Race, Ethnicity, Education, Poverty, and First Cigarette Flavor

Introduction: research shows that race, ethnicity, and socioeconomic status (ses) have multiplicative rather than additive effects on the risk of cigarette smoking. in a national sample of american adult smokers, this study 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) racial and ethnic differences in the effects of educational attainment and poverty status on first cigarette flavor. methods: this cross-sectional study 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. there were three dependent variables: initiating smoking using any, menthol/mint, and candy/fruit-flavored cigarettes. age, sex, and region were the covariates. results: black individuals had higher odds of initiating smoking using menthol/mint-flavored cigarettes (or = 3.86, 95% ci = 3.55-4.20), and hispanics had higher odds of initiating smoking using candy/fruit-flavored cigarettes (or = 1.79, 95% ci = 1.44-2.21). overall, individuals with higher education had lower odds of initiating smoking using menthol/mint-flavored cigarettes (or = 0.94, 95% ci = 0.92-0.96), but higher odds of candy/fruit-flavored cigarettes (or = 1.35, 95% ci = 1.26-1.45). living out of poverty was not associated with initiating smoking using flavored cigarettes.conclusion: in the us, race, ethnicity, and ses show multiplicative rather than additive effects on first cigarette flavor.