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July 13, 2006 -- New research shows that men's odds of dying from a smoking-related illness are twice as high for those in the lowest social class as for those in the highest social class.
The finding, published online in The Lancet, comes from experts including the University of Toronto's Prabhat Jha, MD.
Jha and colleagues studied 1996 death rates for men aged 35-69 years in the U.S., Canada, England, Wales, and Poland.
First, the researchers estimated how many men in that age range died of smoking-related illnesses, including lung cancerlung cancer, chronic obstructive lung disease, and diseases of the circulatory system (vascular disease). They came up with a total of more than 564,000 deaths.
Next, Jha's team matched those deaths to social class. They classified social class by profession (English and Welsh data), education level (U.S. and Polish data), and neighborhood income (Canadian data).
Lastly, the researchers matched the death and social class data. They found that "in each country, there was about a twofold difference between the highest and the lowest social strata in overall risk of dying among men age 35-69 years."
In other words, men in the lowest social classes were twice as likely to die of smoking-related illness, according to the researchers' calculations. However, those figures don't isolate the influence of other factors, such as access to medical care, which class may also affect.
A journal editorial agrees that smoking is "an important contributor" to class differences in death rates. But editorialist Michael Marmot, MBBS, PhD, MPH, who works at University College London's International Institute for Society and Health, isn't totally convinced that Jha's team correctly estimated the scope of the class gap.
Even so, that "does not detract from the essential importance of Jha and colleagues' study," Marmot writes. "If smoking were eliminated, average health would improve and socioeconomic differences in adult mortality would be less although still substantial."
SOURCES: Jha, P. The Lancet, July 14, 2006; online edition. Marmot, M. WebMD Medical Reference provided in collaboration with The Cleveland Clinic: "Vascular Disease and Your Heart." The Lancet, July 14, 2006; online edition. News release, The Lancet.