ArticlePloS one2020
Social inequalities in tobacco-attributable mortality in Spain. The intersection between age, sex and educational level.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 19 citations in OpenAlex.
- Nurse-led smoking cessation with cytisinicline in primary care: An intervention study.International journal of nursing studies advances · 2026Article
- The effect of educational attainment on birthrate in Japan: an analysis using the census and the vital statistics from 2000 to 2020.BMC pregnancy and childbirth · 2024Article
- [Use of Roll Your Own Tobacco in the Basque Country: magnitude, socio-economic inequalities and evolution in the period 2013-2018].Revista espanola de salud publica · 2023Article
- Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis.Frontiers in cardiovascular medicine · 2023Article
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- Effect of Funding Medications for Nicotine Dependence on Tobacco Control: A Narrative Review.Open respiratory archivesReview
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
introductionFirst study of social inequalities in tobacco-attributable mortality (TAM) in Spain considering the joint influence of sex, age, and education (intersectional perspective).
methodsData on all deaths due to cancer, cardiometabolic and respiratory diseases among people aged ≥35 years in 2016 were obtained from the Spanish Statistical Office. TAM was calculated based on sex-, age- and education-specific smoking prevalence, and on sex-, age- and disease-specific relative risks of death for former and current smokers vs lifetime non-smokers. As inequality measures, the relative index of inequality (RII) and the slope index of inequality (SII) were calculated using Poisson regression. The RII is interpreted as the relative risk of mortality between the lowest and the highest educational level, and the SII as the absolute difference in mortality.
resultsThe crude TAM rate was 55 and 334 per 100,000 in women and men, respectively. Half of these deaths occurred among people with the lowest educational level (27% of the population). The RII for total mortality was 0.39 (95%CI: 0.35-0.42) in women and 1.61 (95%CI: 1.55-1.67) in men. The SII was -41 and 111 deaths per 100,000, respectively. Less-educated women aged <55 years and men (all ages) showed an increased mortality risk; nonetheless, less educated women aged ≥55 had a reduced risk.
conclusionsTAM is inversely associated with educational level in men and younger women, and directly associated with education in older women. This could be explained by different smoking patterns. Appropriate tobacco control policies should aim to reduce social inequalities in TAM.
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