Smoking Behavior in a Swiss Urban Population: The Role of Gender and Education

Background.Smoking has become more prevalent among U.S. men and women and European men in lower socioeducational groups. The relation between socioeducational status and smoking among European women has been studied less. Methods.A survey assessing the smoking behavior and educational level of 943 women and 961 men ages 35 to 74 years from Geneva, Switzerland, was conducted. Results.The prevalence of never smokers has declined among younger women but has remained stable among men. More men than women have ever smoked, but the difference has decreased among younger generations. Ever smoking was more prevalent among women with secondary (47.6%, age-adjusted OR 2.03, 95% CI 1.29 to 3.18) or tertiary (46.6%, age-adjusted OR 1.83, 95% CI 1.13 to 2.97) education relative to women with primary education (30.7%). Among males, ever smoking was slightly more prevalent among lower levels of education. There were moderate differences in quit ratio (ex-smokers/ever smokers) across educational levels among women (trendP= 0.08). In contrast, men with tertiary education stopped smoking more often (63.6%) than those with secondary (54.2%) or primary (47.6%) education (trendP= 0.008). For most women, primary education was associated with a later age at start of smoking while the inverse was true for men. Conclusion.Smoking behavior is evolving across generations of women in Geneva. It is more prevalent among educated women of the older generations, but this is less so among the younger generations. Women from Geneva may be currently experiencing the transition of smoking from upper to lower social classes.