title: Trends in socioeconomic inequalities in smoking prevalence, consumption, initiation, and cessation between 2001 and 2008 in the Netherlands. Findings from a national population survey.
abstract: BACKGROUND
  Widening of socioeconomic status (SES) inequalities in smoking prevalence has occurred in several Western countries from the mid 1970's onwards. However, little is known about a widening of SES inequalities in smoking consumption, initiation and cessation.
  
  
  METHODS
  Repeated cross-sectional population surveys from 2001 to 2008 (n ≈ 18,000 per year) were used to examine changes in smoking prevalence, smoking consumption (number of cigarettes per day), initiation ratios (ratio of ever smokers to all respondents), and quit ratios (ratio of former smokers to ever smokers) in the Netherlands. Education level and income level were used as indicators of SES and results were reported separately for men and women.
  
  
  RESULTS
  Lower educated respondents were significantly more likely to be smokers, smoked more cigarettes per day, had higher initiation ratios, and had lower quit ratios than higher educated respondents. Income inequalities were smaller than educational inequalities and were not all significant, but were in the same direction as educational inequalities. Among women, educational inequalities widened significantly between 2001 and 2008 for smoking prevalence, smoking initiation, and smoking cessation. Among low educated women, smoking prevalence remained stable between 2001 and 2008 because both the initiation and quit ratio increased significantly. Among moderate and high educated women, smoking prevalence decreased significantly because initiation ratios remained constant, while quit ratios increased significantly. Among men, educational inequalities widened significantly between 2001 and 2008 for smoking consumption only.
  
  
  CONCLUSIONS
  While inequalities in smoking prevalence were stable among Dutch men, they increased among women, due to widening inequalities in both smoking cessation and initiation. Both components should be addressed in equity-oriented tobacco control policies.
authors.affiliation: STIVORO Dutch Expert Centre on Tobacco Control, PO Box 16070, 2500 BB, The Hague, the Netherlands. gnagelhout@stivoro.nl
authors.forename: Gera E
authors.initials: GE
authors.lastname: Nagelhout
authors.forename: Dianne
authors.initials: D
authors.lastname: de Korte-de Boer
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
authors.forename: Regina M
authors.initials: RM
authors.lastname: van der Meer
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.forename: Boukje M
authors.initials: BM
authors.lastname: van Gelder
authors.forename: Marc C
authors.initials: MC
authors.lastname: Willemsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D007182:Income; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology* / Q000639:trends; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires