[Tobacco, equity and primary health care].

Background: Antitobacco campaigns in industrialized countries (USA, Canada, United Kingdom, Sweden, Finland, Australia) have been less effective FOR low social classes, except for Australia. In order to attain further reductions of tobacco consumption, these countries have to pay attention to tobacco use amongst people of low socioeconomic status. This paper seeks to analyze the causes of it to summarize relevant lessons for our own country.

Methods: Literature review in relation to tobacco consumption, social status, mediating variables between these two elements, and variety of possible interventions.

Results: Low social classes bear higher tensions, more compelling economic, familiar, affective and social relations problems, with a lower capability to adapt, neutralize or change their situation; therefore making their emotional dependence on tobacco, stronger. Family physician's intervention and community participation appear as the recommended alternatives to mass-media public campaigns.

Conclusions: These two interventions should be fostered through the national Primary Health Care Network, as a complement to public campaigns, to guarantee in equity in reducing tobacco consumption and its consequences.