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Background Tobacco control measures carried out in the countries can affect social inequalities in the smoking habit. This study aimed to examine the 20-year trends in social patterning of daily smoking in Lithuania. Methods The data were obtained from 11 biannual cross-sectional postal surveys of Lithuanian Health Behaviour Monitoring, beginning in 1994. Each survey used a randomly selected nationally representative independent sample of 3000-4000 inhabitants aged 20-64 drawn from the population register. In total, 8738 men and 11822 women participated in the surveys. The analysis of daily smoking involved the respondents who had smoked daily for at least one year. Results The prevalence of daily smoking was increasing up to the year 2000, especially among women, while a decreasing trend in men and levelling off a trend in women was observed afterwards. In the last survey, 33.3% of men and 12.5% of women were daily smokers. The proportion of daily smokers was higher among younger than older participants; however, the age difference in smoking decreased over time. The highly educated men and women smoked less than those with low education. The odds ratio (OR) of smoking in men with university versus lower education was 0.42 (95% CI 0.37-0.47) and in women - 0.68 (95% CI 0.60-0.78). The proportion of smoking men decreased in all educational groups; however, the differences in the smoking prevalence remained. Since 2000, the educational gradient in smoking among women was increasing due to a decline in smoking prevalence among women with university education. More women living in big cities than in non-urban areas were daily smokers (OR 1.29; 95% CI 1.15-1.44). Over 20 years, no consistent difference in the smoking trends by place of residence was found in both genders. Conclusions The 20-year trends in social patterning of daily smoking differed between men and women. Inequalities in daily smoking by age and education remained in both genders. Key messages In Lithuania, the trends and social differences in daily smoking were related to gender. Comprehensive tobacco control measures targeting young and lower educated groups should be implemented aiming to reduce social inequalities in smoking.

Social differences in 20-year trends in daily smoking among Lithuanian adult population