Educational Disparities in Home Smoking Bans Among Households With Underage Children in the United States: Can Tobacco Control Policies Help to Narrow the Gap?

Xiao, Zhou; Martínez-Donate, Ana P.; Jones, Nathan R.

doi:10.1093/ntr/ntt090

Cited by 17 publications

(26 citation statements)

References 31 publications

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“…As a result, the solution is not limited to the individual but should address structural and institutional factors that shape MDRs as a mechanism behind health disparities. Pervasive disparities in the burden of tobacco use by race/ethnicity [16,[34][35][36][37] and SES [38][39][40] exist in the US. Despite the overall decline in tobacco use, disparities by SES have increased.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the overall decline in tobacco use, disparities by SES have increased. [40][41][42] Between 1966 and 2015, smoking declined by 83% in individuals with college degree, while the decline for individuals without high school diploma was almost half (40%). [4] A large proportion of such disparities may not be due to individuals making poor choices but higher exposure due to predatory marketing.…”

Section: Discussionmentioning

confidence: 99%

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Unequal Effects of Educational Attainment on Workplace Exposure to Second-Hand Smoke by Race and Ethnicity; Minorities’ Diminished Returns in the National Health Interview Survey (NHIS)

Assari

Bazargan

2019

J Med Res Innov

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Background: One of the mechanisms by which high educational attainment promotes populations’ health is through reducing exposure to environmental risk factors such as second-hand smoke. Minorities’ Diminished Returns theory, however, posits that the protective effect of educational attainment may be smaller for racial and ethnic minority individuals particularly Blacks and Hispanics compared to Whites. Aims: To explore racial and ethnic differences in the association between educational attainment and second-hand smoke exposure at work in a national sample of American adults. Methods: Data came from the National Health Interview Survey (NHIS 2015), a cross-sectional study that included 15,726 employed adults. The independent variable was educational attainment, the dependent variables were any and daily second-hand smoke exposure at workplace, age and gender were covariates, and race and ethnicity were the moderators. Results: Overall, higher educational attainment was associated with lower odds of any and daily second-hand smoke exposure at work. Race and ethnicity both interacted with educational attainment suggesting that the protective effects of educational attainment on reducing the odds of any and daily second-hand smoke exposure at work are systemically smaller for Blacks and Hispanics than Whites. Conclusions: In the United States, race and ethnicity bound the health gains that follow educational attainment. While educational attainment helps individuals avoid environmental risk factors such as second-hand smoke, this is more valid for Whites than Blacks and Hispanics. The result is additional risk of cancer and tobacco related disease in highly educated Blacks and Hispanics. The results are important given racial and ethnic minorities are the largest growing section of the US population. We should not assume that educational attainment is similarly protective across all racial and ethnic groups. In this context, educational attainment may increase, rather than reduce, health disparities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Unequal Effects of Educational Attainment on Workplace Exposure to Second-Hand Smoke by Race and Ethnicity; Minorities’ Diminished Returns in the National Health Interview Survey (NHIS)

Assari

Bazargan

2019

J Med Res Innov

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“…Studies were split fairly evenly across the five main intervention types, with 16 evaluating the equity impact of tobacco price/taxation increases, [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] 17 focusing on smoke-free policies, 20 27 32 35-48 11 on mass media campaigns, 20 24 35 49- 56 15 on sales and marketing controls, 20 27 57-69 and 16 investigating the impact of population-level cessation support. 20 27 70-83 Two studies looked at broader inequalities-focused interventions 84 85 and five evaluated the combined impact of multiple policies.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

2020

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BackgroundWhile price increases and targeted cessation support have been found to reduce inequalities in smoking by socioeconomic status (SES), evidence on other measures is mixed. We aimed to update the most recent (2014) previous review by identifying and appraising evidence published since 2013 on the equity impact of population tobacco control measures.MethodsSystematic searching of 10 electronic databases and hand-searching of four key journals identified 68 primary research articles published since 2013 that sought to examine the equity impact of population tobacco control measures in high-income countries with a negative socioeconomic gradient in smoking. Reported equity impacts were categorised as positive (greater impact among lower SES), neutral (no difference by SES), negative (greater impact among higher SES) or mixed/unclear.ResultsThere was substantial growth in research seeking to evaluate the equity impact of tobacco control interventions, but the majority of new studies showed mixed/unclear results. Findings for price increases and targeted cessation support continue to suggest an equity-positive impact, but limitations in the available evidence make further assessment difficult. Substantial differences in the context, scale and implementation of tobacco control policies make straightforward comparison of findings from the previous 2014 and current reviews problematic.ConclusionResearchers need to adopt more sophisticated, multidisciplinary approaches in evaluating the equity impact of tobacco control measures—developing robust measures of equity effect and using frameworks that take account of context, existing systems/processes and the likely mechanisms of action. Socioeconomic differences in intervention impact within low-income and middle-income countries require evaluation.

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“…The dominant explanation in the field for ethnic disparities in tobacco-related illnesses is socioeconomic status (SES) inequalities across ethnic minority groups. This is because SES indicators such as educational attainment of self and parents operate as the strongest social determinants of tobacco use [4], and ethnicity and SES closely overlap in the U.S. [5]. As a result, ethnic differences in the burden of tobacco use have been traditionally attributed to the low SES of ethnic minority groups [5].…”

Section: Introductionmentioning

confidence: 99%

Parental Educational Attainment and Relatives’ Substance Use of American Youth: Hispanics’ Diminished Returns

Assari

Caldwell

Bazargan

2020

JBM

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Background: Research on Marginalization-related Diminished Returns (MDRs) has shown higher than expected substance use (tobacco and alcohol use) in middle-class Hispanic and Black youth and adults. In theory, some of this more than expected risk might be due to the high substance use problem of their social networks. Objectives: To better understand the role of social networks as an explanatory mechanism behind higher than expected substance use among middle-class Hispanic and Black youth, this study tested MDRs of parental educational attainment on substance use involvement of biological relatives in Hispanic and Black middle-class youth. We compared ethnic groups for effects of parental educational attainment on substance use involvement of biological relatives among American youth. Methods: The current longitudinal study used waves 1 and wave 4 data of the Population Assessment of Tobacco and Health-Adolescents (PATH; 2013-2018) study. The sample included 4264 nationally representative American youth who were followed for 4 years. The independent variable was parental educational attainment. The dependent variable was substance use involvement of biological relatives. Age, gender, and marital status of the family were the covariates. Ethnicity was the moderator. Linear regression was used to analyze the data. Results: Parental educational attainment was inversely associated with substance use involvement of biological relatives in the pooled sample (OR = 1.36, 95% CI = 1.13-1.63 for high school graduation and OR = 0.65, 95% CI = 0.53-0.80 for college graduation). Hispanic ethnicity showed statistically significant interactions with parental educational attainment (OR = 2.26, 95% CI = 1.49-3.44 for high school graduation and OR = 2.98, 95% CI = 1.80-4.93 for college graduation), suggesting that the protective effect of parental educational attainment against substance use involvement of biological relatives

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Educational Disparities in Home Smoking Bans Among Households With Underage Children in the United States: Can Tobacco Control Policies Help to Narrow the Gap?

Abstract: More vigorous tobacco control policies at the state level may help promote the adoption of home smoking bans and reduce educational disparities in these protective behaviors.

Cited by 17 publications

References 31 publications

Unequal Effects of Educational Attainment on Workplace Exposure to Second-Hand Smoke by Race and Ethnicity; Minorities’ Diminished Returns in the National Health Interview Survey (NHIS)

Unequal Effects of Educational Attainment on Workplace Exposure to Second-Hand Smoke by Race and Ethnicity; Minorities’ Diminished Returns in the National Health Interview Survey (NHIS)

Impact of population tobacco control interventions on socioeconomic inequalities in smoking: a systematic review and appraisal of future research directions

Parental Educational Attainment and Relatives’ Substance Use of American Youth: Hispanics’ Diminished Returns

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