Educational Attainment and Tobacco Harm Knowledge Among American Adults: Diminished Returns of African Americans and Hispanics

AbstractBackground and aims: Minorities’ Diminished Returns (MDRs) refer to the smaller effects ofeducational attainment for ethnic minorities compared to the majority group. As a result of MDRs,research has documented more than expected tobacco use among Hispanics and African Americans(AAs) with high educational attainment. In theory, some of this increased risk may be due to lowertobacco harm knowledge. Accordingly, the present study compared ethnic groups for the associationbetween educational attainment and tobacco harm knowledge among American adults in order tobetter understand a potential mechanism behind MDRs of educational attainment on tobacco use ofHispanics and AAs.Methods: The current cross-sectional study used baseline data of ۲۷,۴۰۵ adults, which were obtainedfrom the Population Assessment of Tobacco and Health (۲۰۱۳) study a nationally representative surveyin the United States. The independent and dependent variables were educational attainment andtobacco harm knowledge, respectively. In addition, age, gender, employment, and poverty status werethe covariates and ethnicity was the moderator. Finally, linear regression was used to analyze the data.Results: Educational attainment was inversely associated with tobacco harm knowledge in the pooledsample (b = ۰.۱۱, ۹۵% CI = ۰.۰۹ - ۰.۱۳). Ethnicity showed a statistically significant interaction witheducational attainment (b = -۰.۰۵, ۹۵% CI = -۰.۱۰ - ۰.۰۰ for AAs and b = -۰.۱۴, ۹۵% CI = -۰.۱۹ - -۰.۰۹for Hispanics versus non-Hispanics), suggesting that the effect of educational attainment on tobaccoharm knowledge was smaller for Hispanics and AAs compared to non-Hispanics and Whites.Conclusion: In general, although high educational attainment increases tobacco harm knowledge,highly educated Hispanics and AAs still report a disproportionately low level of tobacco harmknowledge. Eventually, the MDRs of educational attainment on tobacco harm knowledge may explainwhy highly educated Hispanics remain at high risk of tobacco use.

Keywords:

population groups , Ethnicity , Socioeconomic status , Socioeconomic Position , education , Smoking , Tobacco use