Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults
Association of Educational Attainment and Race/Ethnicity With Exposure to Tobacco Advertisement Among US Young Adults
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DOI：
10.1001/jamanetworkopen.2019.19393
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发表时间：
2020-01-17
影响因子：
13.8
通讯作者：
Assari, Shervin
中科院分区：
文献类型：
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作者：
Assari, Shervin
在种族/民族青年群体中，受教育程度与接触烟草广告有什么关联？这项对6700名美国年轻人的横断面研究发现，与非西班牙裔年轻人相比，西班牙裔年轻人的受教育程度与接触烟草广告的负相关较弱。这一发现表明，消除烟草使用方面的种族/民族差异可能需要的不仅仅是在种族/民族群体中实现教育程度的平等。这项横断面研究调查了美国不同种族/民族的年轻人受教育程度与接触烟草广告的关系。重要性研究发现，与种族/族裔多数群体相比，受教育程度与健康状况改善之间的关联在种族/族裔少数群体中较弱。最近的研究也表明，受过高等教育的非裔美国人和西班牙裔成年人的吸烟率高于预期。目的比较美国不同种族/民族青年受教育程度与接触烟草广告的关系。这项横断面研究包括6700名年轻人的数据，他们参加了烟草与健康研究人口评估的第一轮，这是2013年对美国成年人进行的一项全国代表性调查。教育程度被划分为低于高中文凭、高中毕业或大学毕业。分析时间为2019年9月20日至10月4日。自变量为受教育程度（低于高中文凭、高中毕业生和大学毕业生）。因变量是在过去12个月内是否接触过烟草广告。种族/民族、年龄、性别、贫困状况、失业和地区是协变量。采用二元logistic回归和泊松回归对数据进行分析。结果该研究纳入6700名参与者（3366名[50.2%]男性），年龄在18至24岁之间。大多数参与者是非西班牙裔（5257名参与者[78.9%]）和白人（5394名参与者[80.5%]），而1443名参与者（21.5%）是西班牙裔。教育水平包括1167名参与者（17.4%）高中以下学历，4812名参与者（71.8%）高中毕业，4812名参与者（10.8%）大学毕业。共有4728名参与者（70.6%）报告在过去12个月内接触过烟草广告。383名大学毕业生（53.1%）、3453名高中毕业生（71.8%）和892名高中以下教育程度的参与者（76.4%）报告了接触烟草广告。在回归分析中，与受教育程度较低的年轻人相比，高中毕业（优势比为0.79,95% CI为0.68-0.92）和大学毕业（优势比为0.46,95% CI为0.39-0.54）与接触烟草广告的几率较低相关。与非西班牙裔参与者相比，西班牙裔参与者的高中教育程度对烟草广告暴露的保护作用较弱（优势比为1.44；95% CI为1.03-2.01;P = .03），这表明西班牙裔年轻人中高中毕业程度与烟草广告暴露程度较低的关联弱于非西班牙裔年轻人。结论与相关性本研究发现，西班牙裔青年与非西班牙裔青年相比，高中毕业程度与烟草广告接触的负相关较弱。未来的研究应探讨烟草业在种族/少数民族群体高度集中的地区大量宣传烟草的目标营销策略的作用。未来的研究还应评价更具限制性的营销政策对烟草使用中的种族/民族差异的效果。
Question What are the associations of educational attainment with exposure to tobacco advertisements among racial/ethnic groups of young adults? Findings This cross-sectional study among 6700 US young adults found a weaker inverse association of educational attainment with exposure to tobacco advertisement among Hispanic young adults compared with non-Hispanic young adults. Meaning This finding suggests that elimination of racial/ethnic disparities in tobacco use may require more than equalizing educational attainment across racial/ethnic groups.This cross-sectional study examines the association of educational attainment with exposure to tobacco advertisements among diverse racial/ethnic groups of US young adults.Importance Associations of educational attainment with improved health outcomes have been found to be weaker among racial/ethnic minority groups compared with those among the racial/ethnic majority group. Recent research has also documented higher than expected prevalence of smoking in highly educated African American and Hispanic adults. Objective To compare the association of educational attainment with exposure to tobacco advertisements among racial/ethnic groups of US young adults. Design, Setting, and Participants This cross-sectional study included data from 6700 young adults who participated in wave 1 of the Population Assessment of Tobacco and Health Study, a nationally representative survey of US adults in 2013. Educational attainment was classified as less than high school diploma, high school graduate, or college graduate. Analysis was conducted between September 20 and October 4, 2019. Main Outcomes and Measures The independent variable was educational attainment (less than high school diploma, high school graduate, and college graduate). The dependent variable was any exposure to tobacco advertisements in the past 12 months. Race/ethnicity, age, sex, poverty status, unemployment, and region were the covariates. Binary logistic and Poisson regression were used to analyze the data. Results The study included 6700 participants (3366 [50.2%] men) between ages 18 and 24 years. Most participants were non-Hispanic (5257 participants [78.9%]) and white (5394 participants [80.5%]), while 1443 participants (21.5%) were Hispanic. Educational levels included 1167 participants (17.4%) with less than a high school diploma, 4812 participants (71.8%) who were high school graduates, and 4812 participants (10.8%) who were college graduates. A total of 4728 participants (70.6%) reported exposure to tobacco advertisements in the past 12 months. Exposure to tobacco advertising was reported by 383 participants (53.1%) who were college graduates, 3453 participants (71.8%) who were high school graduates, and 892 participants (76.4%) with less than high school educational attainment. In regression analysis, high school graduation (odds ratio, 0.79; 95% CI, 0.68-0.92) and college graduation (odds ratio, 0.46; 95% CI, 0.39-0.54) were associated with lower odds of exposure to tobacco advertisements compared with young adults with lower educational attainment. Compared with non-Hispanic participants, high school education had a weaker protective association for tobacco advertisement exposure among Hispanic participants (odds ratio, 1.44; 95% CI, 1.03-2.01; P = .03), suggesting that the association of high school graduation with lower exposure to tobacco advertisement is weaker among Hispanic young adults than non-Hispanic young adults. Conclusions and Relevance This study found that high school graduation had a weaker inverse association with tobacco advertisement exposure among Hispanic than non-Hispanic young adults. Future research should explore the role of targeted marketing strategies of the tobacco industry that largely advertise tobacco in areas with high concentrations of racial/ethnic minority groups. Future research should also evaluate the efficacy of more restrictive marketing policies on racial/ethnic disparities in tobacco use.