According to a research team at the City College of New York (CCNY), tobacco dependence has a firmer grip on those who are poor or uneducated, making it harder for them to stay off cigarettes.
Smokers who had participated in a statewide smoking cessation program in Arkansas were tracked following the program by researchers from CCNY's Sophie Davis School of Biomedical Education. The participants came from a range of socioeconomic backgrounds, and while both rich and poor groups were able to successfully quit at roughly the same rate, the poorer an individual was, the harder it was for that person to overcome cravings and ultimately remain tobacco free.
Within three months of completing treatment, the poorest participants were 55 percent more likely than the richest to begin smoking again; at six months, that number jumped to 250 percent. Nationwide, Americans from households making less than $15,000 a year smoke three times more often than those making $50,000 a year or more.
Several hypotheses have been offered to explain the wide disparity. Smoking provides stress relief in times of hardship, and those of lower socioeconomic status are more likely to experience hardship, facing discrimination, job insecurity, and financial troubles. In addition, lower-paying jobs are less likely to offer the protection of local, state, and federal smoke-free laws. This means that even if a person successfully quits, he will find himself surrounded by smokers at work every day.
It is important to included these considerations when developing treatment programs, says the team from CCNY. Treatment focused on the needs of the middle class will necessarily require revision to fit lower economic status individuals. Suggestions include custom programs, but the CCNY team says that "booster sessions" after the main sessions are over may improve outcomes. It's hard to predict what stresses might drive someone back to cigarettes several months down the road, so it's important to continuing offering resources to those who will need them the most.
Source: City College of New York
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