Associations between education and tobacco-related indicators by race/ethnicity, National Health Interview Survey, 2010

Research has documented an inverse gradient relationship between current smoking and education; this gradient is most apparent among non-Hispanic whites compared to other race/ethnic groups. Little is known about the education gradient for other tobacco-related indicators, both overall and within race/ethnic groups. Using the 2010 National Health Interview Survey, we examined age-adjusted prevalences and means of current smoking, age of initiation, number of cigarettes per day, quit attempt in the past year, years quit, use of treatment to quit, and smoking inside the home, stratified by education and race/ethnicity. Educational gradients in tobacco-related indicators differed substantially by race/ethnicity. For example, at each level of education, non-Hispanic whites had the highest prevalence of smoking and smoking inside the home, initiated earliest, and smoked the most compared with the other two race/ethnic groups. For these outcomes, stepwise education gradients in the expected direction were generally found among whites and blacks; gradients were less clear among Hispanics. Blacks were most likely to report a quit attempt in the past year, with no educational gradient. In contrast, quit attempts among whites increased with increased education, but among Hispanics, quit attempts decreased with increased education. Among blacks, those with less than a high school education had a lower probability of using treatment to quit compared to those with a college education; this relationship was reversed among whites. These findings suggest that the education gradient in tobacco-related indicators differs both by the tobacco indicator and race/ethnicity.