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Smoking, mortality and social disadvantage

Smoking is a modern scourge. The WHO global burden of disease study suggested that, in developed countries, 26% of male deaths and 9% of female deaths can be attributed to smoking—the single most important risk factor.

An article in the Lancet (synopsis only) points out a distinctive feature of the scourge of smoking – its equity effects. It is well-known that there is substantially greater mortality among those with low social advantage than those with high advantage. About half of this can be explained by the higher incidence of smoking among those who are socially disadvantaged. An accompanying Lancet op ed provides some detail about this study.

This finding will not surprise economists who have long believed that cigarette consumption can be inferior – increases in income reduce consumption. It is now known that while poor people smoke more when their incomes increase that the wealthy and the aged smoke less. Those on high incomes smoke less as their incomes increase.

As economists we often ponder the efficiency costs of addictive forms of behaviour – smoking, alcoholism, gambling and illicit drug consumption. It is good that researchers are looking at the social equity implications of these damaging forms of behaviour and, particularly the most hazardous, cigarette smoking. There is a forthcoming conference 18-19 September in Adelaide on these issues that I will try to attend.

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