Background:
There are well-established socio-economic differences in smoking prevalence in the UK, but conventional socio-economic measures may not capture the range and degree of these associations. We have used a commercial geodemographic profiling system, Mosaic, to explore associations with smoking prevalence in a large primary care dataset and establish whether this tool provides new insights into socio-economic determinants of smoking.
Methods:
We analysed anonymised data from over 2 million patients in The Health Improvement Network database, linked via postcode to Mosaic classifications (11 groups and 61 types) and quintiles of the Townsend Index. Patients’ smoking status was identified using Read codes, and logistic regression used to explore associations between the measures of socioeconomic status and smoking prevalence.
Results:
As anticipated, smoking prevalence increased with increasing deprivation according to the Townsend Index (adjusted OR for highest vs lowest quintile 2.96, 95% CI 2.92-2.99). There were more marked differences in prevalence across Mosaic groups (OR for group G vs group A 4.41, 95% CI 4.33-4.49). Across the 61 Mosaic types, smoking prevalence varied from 8.6% to 42.7%. Mosaic types with high smoking prevalence were characterised by relative deprivation, and more specifically by single-parent households living in public rented accommodation in areas with little community support, having no access to a car and high TV viewing behaviour.
Conclusion:
Conventional socio-economic measures may underplay social disparities in smoking prevalence. Newer classifications, such as Mosaic, encompass a wider range of demographic and lifestyle data, and are valuable in identifying characteristics of groups of heavy smokers which might be used to tailor cessation interventions.