Understanding the social patterning of smoking practices: a dynamic typology.

In many countries, cigarette consumption has been on a declining trend for over 20 years. However, different patterns of smoking practices have emerged. Our goal is to explore how the patterning of smoking practices occurs and persists over time, and to investigate the factors that could help interpret these patterns. Data were derived from the National Population Health Surveys and comprise a large representative sample of the population. Dynamic Typology methods reveal two main classes of typology: monothetic groups with stable patterns of behaviour over time (never-smokers, chronically addicted smokers, long-term ex-smokers); and polythetic groups with substantial behavioural variations. Moreover, socioeconomic inequalities are found among all groups, and gender-specific clusters of behaviour become apparent, with specific risk groups, such as the group of young women aged 20-24 at risk of becoming highly addicted. Our results also show that the effects of socioeconomic position on smoking practices are not significantly mediated by psychosocial variables such as self-esteem and personal control in both females and males. However, these variables still exert independent and differential effects on smoking practices in both genders. Our findings indicate that analysis of temporal patterns of smoking is crucial for tailoring type and timing of health-promoting interventions.