Examining the high rate of cigarette smoking among adults with a GED.
OBJECTIVES
We seek to identify characteristics of GED holders that explain their very high smoking rates compared with high school (HS) graduates.


METHODS
We pooled data from the 2006-2014 National Health Interview Surveys (NHIS) for adults aged 25 and older (n=235,031) to describe cigarette smoking behaviors and smoking history for adults in six education categories, with a focus on comparing GED holders to HS graduates. Logistic regression was used to predict the odds of current cigarette smoking and successful quitting, accounting for demographic, employment, family/sociocultural, mental health, and other potential confounders.


RESULTS
The smoking rate among adults with a GED (44.1%) was more than five times the rate for those with a college degree (8.3%) and almost twice the rate of adults whose highest level of education was a high school diploma (23.6%). GED holders were also more likely to have started smoking before the age of 15 (32.2%) compared with HS graduates (12.2%) (p<0.001). Even after controlling for 23 socio-demographic and health characteristics, GED holders retained significantly higher odds of current smoking compared to HS graduates (OR=1.73; 95% CI: 1.56, 1.93) and significantly lower odds of successful quitting (OR=0.83, 95% CI: 0.73, 0.94).


CONCLUSIONS
GED holders had greater odds of being a current cigarette smoker, regardless of other characteristics that usually explain smoking. Earlier smoking initiation among GED holders, in combination with lower odds of quitting, contributed to their higher current smoking rate.
['Schoenborn|Charlotte A|CA|', 'Stommel|Manfred|M|', 'Lucas|Jacqueline W|JW|']
D000328:Adult D000368:Aged D000073865:Cigarette Smoking D004521:Educational Measurement D005260:Female D006306:Health Surveys D006801:Humans D008297:Male D008875:Middle Aged D015995:Prevalence D014481:United States
Smoking GED Education Tobacco