PT  - JOURNAL ARTICLE
AU  - Fujian Song
AU  - Tim Elwell-Sutton
AU  - Felix Naughton
AU  - Sarah Gentry
TI  - Future smoking prevalence by socioeconomic status in England: a computational modelling study
AID  - 10.1136/tobaccocontrol-2019-055490
DP  - 2021 Jul 01
TA  - Tobacco Control
PG  - 380--385
VI  - 30
IP  - 4
4099  - http://tobaccocontrol.bmj.com/content/30/4/380.short
4100  - http://tobaccocontrol.bmj.com/content/30/4/380.full
SO  - Tob Control2021 Jul 01; 30
AB  - Background The difference in smoking across socioeconomic groups is a major cause of health inequality. This study projected future smoking prevalence by socioeconomic status, and revealed what is needed to achieve the tobacco-free ambition (TFA) by 2030 in England.Methods Using data from multiple sources, the adult (≥18 years) population in England was separated into subgroups by smoking and highest educational qualification (HEQ). A discrete time state-transition model was used to project future smoking prevalence by HEQ deterministically and stochastically.Results In a status quo scenario, smoking prevalence in England is projected to be 10.8% (95% uncertainty interval: 9.1% to 12.9%) by 2022, 7.8% (5.5% to 11.0%) by 2030 and 6.0% (3.7% to 9.6%) by 2040. The absolute difference in smoking rate between low and high HEQ is reduced from 12.2% in 2016 to 7.9% by 2030, but the relative inequality (low/high HEQ ratio) is increased from 2.48 in 2016 to 3.06 by 2030. When applying 2016 initiation/relapse rates, achievement of the TFA target requires no changes to future cessation rates among adults with high qualifications, but increased rates of 37% and 149%, respectively, in adults with intermediate and low qualifications.Conclusions If the current trends continue, smoking prevalence in England is projected to decline in the future, but with substantial differences across socioeconomic groups. Absolute inequalities in smoking are likely to decline and relative inequalities in smoking are likely to increase in future. The achievement of England’s TFA will require the reduction of both absolute and relative inequalities in smoking by socioeconomic status.All data relevant to the study are included in the article or uploaded as online supplementary information.