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Reductions in smoking can reduce health gaps between the rich and the poor.

Evidence of a disproportionate burden of tobacco use among the poor and other less-resourced populations has become increasingly available.

Smoking is more common among the poor than among the rich in most developed countries. Smoking is also more common among poor men than among rich men in almost all developing countries while the situation is more variable amongst women. Tobacco use among groups that are already disadvantaged is likely to exacerbate existing health disparities.

Individuals living in poverty in the US have a median duration of smoking of 40 years as opposed to 22 years among those with incomes three times greater than the poverty level. Median duration of smoking in the US is 40 years among individuals without a high-school diploma, but 18 years among those with a bachelor’s degree or higher. The 15/10-year gap in life expectancy between the rich and the poor man/woman in the US is largely attributable to differences in smoking rates.

Similarly, estimates for Canada, England, Wales, and Poland suggest that the excess mortality of the poor in these countries is largely explained by differences in smoking between the rich and the poor. Reductions in smoking among the poor could reduce these health disparities.

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Hosseinpoor AR, Parker LA, Tursan d'Espaignet E, Chatterji S. Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey. PLoS One. 2012;7(8):e42843.

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Campaign for Tobacco-Free Kids. Tobacco and Socioeconomic Status. Washington, D.C.: Campaign for Tobacco-Free Kids, 2015. logo
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