Abstract B86: Changes in social inequalities in male smoking-attributable mortality in two European countries

Background: Past studies have assessed trends in smoking prevalence among different social strata in developed countries. However, we know of no study that quantifies changes in social inequalities in smoking-attributable mortality rates over time. The aim of this study was to assess changes in social inequalities for smoking-attributable male mortality rates by educational level between two time periods in France and Poland. Methods: The contribution of smoking to adult male mortality in each population was estimated indirectly from disease-specific death rates in that population (using absolute lung cancer rates to indicate proportions due to smoking of mortality from certain other diseases). We applied these methods to male death rates at ages 35-69 years from three different social strata in France and Poland, based on a total of 202,779 deaths. The social strata were low, middle, and high based on completed years of education (less than 12 years, 12 years, and more than 12 years, respectively). For France, the comparison periods were 1990-94 and 1995-99; for Poland, 1995 was compared to 2002. Results: Smoking-attributable mortality rates were 3 to 6 times higher in the lowest education group as compared to the highest education group in both countries. In France, smoking-attributable mortality rates within each education group remained similar between 1990-94 and 1995-99. Between 1995 and 2002, Poland showed a reduction in smoking-attributable mortality rates by 15%, 4%, and 52% in the low, middle, and high education group, respectively. Conclusion: Although men in the lowest education group in France were around four times more likely to die from smoking as compared to those in the highest education group, there was little change between the periods studied for this country. While smoking-attributable mortality rates in the highest education group of Polish males decreased much more compared to the lower education groups; declines were seen in all education groups. Mortality rates from more recent years, when tobacco control efforts have accelerated in both countries, will be of interest to confirm these trends. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B86.