The most striking feature of the evolution of smoking in developed Western countries over the past 20 years has been the increasing association of cigarettes with markers of disadvantage, whether it be socioeconomic position, or a range of factors indicating stressful living circumstances. (47) High rates of smoking are seen in the unemployed, lone parents, people who are divorced or separated, the homeless (United Kingdom Office of Population Censuses and Surveys), heavy drinkers, (47) drug users (United Kingdom Office of Population Censuses and Surveys), and prisoners. (48) Cigarette smoking is strongly associated with psychiatric illness, whether it be schizophrenia/49,50 depressive illness/51 or a variety of other neurotic disorders. ty The association of cigarettes with lowered levels of psychological well being is not confined to those with a formal psychiatric diagnosis, but extends also into the general population of smokers. (5 53) Between 1973 and 1994 rates of smoking among affluent people halved in the United Kingdom, but among the poorest groups prevalence remained unchanged at close to 70 per cent. (54)
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