Smoking disproportionately impacts people of low socioeconomic status (SES). Smoking affects some groups more than others, including those with lower income and lower educational achievement. Smoking has a devastating impact on physical and financial health for people with fewer resources.
Understanding higher smoking rates for people of low SES
There are many reasons why low-SES populations smoke at higher rates and quit at lower rates than higher-SES populations:
- The tobacco industry systematically targets low-income neighborhoods and specific demographic groups with price discounts, direct-mail marketing and in-store promotions.
- Low-SES individuals have less access to:
- Primary care
- Social support to quit
- Financial resources to pay for quit-smoking medications
- Health insurance
- Low-SES populations are less likely to:
- Receive quitting assistance from health care providers
- Use evidence-based treatments to help them quit
- Low-SES populations are more likely to view smoking as a comfort in the face of other challenges, and are less likely to want to give that comfort up.
Smoking and socioeconomic status
14.4 percent of Minnesota adults (580,000 Minnesotans) regularly smoke. The smoking rate is falling, but it remains alarmingly high for some populations, including those of low socioeconomic status (low SES).
Socioeconomic status is one of the greatest predictors of smoking.
- Americans are 40 percent more likely to smoke if they live below the poverty line.
- Nationally, 45.2 percent of adults with a GED smoke, compared to 6.3 percent of adults with a graduate degree.
- In Minnesota, 24 percent of adult smokers are in the lowest income bracket, while only 8.7 are in the highest income bracket (see Figure 1).
- In Minnesota, one in 20 adults who graduated from college smokes. Among those with lower educational levels (i.e., less than high school, high school graduate/GED, some college), one in every five people smokes (see Figure 2).
Tobacco’s disproportionate harms for low-SES populations
Low-SES smokers suffer greater health burdens than the general population, due to higher smoking prevalence and less access to health coverage.
Low-SES smokers are more likely to be exposed to secondhand smoke:
- Low-income children are 91 percent more likely to be exposed to secondhand smoke and twice as likely to live with a smoker than higher-income children are.
- African American male workers, construction workers, blue-collar workers and service workers are some groups who continue to experience particularly high levels of secondhand smoke exposure.
The financial and health-related costs of cigarettes are disproportionate for low-SES smokers:
- A pack-a-day smoker spends roughly $2,700 on cigarettes in a year. This is a much higher proportion of annual income for low-SES families, and therefore harms both the smoker and the family.
- Inadequate health coverage can lead to later diagnosis of and/or inadequate treatment for smoking-related health issues.
- Fewer financial resources and/or inadequate health coverage lead to greater burden of medical costs.
SOURCES: Minnesota Adult Tobacco Survey, Campaign for Tobacco-Free Kids, National Network on Tobacco Prevention and Poverty, U.S. Centers for Disease Control and Prevention (CDC), Health Education Council
Additional resources: “Unequal Opportunity Killer” (CDC video), Tobacco Control in Low-SES Populations (Legacy report), Smoking in Low Socioeconomic-Status Populations (Health Education Council report), U.S. Centers for Disease Control and Prevention (CDC)