Understanding long-term trends in smoking in England, 1972–2019: an age–period–cohort approach

Opazo Breton, Magdalena; Gillespie, Duncan; Pryce, Robert; Bogdanovica, Ilze; Angus, Colin; Hernandez Alava, Monica; Brennan, Alan; Britton, John

Abstract

Background and aims:

Smoking prevalence has been falling in England for more than 50 years, but remains a prevalent and major public health problem. This study used an age–period–cohort (APC) approach to measure lifecycle, historical and generational patterns of individual smoking behaviour.

Design:

APC analysis of repeated cross-sectional smoking prevalence data obtained from three nationally representative surveys.

Setting:

England (1972–2019). Participants: Individuals aged 18–90 years.

Measurements:

We studied relative odds of current smoking in relation to age in single years from 18 to 90, 24 groups of 2-year survey periods (1972–73 to 2018–19) and 20 groups of 5-year birth cohorts (1907–11 to 1997–2001). Age and period rates were studied for two groups of birth cohorts: those aged 18–25 years and those aged over 25 years.

Findings:

Relative to age 18, the odds of current smoking increased with age until approximately age 25 [odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.41–1.56] and then decreased progressively to age 90 (OR = 0.06, 95% CI = 0.04–0.08). They also decreased almost linearly with period relative to 1972–73 (for 2018–19: OR = 0.30, 95% CI = 0.26–0.34) and with birth cohort relative to 1902–06, with the largest decreased observed for birth cohort 1992–96 (OR = 0.44, 95% CI = 0.35–0.46) and 1997–2001 (OR = 0.35, 95% CI = 0.74–0.88). Smoking declined in the 18–25 age group by an average of 7% over successive 2-year periods and by an average of 5% in those aged over 25.

Conclusions:

Smoking in England appears to have declined over recent decades mainly as a result of reduced smoking uptake before age 25, and to a lesser extent to smoking cessation after age 25.

Citation

Opazo Breton, M., Gillespie, D., Pryce, R., Bogdanovica, I., Angus, C., Hernandez Alava, M., Brennan, A., & Britton, J. (2022). Understanding long-term trends in smoking in England, 1972–2019: an age–period–cohort approach. Addiction, 117(5), 1392-1403. https://doi.org/10.1111/add.15696

• Journal Article Type: Article
• Acceptance Date: Sep 9, 2021
• Online Publication Date: Sep 29, 2021
• Publication Date: May 1, 2022
• Deposit Date: May 12, 2025
• Publicly Available Date: May 15, 2025
• Journal: Addiction
• Print ISSN: 0965-2140
• Electronic ISSN: 1360-0443
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 117
• Issue: 5
• Pages: 1392-1403
• DOI: https://doi.org/10.1111/add.15696
• Keywords: Psychiatry and Mental health; Medicine (miscellaneous)
• Public URL: https://nottingham-repository.worktribe.com/output/7354315
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/add.15696