Impact of the 1976 Tobacco Control Act in Finland on the proportion of ever daily smokers by socioeconomic status

Objective. To assess the impact of the 1976 Tobacco Control Act (TCA) on smoking initiation across socioeconomic groups. Methods. Nationwide data from independent annual cross-sectional postal surveys in 1978–2002 in Finland. Subjects were 25–64-year-old men and women born 1926–1975 (n = 68 071). Socioeconomic status was derived individually from population census data. Logistic regression was applied to assess the impact of the 1976 TCA on the prevalence of ever daily smoking in birth cohorts and socioeconomic groups. Results. Clear socioeconomic differences in ever daily smoking among men and women were found. In all socioeconomic groups a declining cohort trend was observed among men whereas women showed an increasing trend in early cohorts and a declining one thereafter. A statistically significant decline in the proportion of ever daily smokers compatible with the impact of the TCA was found in all socioeconomic groups except farmers. Among women the decline was roughly similar in each socioeconomic group, while among men it varied and was most pronounced among white collar employees. Conclusions. The impact of the 1976 TCA was less pronounced among male lower socioeconomic groups. In spite of the even impact of the TCA on female smoking across socioeconomic groups, large socioeconomic disparities remain. Tobacco control policy measures specifically directed at lower socioeconomic groups are needed.