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

Abstract

Abstract<br />Background and aims: Minorities' Diminished Returns (MDRs) refer to the smaller effects of<br />educational attainment for ethnic minorities compared to the majority group. As a result of MDRs,<br />research has documented more than expected tobacco use among Hispanics and African Americans<br />(AAs) with high educational attainment. In theory, some of this increased risk may be due to lower<br />tobacco harm knowledge. Accordingly, the present study compared ethnic groups for the association<br />between educational attainment and tobacco harm knowledge among American adults in order to<br />better understand a potential mechanism behind MDRs of educational attainment on tobacco use of<br />Hispanics and AAs.<br />Methods: The current cross-sectional study used baseline data of 27,405 adults, which were obtained<br />from the Population Assessment of Tobacco and Health (2013) study a nationally representative survey<br />in the United States. The independent and dependent variables were educational attainment and<br />tobacco harm knowledge, respectively. In addition, age, gender, employment, and poverty status were<br />the covariates and ethnicity was the moderator. Finally, linear regression was used to analyze the data.<br />Results: Educational attainment was inversely associated with tobacco harm knowledge in the pooled<br />sample (b = 0.11, 95% CI = 0.09 - 0.13). Ethnicity showed a statistically significant interaction with<br />educational attainment (b = -0.05, 95% CI = -0.10 - 0.00 for AAs and b = -0.14, 95% CI = -0.19 - -0.09<br />for Hispanics versus non-Hispanics), suggesting that the effect of educational attainment on tobacco<br />harm knowledge was smaller for Hispanics and AAs compared to non-Hispanics and Whites.<br />Conclusion: In general, although high educational attainment increases tobacco harm knowledge,<br />highly educated Hispanics and AAs still report a disproportionately low level of tobacco harm<br />knowledge. Eventually, the MDRs of educational attainment on tobacco harm knowledge may explain<br />why highly educated Hispanics remain at high risk of tobacco use.