Trends in Education-related Smoking Disparities among U.S. Black/African American and White Adults:
Tuesday, October 25, 2022
Posted by: Natalia Gromov
Choi
K, Jones JT, Ruybal AL, McNeel T, Duarte DA, Webb Hooper M.
Trends in
Education-related Smoking Disparities among U.S. Black/African American and
White Adults: Intersections of Race, Sex, and Region.
[published online ahead of print, 2022 Oct 14]. Nicotine Tob Res.
2022;ntac238. doi:10.1093/ntr/ntac238
Introduction. Despite
its overall decline in the U.S., trends in cigarette smoking could vary by
intersection with demographic characteristics. We explored trends in
education-related disparities in current smoking among U.S. adults by race
(Black/African American and White), sex, and U.S. census region.
Methods. Data
were from U.S. civilian non-institutionalized adults (aged 18+ years) who
self-identified as Black and White and participated in the 1995-2019 Tobacco
Use Supplement to the Current Population Survey. We estimated average annual
percent changes in current cigarette smoking by the intersections of race, sex,
census region, and educational attainment. We calculated educated-related
prevalence differences (PDs) in current cigarette smoking by subtracting the
prevalence of bachelor's degrees from that of <high school in 1995-1996 and
2018-2019, then examined their variations by the intersection of sex, race, and
region. Weighted multivariable logistic regression models were used to test
education*survey year interactions across sexes, races, and regions.
Results. Education-related
disparities in current cigarette smoking increased over time, especially among
Black/African American male (PD1995-1996=22.8%; PD2018-2019=27.2%) and female
adults (PD1995-1996=12.1%; PD2018-2019=16.5%). By region, Black/African
American male adults in the Midwest showed the largest increase in
education-related current cigarette smoking disparities, followed by
Black/African American male and female adults in the South, and White male and
female adults in the Midwest. These findings were because of small to no
declines in the prevalence of current cigarette smoking among those with
<high school education.
Conclusion and
relevance. The gap in prevalence of current cigarette
smoking by education widened over time, especially among Black/African American
adults in certain regions.
Implications. Despite
the decline in the prevalence of current cigarette smoking in the U.S.
population overall, such public health gain may not benefit all individuals
equally. Using the data from a U.S. representative serial cross-sectional
survey study during 1995-2019, we found that disparities in current cigarette
smoking prevalence between those with <high school versus bachelor's degree
education widened especially among Black/African American adults. Future
research to investigate the barriers for progress among Black/African American
adults with <high school education could inform interventions to reduce
racial and education-related cigarette smoking disparities.
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