title: Educational inequalities in three smoking-related causes of death in 18 European populations.
abstract: BACKGROUND
  Smoking is an important determinant of socioeconomic inequalities in mortality in many countries. As the smoking epidemic progresses, updates on the development of mortality inequalities attributable to smoking are needed. We provide estimates of relative and absolute educational inequalities in mortality from lung cancer, aerodigestive cancers, and chronic obstructive pulmonary disease (COPD)/asthma in Europe and assess the contribution of these smoking-related diseases to inequalities in all-cause mortality.
  
  
  METHODS
  We use data from 18 European populations covering the time period 1998-2007. We present age-adjusted mortality rates, relative indices of inequality, and slope indices of inequality. We also calculate the contribution of inequalities in smoking-related mortality to inequalities in overall mortality.
  
  
  RESULTS
  Among men, relative inequalities in mortality from the 3 smoking-related causes of death combined are largest in the Czech Republic and Hungary and smallest in Spain, Sweden, and Denmark. Among women, these inequalities are largest in Scotland and Norway and smallest in Italy and Spain. They are often larger among men and tend to be larger for COPD/asthma than for lung and aerodigestive cancers. Relative inequalities in mortality from these conditions are often larger in younger age groups, particularly among women, suggesting a possible further widening of inequalities in mortality in the coming decades. The combined contribution of these diseases to inequality in all-cause mortality varies between 13% and 32% among men and between -5% and 30% among women.
  
  
  CONCLUSIONS
  Our results underline the continuing need for tobacco control policies, which take into account socioeconomic position.
authors.affiliation: Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands;
authors.forename: Margarete C
authors.initials: MC
authors.lastname: Kulik
authors.forename: Gwenn
authors.initials: G
authors.lastname: Menvielle
authors.forename: Terje A
authors.initials: TA
authors.lastname: Eikemo
authors.forename: Matthias
authors.initials: M
authors.lastname: Bopp
authors.forename: Domantas
authors.initials: D
authors.lastname: Jasilionis
authors.forename: Ivana
authors.initials: I
authors.lastname: Kulhánová
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Olof
authors.initials: O
authors.lastname: Östergren
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012907:Smoking / Q000401:mortality*; D012959:Socioeconomic Factors