Impact of Educational Level in Tobacco Use and Alcohol Consumption in Dominican Republic: A Social Gradient Perspective

Background: Education represents a permanent indicator of socioeconomic status (SES). Evidence supports the impact of education on smoking and alcohol consumption. Objectives: We assessed the relationship between the educational attainment, tobacco use and alcohol consumption among adults in Dominican Republic (DR). We also explored whether there were differences by gender and residential location (general population vs. sugar cane plantations or Bateyes). Methods: We analyzed data drawn from the Demographic and Health Surveys (DHS) collected in DR in 2007. The final sample was composed by 59,565 participants aged 15 to 59 years, 55,170 from the general population (27,975 males and 27,195 females), and 3,395 from the sugar cane plantations or Bateyes (1,820 males and 1,575 females). Descriptive statistics and logistic regression were performed. Results: Results indicated that having high educational levels (secondary or higher) decreased the likelihood of smoking when compared to those with no education. There was a social gradient in the use of alcohol consumption. Those with incomplete primary education were about two times more likely to use alcohol (OR=1.95, 95% CI 1.80-2.12; p<0.001) than those with no education, whereas the odds-ratio was about three times higher among those with more than secondary education (OR=3.12, 95% CI 2.83-3.43; p<0.001). Women were less likely to smoke (OR=0.53, 95% CI 0.50-0.56) and to consume alcohol (OR=0.29, CI 95% 0.29-0.31) than men. Residential location was not statistically significant. Conclusion: These findings reinforce the need of gender-specific, social class-targeted interventions to prevent tobacco use and alcohol consumption in DR.