Smoking, physical activity levels vary in different groups

In brief

  • Smoking and physical activity levels vary in Canada based on individuals’ education levels.
  • Population health interventions must be designed with care to provide all groups equal opportunities and environments to change and improve health behaviours.

Why was this study done?

In the past 20 years, smoking rates have decreased and physical inactivity rates have gone up across Canada. What remains unclear is if certain groups within the population are benefiting more than others from these trends. This study addresses this issue by looking at smoking and physical activity in groups with different education levels. Education represents one dimension of an individual’s position in society. It is related to his or her occupational and labour market earning opportunities.

How was the study done?

The study is based on analyses of population-based surveys dating from 1974 to 2005. Researchers estimated smoking and physical activity rates among groups with different education levels. Some of the surveys examined were: the 1974 Smoking Habits of Canadians; the 1981 Canadian Fitness Survey; the 1990 Health Promotion Survey; the 1996 National Population Health Survey, and the 2000 and 2005 Canadian Community Health Surveys.

What did the researchers find?

In every survey, smoking and physical activity levels differed across educational groups. Those with lower educational levels were more likely to be inactive and heavy smokers. For smoking, these differences widened between 1974 and 2005. (In other words, reductions in heavy smoking were greatest among the more highly educated.) For physical activity, these differences narrowed between 1981 and 1996 before widening again between 1996 and 2005. Researchers did not find significant differences in the health behaviours of men and women.

It is unlikely that people within the various educational groups had different knowledge of the benefits of not smoking or being active. More likely, the findings reflect differences in resources and/or opportunities to benefit from population health initiatives. Population health approaches aimed at changing health behaviours need to focus on equity and on creating supportive environments with equal opportunities for change for all educational groups.

What are some strengths and weaknesses of the study?

This study examined important inequalities in health by analyzing relevant population-based surveys. However, measures of physical activity may not be completely accurate, because participants had to recall activity over three months, and were not asked about physical activities such as housework or commuting to work by biking or walking.

Publication Information


Trends in educational inequalities in smoking and physical activity in Canada: 1974 to 2005


Smith P, Frank J, Mustard C


Journal of Epidemiology and Community Health, 2009: vol. 63, no. 4, pp. 317-323