In many countries smoking prevalence is highest among younger adults and lower socio-economic (SES) groups and concerns exist about how to reduce disparities.
We investigated the relative impact on smoking prevalence among these population subgroups during a period of substantial strengthening of tobacco control policies and mass media campaign investment in Victoria Australia (2005-2011), compared with an earlier period of lower tobacco control activity (1998-2004).
Annual telephone surveys with randomly selected Victorian adults from 1998 to 2011 (n=1963 to n=4503) were used to monitor the rate of decline in regular smoking prevalence in the Victorian population. Adjusted interaction analyses examined differences in the rate of decline between demographic groups across the two phases (1998-2004 and 2005-2011).
From 1998-2011, there was a significant linear decline in regular smoking among Victorian adults from 21.2% to 14.4%. While the rates of decline in regular smoking across the whole population were similar across the two phases, significant interaction effects were found between age and SES groups. From 1998-2004, the prevalence of regular smoking declined most rapidly among older Victorians (4.6% annual decrease in odds of being a regular smoker) and higher SES adults (7.4% annual decrease in odds). This trend reversed between 2005-2011, when regular smoking declined most rapidly among lower SES (5.3% annual decrease in odds) and younger adults (18-29 years: 7.9% annual decrease in odds).
The recent period of stronger tobacco control activity, involving smoke-free bars, a tobacco tax increase, more comprehensive tobacco marketing bans, graphic health warnings, and ongoing investment in high intensity high emotion anti-smoking campaigns was associated with relatively greater declines in smoking prevalence among younger and low SES adults. This adds to the wider literature suggesting that more comprehensive implementation of tobacco control policies and programs benefits those with higher smoking prevalence.