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Social Determinants of Smoking in Low- and Middle-Income Countries: Results from the World Health Survey


  • Ahmad Reza Hosseinpoor
  • Lucy Anne Parker
  • Edouard Tursan d'Espaignet
  • Somnath Chatterji


Introduction: Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries. Methods: We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants. Results: The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group. Conclusion: Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations.

Suggested Citation

  • Ahmad Reza Hosseinpoor & Lucy Anne Parker & Edouard Tursan d'Espaignet & Somnath Chatterji, 2011. "Social Determinants of Smoking in Low- and Middle-Income Countries: Results from the World Health Survey," PLOS ONE, Public Library of Science, vol. 6(5), pages 1-7, May.
  • Handle: RePEc:plo:pone00:0020331
    DOI: 10.1371/journal.pone.0020331

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    References listed on IDEAS

    1. Hassmiller, K.M. & Warner, K.E. & Mendez, D. & Levy, D.T. & Romano, E., 2003. "Nondaily Smokers: Who Are They?," American Journal of Public Health, American Public Health Association, vol. 93(8), pages 1321-1327.
    2. Pampel, Fred, 2008. "Tobacco use in sub-Sahara Africa: Estimates from the demographic health surveys," Social Science & Medicine, Elsevier, vol. 66(8), pages 1772-1783, April.
    3. Hajat, A. & Kaufman, J.S. & Rose, K.M. & Siddiqi, A. & Thomas, J.C., 2010. "Do the wealthy have a health advantage? Cardiovascular disease risk factors and wealth," Social Science & Medicine, Elsevier, vol. 71(11), pages 1935-1942, December.
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    1. Joseph L Ward & Russell M Viner, 2016. "Secondary Education and Health Outcomes in Young People from the Cape Area Panel Study (CAPS)," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
    2. Qing Wang & Jay J Shen & Michelle Sotero & Casey A Li & Zhiyuan Hou, 2018. "Income, occupation and education: Are they related to smoking behaviors in China?," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
    3. Ernest Ouedraogo & Yienouyaba Gaetan Ouoba & Emmanuel Lompo, 2020. "The Social and Economic Correlates of Tobacco Consumption in Developing Countries Compared to Developed Countries: Evidence from Burkina Faso and Canada," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(11), pages 33-44, October.

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