Smoking and health inequalities in Scotland
Welcome to our briefing on smoking and health inequalities in Scotland.
To understand some of the terms we use to describe inequalities, please read this section on how deprivation is described and measured in Scotland. The Scottish Index of Multiple Deprivation (SIMD) is a relative measure of deprivation across 6,976 small areas. If an area is identified as ‘deprived’, this can relate to people having a low income but it can also mean fewer resources or opportunities. SIMD looks at the extent to which an area is deprived across seven domains: income, employment, education, health, access to services, crime and housing.
"While smoking prevalence in Scotland has declined in recent years, There is a smoking prevalence of 25% in the most deprived (SIMD 1) compared to 7% in the least deprived (SIMD 5) quintile."
Facts on health inequalities
The incidence of lung cancer is around three times higher in the 20% most deprived areas of Scotland than in the 20% least deprived.
Children in the most deprived areas are significantly more likely to become life-long smokers. At age 15, there is a one percentage difference in regular smoking prevalence between the 3.6% in the most and 2.6% in the least deprived quintiles.
The difference increases to 18% for adults in those areas.
Smoking-attributable hospital admission rates have decreased over time. Health inequalities, however, have worsened.
In 2008, admissions in the most deprived areas were 3.3 times higher compared to the least deprived areas and, in 2022, the rate increased to four times higher.
People with mental health problems are more likely to smoke and smoke more than those without.
In 2022, 35% of people with a self-reported long-term mental health condition smoked, compared to 15% without a condition. This is further exacerbated in areas of deprivation where many people who smoke do so in the belief that smoking is a tool that can help them to cope during times of stress, which are increasing during the cost-of-living crisis in the UK.
People with alcohol or substance use problems are significantly more likely to smoke, but less likely to receive support to quit.
Research conducted by the University of Edinburgh shows that shops selling tobacco are more common in the most deprived areas. This is a factor associated with smoking prevalence and tobacco consumption, and subsequent negative health outcomes.
Learn more about smoking and health inequalities in our e-learning module.
Smoking in pregnancy perpetuates health inequalities
- The poorer you are, statistically the more likely you are to smoke and continue to smoke during pregnancy and experience subsequent health implications including miscarriage, stillbirth, and cot death.
- In 2022, expecting mothers from the most deprived communities were 8.5 times more likely to smoke than mothers from the least deprived communities. Expectant mothers’ chances of quitting smoking are greatly improved with support from those around them. 77% of all pregnant women who smoke are from SIMD1 or SMID2 areas.
- Children whose parents or carers smoke are four times more likely to take up smoking themselves.
"Smoking is both a cause and an effect of health inequalities."
Smoking, finances and poverty
You can download a PDF file of the 'Smoking and health inequalities in Scotland' factsheet which includes references.
