Socioeconomic Status and Tobacco Use

Extract

In this issue of Nicotine and Tobacco Research, Shoenbill et al.¹ examined whether the transition of a United States (US)-based inpatient tobacco treatment program from in-person to virtual² differed in reach by social determinants of health. Social determinants of health were assessed using the social vulnerability index (SVI) which includes factors such as socioeconomic status (SES), housing and transportation, and minority status and language. The author found that the reach of the program was similar before and after the transition to virtual services by SVI, suggesting that both the in-person and the virtual services engaged different SES levels in a similar way. As done in this study, it is important to understand the influence of social determinants of health, especially SES, on all aspects of tobacco use including the reach of tobacco use disorder treatment.

In a number of countries including the US, lower SES is related to greater use of cigarettes and other tobacco products^3–8 as well as lower odds of quitting tobacco use^3,9 with evidence that these disparities have increased over time.^3,7 There are several factors to consider when studying SES in relation to tobacco use and two of these considerations will be briefly introduced here. First, there are a range of ways to assess SES (eg, income, education, occupation, insurance coverage, composite indices),¹⁰ and the relationship between SES and tobacco use may differ based on the way that SES is assessed. For example, among a national sample of US adults, greater odds of smokeless tobacco use were associated with lower education while smokeless tobacco use was not related to income.⁴ It would be important for researchers to clearly describe the measures of SES in papers and to consider examining differences if more than one SES variable is assessed.