Table 2

Summary of evidence for equity impact of tobacco control interventions

InterventionTCS weighting*Likely equity impact†Strength of evidence
Price increases30PositiveStrong evidence of greater price-responsiveness in low-income groups.20 34–37 Mixed evidence in relation to impact by education19 36 38 39
Smoke-free environments22MixedConsistent evidence that workplace exposure to tobacco smoke is higher among less advantaged social groups,45–47 56 but no clear evidence on how the introduction of smoke-free legislation may affect this gradient (since evaluative studies have not demonstrated a differential impact by SES50–52)
Educational media campaigns15MixedMixed evidence base. Several studies suggest media campaigns are less effective among low-SES groups.57 Some evidence that advertisements using personal testimony may do better in reaching low-SES smokers; cf more traditional advertisments60 61
Advertising bans13No evidence
Health warnings10No evidence
Smoking cessation support10NegativeConsistent evidence of lower quit rates in low-SES smokers using cessation services.24 72 74 75 78–80 94–96 101 109 Negative equity impact may be attenuated by concentrating services in more deprived areas72 76
Multi-faceted (community-based)NANo clear effectVery limited evidence
  • *Maximum score on 100-point Tobacco Control Scale.17 ,18

  • †That is, whether the intervention is associated with a decrease (=positive) or increase (=negative) in the SES gradient in smoking.

  • SES, socioeconomic status; TCS, Tobacco Control Scale.