Trends in cigarette smoking in Spain by social class.

Objective: . The aim of this study was to evaluate smoking trends among Spanish men and women by social class between 1987 and 1997.

Methods: We used secondary analysis of the National Health Interview Surveys of 1987, 1993, 1995, and 1997. The main outcome measures were prevalence of smoking, smoking cessation activity (quit ratio), and smoking initiation in the manual and nonmanual social class in each year and smoking prevalence ratio, smoking cessation ratio, and smoking initiation ratio in 1997 versus 1987 in each social class.

Results: Among men ages 25 years and older the prevalence of smoking in both the manual and the nonmanual social class decreased between 1987 and 1997 in all age groups, and the relative magnitude of the decrease was always greater in the nonmanual social class. In contrast, among women the prevalence of smoking increased in both social classes: in the 25- to 44-year age group the smoking prevalence ratios in 1997 versus 1987 were 1.20 in the nonmanual social class and 1.61 in the manual social class, while in the 45- to 64-year age group the prevalence ratios were 2.52 and 2.15, respectively. The quit rate among men increased in both social classes in all age groups between 1987 and 1997; in contrast, among women the quit rate increased only among those ages 25 to 44 years in the nonmanual social class. Smoking prevalence for people ages 16 to 24 years--smoking initiation--decreased among men and women between 1987 and 1997 in both social classes.

Conclusions: Smoking trends in Spain by social class have differed among men and women. The findings are considered in the context of policies and programs aimed at reducing smoking.