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Popul Res Policy Rev. 2017 Jun;36(3):309-330. doi: 10.1007/s11113-016-9424-y. Epub 2017 Jan 09.

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States.

Population research and policy review

Fred C Pampel, Damien Bricard, Myriam Khlat, Stéphane Legleye

Affiliations

  1. Institute of Behavioral Science, University of Colorado, Boulder, 80309-0483 USA.
  2. Institut de Recherche et Documentation en Economie de la Santé (IRDES), Paris, France.
  3. Institut National d'Etudes Demographiques, 133, boulevard Davout - 75020 Paris, France.
  4. INSERM U1178, Université Paris-Sud, UVSQ, Université Paris-Saclay, Villejuif, France.

PMID: 29056801 PMCID: PMC5648022 DOI: 10.1007/s11113-016-9424-y

Abstract

Widening of educational disparities and a narrowing female advantage in mortality stem in good part from disparities in smoking. The changes in smoking and mortality disparities across cohorts and countries have been explained by an epidemic model of cigarette use but are also related to life course changes. To better describe and understand changing disparities over the life course, we compare age patterns of smoking in three cohorts and two nations (France and the United States) using smoking history measures from the 2010 French Health Barometer (N = 20,940) and the 2010 U.S. National Health Interview Survey Sample Adult File (N = 20,444). The results demonstrate statistically significant widening of gender and educational differences from adolescence to early and middle adulthood, thus accentuating the disparities already emerging during adolescence. In addition, the widening disparities over the life course have been changing across cohorts: Age differences in educational disparities have grown in recent cohorts (especially in France), while age differences in gender disparities have narrowed. The findings highlight the multiple sources of inequality in smoking and health in high-income nations.

Keywords: Cohort; Education; Gender; Life course; Smoking

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