Document Type : Original Article
Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA
Introduction: Research shows that Blacks and Hispanics with high socioeconomic status (SES) remain at high risk of cigarette smoking, a pattern called Minorities’ Diminished Returns (MDRs) of SES. In a national sample of American adult smokers, we tested (1) the effects of race, ethnicity, educational attainment, and poverty status on first cigarette flavor in a national sample of American adult smokers, and (2) whether racial and ethnic differences exist in the effects of educational attainment and poverty status on first cigarette flavor.
Methods: This cross-sectional entered 22,144 ever smoker adults who had participated in the Population Assessment of Tobacco and Health (PATH; 2013), a nationally representative study in the US. Independent variables were race, ethnicity, educational attainment, and poverty status.
Results: Individuals with higher education had lower odds of initiating smoking using menthol/mint flavored cigarettes (OR = 0.94) but higher odds of candy/fruit flavored cigarettes (OR = 1.35). Living out of poverty did not associate with initiating smoking using flavored cigarettes. Education showed a weaker (OR = 1.08) protective effect on reducing the odds of initiating smoking using menthol/mint-flavored cigarettes for Hispanics, and living out of poverty had a larger protective effect for Whites than Blacks on the odds of initiating smoking using any flavored cigarettes (OR=1.19). Education had a larger protective effect for Blacks against initiating their smoking using any (OR = 0.88) or menthol/mint (OR = 0.90) flavored cigarettes and education better protected Hispanics than non-Hispanics against initiating smoking using candy/fruit-flavored cigarettes (OR = 0.82).