Educational Attainment and tobacco harm knowledge among American Adults: Minorities’ Diminished Returns

Document Type: Original Article




Background: Minorities’ Diminished Returns (MDRs) refer to the smaller protective effects of educational attainment on the health of ethnic minorities compared to the majority group. Similarly, previous research has documented weaker effects of educational attainment on reducing tobacco use of Hispanics and African Americans (AAs) than non-Hispanic Whites. In theory, some of the increased risk of tobacco use among highly educated Hispanics and AAs, relative to Whites may be due to lower tobacco harm knowledge. Aims: To better understand a potential mechanism behind MDRs of educational attainment on cigarette smoking of Hispanics and AAs, we compared ethnic groups for the association between educational attainment and tobacco harm knowledge among American adults. Methods: Current cross-sectional study used baseline data of 27,405 adults. The data came from the Population Assessment of Tobacco and Health (PATH; 2013) study, a nationally representative survey in the U.S. The independent variable was educational attainment. The dependent variable was tobacco harm knowledge in the past 12 months. Age, gender, employment, and poverty status were the covariates. Ethnicity was the moderator. Linear regression was used to analyze the data. Results: Educational attainment was inversely associated with tobacco harm knowledge in the pooled sample. Ethnicity showed statistically significant interactions with educational attainment, suggesting that the effect of educational attainment on tobacco harm knowledge is smaller for Hispanics and AAs than for Whites and non-Hispanics. Conclusions: While high educational attainment increases tobacco harm knowledge, highly educated Hispanics still report disproportionately low level of tobacco harm knowledge.