The Role of financial STRain and educaTional aTTainmenT on Smoking abSTinence of afRican ameRicanS and WhiTeS Who Smoke

Abstract

Objective: To examine if reduced financial strain and higher educational attainment would confer less advantage for successful cessation among African Americans than for White individuals. Design: A secondary data analysis of the Quit2Live study, a smoking cessation intervention for individuals who smoke. Setting: Recruited participants from a metropolitan city in the Midwest. Participants: The sample included 224 African American and 225 White individuals who smoke. Methods: We implemented a logistic regression analysis and a two-way interaction of the combined financial strain and educational attainment variable and race on smoking abstinence. Main Outcome Measures: Our outcome variable was cotinine-verified smoking abstinence at the end-of-treatment (week 12). Our explanatory variables were a combination of financial strain (high, low) and educational attainment (high, low). Results: About 25% of the study participants were low financial strain and high education, 41% high financial strain and high education, 23% high financial strain and low education, and 11% low financial strain and low education. A greater proportion of African Americans vs Whites were in the high financial strain/low educational attainment category (28% vs 18%, P = .01). Participants with high financial strain and low educational attainment had substantially lower odds of abstinence (OR = .29 [95% CI: .12, .68]) compared to participants with low financial strain and high educational attainment. Contrary to our hypothesis, race did not moderate this association. Conclusion: Findings highlight the constraining role of high financial strain and low educational attainment, irrespective of race, on smoking abstinence among smokers actively engaged in a quit attempt.