eprintid: 10136388 rev_number: 16 eprint_status: archive userid: 608 dir: disk0/10/13/63/88 datestamp: 2021-10-14 13:32:22 lastmod: 2021-12-08 23:36:00 status_changed: 2021-10-14 13:32:22 type: article metadata_visibility: show creators_name: Kock, L creators_name: Brown, J creators_name: Shahab, L creators_name: Tattan-Birch, H creators_name: Moore, G creators_name: Cox, S title: Inequalities in smoking and quitting-related outcomes among adults with and without children in the household 2013-2019: A population survey in England ispublished: inpress divisions: UCL divisions: B02 divisions: D12 divisions: J96 note: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. abstract: INTRODUCTION: Smoking among those who live with children is an important influence on smoking initiation among children. This study assessed socioeconomic inequalities in smoking and quitting-related outcomes among all adults with and without children in the household. METHODS: Monthly repeat cross-sectional household survey of adults (16+) from 2013-2019 in England (N=138,583). We assessed the association between cigarette smoking and quitting-related outcomes and having children in the household, and whether these relationships were moderated by occupational social grade (categories AB-E from most to least advantaged). Trends in smoking prevalence among adults with and without children in the household were explored. RESULTS: In adjusted analysis, the association of having children in the household with smoking prevalence depended on social grade: smoking prevalence was between 0.71 (95%CI 0.66-0.77) to 0.93 (0.88-0.98) times lower among social grades AB-D with children in the household relative to those without. Conversely, it was 1.11 (1.05-1.16) times higher among social grade E. Yearly prevalence declined similarly among those with and without children (both PR: 0.98, 95%CI 0.97-0.99). Motivation to stop smoking was higher among those with children than those without, but lower among disadvantaged than more advantaged groups. Social grades D-E had greater heavy smoking, but higher prevalence of past-month quit attempts. CONCLUSIONS: Among the most disadvantaged social grade in England, smoking prevalence was higher in those with children in the household than without. To attenuate future smoking-related inequalities, there is an urgent need to target support and address barriers to quitting and promote longer term quit success. IMPLICATIONS: In the most disadvantaged occupational social grade, having children in the household was associated with higher smoking prevalence compared with not having children. This contrasts with all other social grades in which there was lower comparative smoking prevalence among those with than without children in the household. Without attention this disparity could exacerbate existing and future health inequalities related to smoking. date: 2021-10-11 date_type: published official_url: https://doi.org/10.1093/ntr/ntab211 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1893097 doi: 10.1093/ntr/ntab211 pii: 6387990 lyricists_name: Brown, James lyricists_name: Cox, Sharon lyricists_name: Kock, Loren lyricists_name: Shahab, Lion lyricists_name: Tattan-Birch, Harry lyricists_id: JBROW12 lyricists_id: SACOX23 lyricists_id: LKOCK45 lyricists_id: LSHAH80 lyricists_id: HOTAT87 actors_name: Brown, James actors_id: JBROW12 actors_role: owner full_text_status: public publication: Nicotine & Tobacco Research event_location: England citation: Kock, L; Brown, J; Shahab, L; Tattan-Birch, H; Moore, G; Cox, S; (2021) Inequalities in smoking and quitting-related outcomes among adults with and without children in the household 2013-2019: A population survey in England. Nicotine & Tobacco Research 10.1093/ntr/ntab211 <https://doi.org/10.1093/ntr%2Fntab211>. (In press). Green open access document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10136388/1/ntab211.pdf