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Decrease in smoking is seen among those with more education

Posted by db last modified January 07, 2009

Analysis of the Ohio BRFSS (Behavioral Risk Factor Surveillance System) data from 2000 to 2007 reveals that the percent of current smokers decreased significantly among those with college degrees only. Since 2000, the percentage of current smokers decreased only slightly, or remained steady, among those with less education.

Analysis of the Ohio BRFSS (Behavioral Risk Factor Surveillance System) data from 2000 to 2007 reveals that the percent of current smokers decreased significantly among those with college degrees only. The percentage of Ohio residents with less education completed decreased only slightly since 2000; however, these changes were not statistically significant.

(Click image to enlarge.)

In 2000, 12.1% of Ohioans with a college degree were current smokers when asked. This dropped to 9.3% in 2007, or about every 1 in 11 with a college degree.

About every four in 10 Ohioans with less than a high school diploma were current smokers when asked. Despite some variation percentages (38.0% to 47.5% saying, "yes"), the level has been steady for the past three years.

About every three in 10 Ohioans with a high school diploma or G.E.D certificate were current smokers from 2000 to 2007. There level was fairly consistent from year to year.

About every one in four (or 2.5 in 10) Ohioans with some education after high school/G.E.D were current smokers when asked. Levels ranged from 19.8% to 29.0%.

Other studies have shown that, despite increases in cigarette prices due to increased taxes, cigarette use among the poor (lower socioeconomic status) has not significantly decreased. (1,2) In fact, increased education and income often led to greater decreases in cigarette smoking. These findings were also seen in a 2008 poll done by the Gallup Organization and in a study by the US Bureau of Labor Statistics and the US Census (3,4).

Local research by the Cuyahoga County Comprehensive Partnership for Tobacco Reduction (click link to the report here) found that more county residents with lower incomes or education made an effort to quit smoking compared to smokers with more education or income.  However, those with lower education or income were less likely to succeed in quitting.

Race is a complicating factor

In 2007 BRFSS data for Ohio, 25.9% of Black respondents were current smokers compared to 22.4% of White respondents. The percentage of Blacks as current smokers ranged from a low of 18.8% in 2000 to a high of 31.0% in 2004, and for White respondents, 21.0% in 2006 and 27.1% in 2001. Year-to-year variation was largest among Black respondents.

Among White respondents, there is a significant decrease from about 27% in 2000-2002 to about 22% during 2005-2007. 

However, data combining race and education is not available from BRFSS.

What does this mean?

Tobacco use is widespread among those that can less likely afford it, even when there are many forms of support to help users quit tobacco offered by public health agencies and medical care providers. The use of higher taxes to provoke tobacco users to quit may not be so effective among those with less education or income. Tobacco users make greater trade-offs to maintain their habit, thereby putting their own health, and others exposed, at even greater risk.

Blacks may be more resistant to messages to quit or prevent tobacco use as compared to Whites. Also possible is that messages are not targetting Blacks effectively or appropriately. 

Increases in bidi use, small cigars (Black and Milds, Sweets, and others) have been on the increase among Blacks in Cuyahoga County BRFSS studies as performed by Case Western Reserve University's Center for Health Promotion and Research.  (See http://www.case.edu/affil/healthpromotion/index.html) Alternative forms of tobacco may not be part of current prevention messages to Black Ohioans.

Regardless of race, completing a college education appears to be a strong indicator whether people avoiding smoking on a consistent basis.

Ohio Provides Toll-Free Phone Number to Help Smokers Quit

Ohio Tobacco Quit Line (click here for more information) provides counseling and referral for services to anyone who wants to kick the tobacco habit. Smokers can call 1-800-QUIT-NOW (1-800-784-8669) or 1-888-229-2182 for TTY service.

How do the confidence intervals work?

Statistical significance is determined by comparing the confidence intervals between years. Because the survey takes a sample of Ohioans, there will naturally be some variation to the estimate. For example, if the survey was repeated several times, the resulting percentages would not be the same each time but would create a range for each education level. The confidence interval represents a range where we can expect the true population level (percentage) to be found with a high degree of confidence.

References

(1) Frank P, Jerant AF, Legih JP. American Journal of Public Health, 2007, Vol 97, pp 1873-1877.

(2) Ahrens D. American Journal of Public Health, 2008, Vol 99, pp 6. (letter)  

(3) The Gallop Organization. Among Americans, smoking decreases as income increases. 2008. www.gallop.com/poll/105550/Among-Americans-Smoking-Decreases-Income-Increases.aspx

(4) Current Population Survey, Tobacco Use Supplement File. Sept 1995, Sept. 1998, Jan. 1999, June 2001, Nov 2001, Feb 2002. Wash. D.C. Bureau of Labor Statistics and US Census Bureau; 2006.


Keywords: Disparity, Education, Poverty, State, Statistics, Substance Abuse, Tobacco

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