Social capital, social class and tobacco smoking.

In all developed and some developing countries there are socioeconomic status (SES) differences in tobacco smoking. People with a low of education, manual occupation, low income as well as the unemployed are daily smokers to a higher extent than those with high SES. People with low SES also stop smoking to a lesser extent in many developed countries. Several theories have been proposed to account for SES differences in health. Social capital concerns the relationships of trust, participation and reciprocity among individuals, groups and institutions in a society that may enhance health and health-related behaviors. The materialist standpoint concerns material conditions. Studies with ecological, individual and multilevel study design, mostly cross-sectional studies, suggest that both (individual level) social capital and material factors are related to tobacco smoking, although multilevel studies concerning contextual level social capital are few and mostly, at least in adult populations, fail to demonstrate associations. There is also a want of longitudinal studies to investigate the associations between social capital and material conditions, smoking initiation, smoking continuation as well as smoking cessation, since cross-sectional studies analyze only prevalence data. More sophisticated multilevel studies are needed to investigate the association between social capital and material conditions, and tobacco smoking in SES groups in different social contexts.