UC San Diego

Early smoking onset is associated with higher nicotine dependence and increased difficulty to quit smoking. The highest level of education one attains links to both the age of regular smoking escalation and cessation, but whether education is a confounder between the age of escalation and cessation is unknown.

We analyzed a cross-sectional survey from the wave 4 nationally representative Population Assessment of Tobacco and Health (PATH) study and restricted the sample to respondents who had smoked at least 100 cigarettes, escalated to regular smoking before the age of 24, and were under 34 years old at the time of the 2017 survey. Logistical regression analysis was used to investigate the association between the age of smoking escalation (<18 years versus 18-24 years), educational attainment (college degree, some college, and no college), and smoking abstinence (1+ day abstinence and 12+ month abstinence).

We discovered a gradient between the age of escalation and educational attainment: The lower the educational attainment respondents held, the higher the proportion of early onset of smoking escalation observed in this population. Similarly, as the level of education increased, the proportion of respondents who was abstinent 1+ day also increased. However, educational attainment was not associated with successful long-term cessation. We found no evidence that educational attainment predicts 12+ month abstinence in the respondents.

In summary, educational attainment, instead of age of escalation, predicted cigarette abstinence in youth. Future studies should further investigate education and related socioeconomic factors to improve smoking prevention and cessation programs