Changes in the Socioeconomic Pattern of Smoking Among Male Adults in Thailand from 2001 to 2021

The smoking rate in Thailand has been steadily decreasing for decades alongside the government’s tobacco control policies. However, evidence of whether the decrease to date has occurred equally across all population groups is scarce. Therefore, this study aimed to examine the changes in the socioeconomic patterns of smoking among male adults in Thailand from 2001 to 2021. This study employed a pooled cross-sectional design with 296,011 male adults aged 15 years or older from the Health and Welfare Survey 2001 ( n = 74,003), 2003 ( n = 14,940), 2006 ( n = 25,088), 2009 ( n = 26,370), 2013 ( n = 26,919), 2015 ( n = 52,904), and 2021 ( n = 75,787). Descriptive analysis and binary logistic regression were used. The results indicated that the smoking rate decreased by approximately 25% from 46.81% in 2001 to 35.01% in 2021. This decrease was significantly greater in high- and low-level socioeconomic groups than in mid-level groups. Specifically, high- and low-income, high- and low-educated, older, married and divorced, employed, and urban and rural people exhibited larger decreases in smoking rates than middle-income, middle-educated, middle-aged and younger, single, unemployed, and Bangkok metropolitan people, respectively. Additionally, the smoking rates of low-income groups decreased as cigarette retail prices increased, whereas those of high-income groups decreased regardless of tobacco control policies. The government’s price policy and health awareness may have significantly influenced the decrease in smoking rates of the low- and high-level socioeconomic groups, respectively. Therefore, the government should continue its price policy and public relations practices to further decrease smoking rates.