IPR Seminar Series - Graduate Student Flash Session

Abstract: Despite extensive research on the impact of smoking on health, the temporal association between smoking and level of education and racial/ethnic groups remains unclear. We investigate how smoking initiation and cessation shape the racial heterogeneity in the trend of education gap in smoking prevalence among women across birth cohorts. With a sample of 336,732 women from the U.S. National Health Interview Survey (1997-2018), we analyze the relative risks of initiation and cessation of smoking across birth cohorts by race/ethnicity and education using Cox proportional hazards models. The education gap in smoking prevalence has increased across cohorts most pronouncedly among White women, followed by Black and Hispanic women. White women show the most apparent widening education gap in the rate of smoking initiation across cohorts, which is due to the declining rate among individuals with a college degree and the soaring rate among those without a college degree. In contrast, among Black and Hispanic women, the rate of smoking initiation has declined in recent cohorts with a larger decline among those with a college degree. Meanwhile, smoking cessation rates have increased similarly across cohorts regardless of education level within each racial group. Therefore, the widening education gap in smoking prevalence across cohorts is not caused by the effect of a college degree on smoking cessation, but by the increasing education gap in smoking initiation. Since the initiation of smoking generally occurs before school completion, this reflects an increasing selection of smokers into cohorts without a college degree.