Disparities seen in declines in smoking prevalence

Declines in smoking prevalence occurred more slowly for young adults with less formal education from 2002 to 2019, according to a research letter published online March 30 in JAMA Network Open.

Alyssa F. Harlow, Ph.D., from the University of Southern California in Los Angeles, and colleagues used a representative sample of 187,821 U.S. young adults (ages 21 to 25 years) from the National Survey on Drug Use and Health to examine racial, ethnic, and education-related differences in smoking prevalence and age of smoking initiation between 2002 and 2019.

The researchers found that the prevalence of ever and daily smoking declined significantly from 2002 to 2019 for all education and racial and ethnic groups, and was lowest among those with at least some college education and for Asian and Black young adults. Five-year decreases in the prevalence of ever and daily smoking were significantly slower for participants with less than high school or a high school education (e.g., trend in ever smoking among those with less than a high school education: odds ratio, 0.88; trend in ever smoking among those with at least some college education: odds ratio, 0.73) and for Black and Hispanic (versus White) young adults. Education, race, and ethnicity did not significantly impact age of daily smoking initiation trends, but the proportion who initiated ever and daily smoking during young adulthood (aged 18 to 25 years) versus adolescence (younger than 18 years of age) increased significantly during the study period.

"Targeted marketing, availability of menthol cigarettes, economic inequalities, and racism and discrimination may have contributed to slower decreases in smoking prevalence and slower increases in the age of smoking initiation for minoritized racial and ethnic young adults as well as those with less education," the authors write.

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