Intergenerational social mobility and smoking trajectories in middle-aged adults - The French CONSTANCES cohort study (2012-2020) (2026)

INTRODUCTION: Tobacco smoking remains a public health challenge, particularly among low-income populations. Beyond individuals' own socioeconomic position, their family background and the type of social trajectory they experienced, could also be related to smoking behaviors as tobacco use starts generally in adolescence. In the present study, we tested the association between intergenerational social mobility and individuals' smoking trajectories up to midlife.
METHODS: Using data from the CONSTANCES cohort, a French longitudinal population-based study, we applied Group-Based Trajectory Modeling to analyze participants' smoking patterns from 2012 to 2020 among 201,731 participants. These groups were combined with baseline lifetime smoking status to differentiate between never smokers and former smokers. Participants were classified into four groups based on information about their own and their parents' occupational status: persistently high socioeconomic status (SES), upward mobility, downward mobility, and persistently low SES. Multinomial logistic regression models were used to study the relationship between social mobility patterns and smoking trajectories.
RESULTS: Three groups of participants were identified: nonsmokers (75.4%), former smokers (9.3%), and long-term smokers (15.3%). Upward mobility was associated with decreased odds of long-term smoking, while downward mobility and persistently low SES was associated with increased odds of long-term smoking. Both upward social mobility and persistently low SES were associated with lower odds of quitting smoking compared to persistently high SES.
CONCLUSIONS: Long-term smoking behaviors are significantly associated with social mobility patterns from childhood to adulthood. This highlights the necessity to consider early life influences in smoking cessation programs. [Author's abstract]