specific needs of population sub-groups or more draconian approaches such as extensions to prohibition may be required to reduce prevalence further while avoiding a widening of inequalities.
摘要：
背景：虽然高收入国家的吸烟率随着时间的推移而下降，吸烟的社会经济不平等已经扩大。这项研究是为数不多的研究与收入相关的吸烟不平等的纵向模式的研究之一，只有第二个在分析中使用集中指数。
方法：使用集中指数使用北爱尔兰连续家庭调查数据来衡量与收入相关的吸烟不平等。在1985-1995年、1997-2005年和2007-2015年三个时期对吸烟不平等进行了定量和视觉比较。Joinpoint分析用于测量吸烟不平等的总体时间趋势。亚组分析用于检查人口亚组之间吸烟不平等变化的性质。
结果：在整个1985-2015年期间，吸烟更集中在穷人中（标准浓度指数为-0·131，p<0·001）。虽然患病率在人群中急剧下降，与收入相关的不平等在总体上和分组内急剧增加。在受过高等教育的人群和受雇人群中，与收入相关的吸烟不平等明显更大。在此期间，在采取任何具体政策措施方面没有观察到结构性中断。
结论：目前的烟草控制方法可能不适合解决吸烟不平等问题，甚至可能适得其反。可能需要采取更有针对性的方法来解决人口分组的具体需求，或者采取更严厉的方法，例如扩大禁令，以进一步降低患病率，同时避免不平等现象的扩大。
方法：使用集中指数使用北爱尔兰连续家庭调查数据来衡量与收入相关的吸烟不平等。在1985-1995年、1997-2005年和2007-2015年三个时期对吸烟不平等进行了定量和视觉比较。Joinpoint分析用于测量吸烟不平等的总体时间趋势。亚组分析用于检查人口亚组之间吸烟不平等变化的性质。
结果：在整个1985-2015年期间，吸烟更集中在穷人中（标准浓度指数为-0·131，p<0·001）。虽然患病率在人群中急剧下降，与收入相关的不平等在总体上和分组内急剧增加。在受过高等教育的人群和受雇人群中，与收入相关的吸烟不平等明显更大。在此期间，在采取任何具体政策措施方面没有观察到结构性中断。
结论：目前的烟草控制方法可能不适合解决吸烟不平等问题，甚至可能适得其反。可能需要采取更有针对性的方法来解决人口分组的具体需求，或者采取更严厉的方法，例如扩大禁令，以进一步降低患病率，同时避免不平等现象的扩大。
