Temporal changes and determinants of smoking habits with respect to prevention

Smoking habits are seen as one of the most important risk factors in developed countries for the incidence of cardiovascular diseases and as the major single cause of premature death. The present study analysed smoking habits in participants of the MONICA-Surveys S1 (1984/85), S2 (1989/90) and S3 (1994/95) concerning prevalence, associated factors, time trends and preventive consequences. An essential aim of these studies was to identify risk groups, that should be addressed in prevention campaigns leading to a reduction of the high mortality due to cardiovascular diseases. The participants of the MONICA-Survey S3 (1994/95) had lower proportions of smokers (31.2% for men and 22.0% for women) as compared to estimated proportions of the entire German population (National health survey 1998: 37.4% und 29.9%). Women had always a lower proportion of smokers than men in each age group or sociodemographic factor. Strong associations of smoking habits with educational levels, family status and occupational position were observed for men and women. A positive time trend with decreasing smoking prevalence was determined for men. In contrast, an increase in the prevalence of female smokers was observed. The intention to change smoking habits was associated with different factors in men and women. For men, mainly, external" factors like social status or physical activity were important. Women seemed to be more influenced by, internal" matters (somatic complaints, negative self-rated health). Sex-, age- and educational status-specific activities and recommendations are considered to be essential for targeting different person groups in a more focused way.