The changing contribution of smoking to educational inequality in female mortality

The negative association between education and mortality is well established in international research. The harmful effect of smoking on health is well known. However, the contribution of smoking to educational inequality in mortality varies across studies, and in some studies, the contribution is negligible. This paper demonstrates the use of an analytical approach to provide one explanation for this phenomenon. Analysing nationally representative survey data for two cohorts of Australian women born in 1920-1928 and 1945-1951 respectively, we found that in the 1994-2006 period, the less educated are subject to higher mortality by 38-50 %. In the total sample, the smoking contribution to excess mortality due to lower education is negligible. However, when the cohorts are analysed independently, the smoking contribution ranges from -13 % among those born in 1920-1928 to +23 % among those born in 1945-1951. The smoking contribution is only seen in the cohort-specific analysis because smoking is more prevalent among tertiary degree holders in the earlier cohort but more prevalent among less educated women in the later cohort. The disaggregated analytical approach taken here deserves further attention in research on inequality.