Socioeconomic disparities in quitting smoking and in steps on the smoking cessation pathway among smokers in Italy: findings from the SIDRIAT cohort study

Objectives: The aim of this research was to examine socioeconomic disparities in quitting smoking and the association between socioeconomic status (SES) and steps in the smoking cessation pathway.Methods: We conducted an 11-year longitudinal cohort study examining the association between SES and quitting smoking among 721 current smokers at baseline. At the follow-up survey there were 466 smokers composed by those who continued smoking since baseline and those who began ore relapsed smoking. Among these we then studied the association between SES and steps on the pathway of quitting: nicotine dependence, motivational factors (expectancy of gains in quality of life after quitting; worries about health; favourable attitudes about smoking), beliefs about quitting (intention to quit smoking within the next 6months; self-efficacy), and past quitting history.Results: Smokers with fewer years of education were less likely to quit. Higher nicotine dependence was associated with lower education and with workers classified as managers and professionals, who were also more likely to record favourable smoking attitudes, and to have made 1 quit attempts. Manual workers reported lower self-efficacy in quitting, and were less likely to report 6months of abstinence.Conclusions: Higher education levels may predict quitting smoking over a long period. Interventions are needed to reduce dependence and to enhance self-efficacy in lower educated smokers, as well as to reduce favourable smoking attitudes among higher occupational classes.