A new study from RCSI University of Medicine and Health Sciences sheds light on significant disparities in smoking habits based on socioeconomic status in Ireland, revealing that individuals with lower levels of education and those living in disadvantaged areas are more likely to smoke daily.

The study, conducted by researchers in RCSI’s School of Population Health, has broad implications for public health policy as the Irish Government’s aim to achieve a ‘tobacco-free Ireland’ with smoking prevalence of less than 5% by 2025 quickly approaches.

People with primary school education as their highest qualification are eleven times more likely to smoke every day compared to those with postgraduate qualifications according to the study, while those in the most deprived areas in Ireland are four times more likely to be daily smokers than residents in affluent areas. The researchers analysed Healthy Ireland survey data from 2015-2022 with participation of more than 52,000 adults in Ireland.

The findings highlight that although overall smoking rates in Ireland have declined, socioeconomic inequalities persist and are, in fact, worsening among the least educated groups and residents in the most disadvantaged areas. This growing gap underscores the need for tailored smoking cessation interventions targeting these populations.

Prioritising disadvantaged areas

Professor Frank Doyle, co-principal investigator for the study and Associate Professor, Department of Health Psychology, RCSI School of Population Health, commented: "This research highlights the urgent need for targeted health initiatives in Ireland’s most disadvantaged areas. By prioritising support for these communities, we can help reduce health inequalities, improve overall population health, and work towards the national goal of reducing smoking prevalence."

Dr Gintare Valentelyte, lead author of the study and Postdoctoral Researcher at Converge: Centre for Chronic Disease and Population Health Research, added: "Our findings show that while smoking rates are falling, those from less advantaged backgrounds are not benefiting equally. For tobacco control policies to be effective, they must account for the unique challenges faced by these groups and offer tailored support that addresses the barriers they encounter in quitting."

A sustained reduction

While Ireland is recognised as a leader in tobacco control, smoking-related harm remains the leading preventable cause of ill health and premature mortality, accounting for more than 5,000 deaths annually and a cost to the hospital system of €460 million each year. These findings underscore that further, equity-oriented efforts are necessary if Ireland is to achieve a sustained reduction in smoking rates across all socioeconomic groups.

This research was funded by the HSE Tobacco Free Ireland Programme, as part of a collaboration with RCSI’s School of Population Health. The findings are informing a number of initiatives which the HSE Tobacco Free Ireland Programme is taking forward.