Social Class and Smoking

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The New York Times highlights the issue of hospitals opting not to hire smokers. It’s not clear how many places of employment are really banning smoking (or even how strictly such regulations will be enforced), but certainly there have at least been some high-profile cases (ie, Cleveland Clinic). One question that comes immediately to mind are — who still smokes? The NYT article includes this bit:

But the American Legacy Foundation, an antismoking nonprofit group, has warned that refusing to hire smokers who are otherwise qualified essentially punishes an addiction that is far more likely to afflict a janitor than a surgeon. (Indeed, of the first 14 applicants rejected since the policy went into effect in October at the University Medical Center in El Paso, Tex., one was applying to be a nurse and the rest for support positions.)

I had the impression that the remaining prevalence of smoking is strongly stratified by social class, geography, and education; and found this study from the CDC confirms as much:

One of the biggest predictors of smoking is education. Interestingly, the least educated (<8 years) have a lower smoking rate than average, particularly if female. This rises with more education, peaking with GED holders (42%) and falling to a low of 7.2% for graduate holders. This confirms the pattern, seen elsewhere, that credentials matter as well as years of education. ie, even among the group with 12 years of education, there is a large variance between those without a diploma (31%); those with a GED (42%), and those with a diploma only (25%). Similarly, there is a large difference between some college (23%, similar to HS grads) and getting a diploma (12%).

There is also a strong gender disparity among Asians — the smoking rate for Asian men is not much lower than the average (19%), yet among women, being Asian has a comparable effect as having a graduate degree (6.5% v. 6.4%). Asian countries also have these stark gender differences when it comes to smoking rates.

Income is another big factor — 24% smoking rate above the poverty line, 33% below. I checked this out a little more in the GSS. Here, you sometimes see the "inverse U" pattern as with education — the smoking rate for 1991 stays under 33% for the first few thousand dollars, goes up to the 40s-50s for the next few thousand, and then falls to 17% for the $75k+ crowd.

Here's political affiliation:

I’ve seen this pattern a few other places as well — Independents differ on some criteria from both Republicans and Democrats. Their lack of a coherent political ideology is indicative of other traits.

Anyway, it does seem that the class concerns of a smoking ban are somewhat warranted. This is a policy unlikely to affect the doctors, surgeons, or administrators at hospitals — while it will act as a much stronger burden on less educated support staff (who are of course facing substantially higher unemployment rates now anyway).


  1. The disparity between male and female smoking rates is interesting. On the international stage, it seems that the gap is strongest in the middling countries economically, where the rate of smoking among males peaks. The rate among females seems to increase with GDP per capita.

    More than that, female rates are particularly close to male rates in Western European countries and it seems the closest in Anglo countries. In contrast, in economically well-off Japan 44% of males over 15 smoked in 2005 according to the WHO, whereas only 14% of females did.

    So, it’s interesting that in the United States, while Asians don’t have the high smoking rates that they do in Asian countries, the gender gap is present.

    Links to relevant graphs by Gapminder:

  2. I remember being surprised by the political correlation mentioned in Honestly, Who Else Wound Fund Such Research? Ilkka Kokkarinen would not have been.

  3. Did you just accuse everyone who isnt a dem or rep of not having a coherent political philosophy? Really?

  4. There’s also a very high gender gap among Hispanics.

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