Premium
Understanding long‐term trends in smoking in England, 1972–2019: an age–period–cohort approach
Author(s) -
Opazo Breton Magdalena,
Gillespie Duncan,
Pryce Robert,
Bogdanovica Ilze,
Angus Colin,
Hernandez Alava Monica,
Brennan Alan,
Britton John
Publication year - 2022
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15696
Subject(s) - demography , medicine , confidence interval , odds ratio , cohort , odds , cohort effect , cohort study , relative risk , logistic regression , sociology
Background and aims Smoking prevalence has been falling in England for more than 50 years, but remains a prevalent and major public health problem. This study used an age–period–cohort (APC) approach to measure lifecycle, historical and generational patterns of individual smoking behaviour. Design APC analysis of repeated cross‐sectional smoking prevalence data obtained from three nationally representative surveys. Setting England (1972–2019). Participants Individuals aged 18–90 years. Measurements We studied relative odds of current smoking in relation to age in single years from 18 to 90, 24 groups of 2‐year survey periods (1972–73 to 2018–19) and 20 groups of 5‐year birth cohorts (1907–11 to 1997–2001). Age and period rates were studied for two groups of birth cohorts: those aged 18–25 years and those aged over 25 years. Findings Relative to age 18, the odds of current smoking increased with age until approximately age 25 [odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.41–1.56] and then decreased progressively to age 90 (OR = 0.06, 95% CI = 0.04–0.08). They also decreased almost linearly with period relative to 1972–73 (for 2018–19: OR = 0.30, 95% CI = 0.26–0.34) and with birth cohort relative to 1902–06, with the largest decreased observed for birth cohort 1992–96 (OR = 0.44, 95% CI = 0.35–0.46) and 1997–2001 (OR = 0.35, 95% CI = 0.74–0.88). Smoking declined in the 18–25 age group by an average of 7% over successive 2‐year periods and by an average of 5% in those aged over 25. Conclusions Smoking in England appears to have declined over recent decades mainly as a result of reduced smoking uptake before age 25, and to a lesser extent to smoking cessation after age 25.