The epidemic and associated disease bruden of tobacco use is growing, particularly in low- and middle-income countries. Increasing the effectiveness of smoking cessation policies and programs may require greater consideration of the complexity of cultural and socioeconomic situations that shape the smokers’ universe.
The purpose of this paper is to explore the association between educational level and “selected midpoints” linked to smoking cessation in Brazil.
As part of the Global Adult Tobacco Survey (GATS) conducted in 2008, data were collected from a representative sample of adult smokers (N=7,003). We calculated the proportion of smokers who made a quit attempt in the last 12 months previous to the survey, as well as the proportions of smokers who visited a doctor in the last 12 months and received advice concerning quitting smoking, stratified by educational level. A Poisson regression model was used to assess the relationship between schooling level and smoking cessation questions.
After controlling for age and gender, there were no statistical differences in quit attempts by educational level. However, smokers who had, at least, some college education and attempted to quit in the last 12 months (N = 0.5 million, after sampling expansion) visited a doctor and received advice to quit smoking, respectively, 1.3 times and 1.7 times more often than illiterate smokers who tried to quit in the 12 months prior of the survey (N = 1.6 million, after sampling expansion) (p-values < 0.001).
Although Brazil has been one of the most successful countries in reducing tobacco use and is the largest seventh economy of the world, disparities in health and education are still a major challenge for policymakers. Our results demonstrate that there is a niche to be explored to increase the population impact of tobacco control actions worldwide.