Iranian households show divergent cigarette inequality by tobacco origin

A national cross-sectional analysis of 37,759 Iranian households found that cigarette smoking affected 14.5% of households in 2021, but the distribution of this burden differed sharply according to whether cigarettes were domestically produced or imported. The overall concentration index was close to zero and statistically nonsignificant, indicating no detectable socioeconomic inequality across households when both types of cigarette were combined. The estimate was −0.011, with a 95% confidence interval from −0.033 to 0.010. By contrast, smoking of domestically produced cigarettes was concentrated among poorer households, whereas smoking of imported cigarettes was more prevalent among wealthier households.

The study used household-level data from the Iran Household Income and Expenditure Survey of 2021. Researchers estimated the prevalence of cigarette smoking and examined its concentration across socioeconomic groups with a concentration index, while univariate analysis and logistic regression assessed factors associated with smoking. The analyses incorporated survey weights and cluster-robust standard errors, and the researchers used Stata 17. Reported smoking prevalence was 8.5% for domestically produced cigarettes and 5.9% for imported cigarettes. These percentages describe the study’s household population and should not be interpreted as population-wide rates for individual smokers.

The pattern for domestic and imported cigarettes ran in opposite directions. The concentration index for domestic cigarette smoking was −0.061, with a 95% confidence interval of −0.090 to −0.033, a result the authors characterized as pro-poor inequality. For imported cigarettes, the index was positive at 0.048, with a 95% confidence interval of 0.011 to 0.084, indicating a pro-rich pattern. The significant confidence intervals and opposing signs show that pooling the two categories masked meaningful differences. Although the combined estimate was nonsignificant, that result did not mean that the absence of overall inequality implied an absence of inequality within each cigarette category.

Household characteristics were also associated with the odds of smoking. Smoking odds were higher in male-headed and unemployed-headed households and among households in the second, or middle, socioeconomic quintile. Households containing more literate, employed or income-earning members also had higher odds of cigarette smoking in the fitted models, while higher education of the household head was associated with lower odds; the authors reported these associations as significant at P < 0.05. The study did not establish that these characteristics caused smoking, and its cross-sectional design could not examine changes over time or the effects of household income, employment, education or cigarette type. The findings instead identify groups that were more likely to report smoking in the 2021 survey and reveal that economic gradients depended on the origin of the cigarettes used.

Subject of Research: A 2021 national analysis of socioeconomic inequalities in household cigarette smoking in Iran, separated by domestic and imported cigarette use.

Article Title: Socioeconomic inequality in cigarette smoking among Iranian households

Article References: Mahdian, M., Kavosi, Z., & Bayati, M. (2026). Socioeconomic inequality in cigarette smoking among Iranian households. Discover Social Science and Health. https://doi.org/10.1007/s44155-026-00504-5

Image Credits: AI Generated

DOI: 10.1007/s44155-026-00504-5

Keywords: Iran, cigarette smoking, socioeconomic inequality, households, tobacco, domestic cigarettes, imported cigarettes, concentration index, cross-sectional study, Socioeconomic, inequality, cigarette