[Smoking and low socio-economic status].

People of lower socio-economic strata increasingly use legal as well as illegal drugs. Tobacco and alcohol are legal drugs that cause particular concern. Both drugs are widely abused in Germany by people attempting to escape their everyday problems. For decades it has been known that tobacco and alcohol use are more prevalent in lower socio-economic strata of society (those with low educational achievement, compared to people with further or higher education qualifications). Tobacco and alcohol abuse is particularly high among the unemployed, either temporarily or longterm, as well as among persons living alone. Children and women are more concerned about smoking than men. Male loneliness, often accompanied by the appearance of depressive reactions or of depression, increases the likelihood of cigarette smoking. Poor people spend up to 20 % of their income on tobacco. In many industrialised countries, the age of onset of smoking is becoming younger and younger, increasing the risk of development of avoidable tobacco-related illnesses at an earlier age. This means that young smokers who develop chronic tobacco-related illnesses require medical care for many years, increasing the cost of treating tobacco-related disease. Within the next few years, effective prevention programmes against smoking must be developed, particularly for the lower socio-economic populations, to prevent the cost of health care systems spiralling during the next few decades.