ASPO Abstracts
Education, Income, and Race/Ethnicity: An Intersectional Analysis of Tobacco Use in the Population Assessment of Tobacco and Health (PATH) Study
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose of the study: Despite decades of progress in tobacco control, a disparate
tobacco burden persists among vulnerable populations. The current study used the
intersectionality framework to measure disparities in tobacco use prevalence in the
United States.
Methods: We used data from the Population Assessment of Tobacco and Health (PATH)
Study Wave 1 (2013-2014) to identify patterns of tobacco use behavior among adults at
the intersection of sociodemographic population groups. Groups were defined as follows:
gender; race/ethnicity (non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic);
age (18-24, 25-44, 45-64, 65+); income (0k-15k, 15k-35k, 35k-75k, >75k); education
(less than high school (HS), HS and some college, Bachelor's or higher). Tobacco use
was identified as current use of any type of tobacco/nicotine product including cigarettes,
e-cigarettes, cigars, hookah and smokeless/snus.
Results: Among 32,317 adult respondents, the tobacco use rate was 26.7%. The rates
varied widely among different groups. Higher rates of tobacco use where found for
individuals who were male (33.8%), younger (38.7%), less wealthy (38.2%), or who had
less than a HS education (36.6%). While many studies report that white and black
tobacco use is similar, we found that the racial/ethnic group with the highest rate was
NHB (30.9%); the NHW rate was 26.4%. Tobacco use was higher at the intersection of
vulnerable population groups. The Hispanic adults under 25y used at a rate of 36.5%.
Having higher education (Bachelors degree) or an income over $87.5K were protective
factors, with rates being low in every intersection. The highest rate were at the
intersections of less than HS with ages <25y or 25–44y (48.5 and 44.9%); and at the
intersections of low income with young age or male gender (44.5% and 46.1%).
Conclusions: The study highlights the complex role of sociodemographic factors in
inequalities of tobacco use across multiple intersections of vulnerability, with large
disparities associated with education, income, gender, and age. The high rates of
tobacco use in younger adults of both genders and all racial/ethnic groups is concerning,
possibly demonstrating a compromising of the successes of decades of tobacco control
efforts.
Keywords: Tobacco, smoking, disparity