The 13th World Conference on Tobacco OR Health

Objective: Studies in the 1980s and early 1990s found reductions in smoking rates which were largely confined to white collar occupational groups resulting in a growing disparity between blue collar and white collar workers. This study examines whether this trend has continued into the new millennium.

Methods: The National Health Interview Survey (NHIS) is a multistage area probability cross-sectional survey of the US civilian population. Data on occupational and smoking status were collected annually on >18,000 adult participants from the 1997-2003 NHIS. Analyses were completed with adjustment for sample weights and design effects.

Results: Annual smoking rates among all workers declined from 27% in 1997 to 23% in 2003 (p<0.001). Significant downward trends were noted for the following worker groups: other transportation workers [expect motor vehicles] (yearly reduction=4.5%; p<0.05); architects and surveyors (1.8%; p<0.05); cleaning and building service workers (1.3%; p<0.001); farm workers and other agricultural workers (1.0%; p<0.05); health service workers (1.0%; p<0.05); food service workers (0.9%; p<0.01); and health diagnosing occupations (0.7%; p<0.05). The lowest 1997-2003 pooled smoking rates were found in workers employed in the health diagnosing occupations (5%); food service workers and those employed in the construction and extractive trades had the highest pooled prevalence rates (39%). In contrast to findings from the mid-1980s to the mid 1990s, smoking prevalence rates are declining for select blue-collar worker groups. However, blue-collar worker groups still have the highest prevalence of smoking and the development of effective smoking prevention strategies targeting blue-collar groups is warranted.