Socioeconomic status and tobacco consumption: Analyzing inequalities in China, Ghana, India, Mexico, the Russian Federation and South Africa

Introduction Globally, there has been a rapid rise in non-communicable diseases driven by changing lifestyle choices and health behaviors. Different lifestyle choices threaten to exacerbate existing health inequalities, yet evidence monitoring the extent of this impact in emerging economies is lacking. The article sets out to measure the level of wealth-related inequality and its drivers in one of these lifestyle choices, tobacco consumption, among populations aged ≥50 years in six Low- and Middle-Income Countries. Methods The study provides empirical evidence of the inequality in tobacco consumption across wealth groups in China, Ghana, India, Mexico, the Russian Federation and South Africa using the Erreygers’ corrected concentration indices. These inequalities are then decomposed to gain a deeper understanding of the factors and broader social forces driving inequality. The WHO SAGE data set, collected between 2008 and 2010, is used for the analysis. Results Current tobacco consumption is concentrated among the poor in China, Ghana, India, and South Africa, and among the wealthy in the Russian Federation and Mexico. The inequalities widen when we focus solely on the male population. Although the results differ by country, the major drivers of inequality include wealth, locality, and gender. Conclusions The focus on tobacco consumption in this age group is key to curbing rising healthcare costs and ensuring longevity. Policies aimed at reducing wealthrelated inequalities should especially target high tobacco consumption rates among males, while simultaneously pre-empting and curbing rising rates among women