摘要：Objectives. We sought to determine whether the educational backgrounds of young adult smokers (aged 18 to 24 years) affect their cessation attitudes or behaviors in ways that could be used to improve smoking interventions. Methods. We surveyed 5580 members of the HealthPartners health plan and conducted a follow-up survey 12 months later of current and former smokers. Respondents were divided into subgroups according to educational level. Results. Higher levels of education were associated with lower smoking rates (16% among students in 4-year colleges, 31% among those in technical or 2-year colleges, and 48% among those with a high school education or less) as well as less frequent or heavy smoking. However, number of quit attempts in the past year, level of interest in quitting, and smoking relapse rates did not vary according to educational level. Seventy-three percent of those who had attempted to quit had not used some form of assistance. Conclusions. Rates of smoking among young adults, especially those at low educational levels, are relatively high. However, most members of this age group are interested in quitting, regardless of educational background. Although overall smoking rates in the United States have decreased slowly over the past 10 years, these decreases have not been observed among young adults (i.e., individuals aged 18 to 24 years). According to the National Health Interview Survey, smoking prevalence rates among young adults have remained high and relatively stable. For instance, smoking rates in this group were 24.5% in 1990 and 23.6% in 2004; in 2004, more than 38% of men with a high school education or less smoked. 1 Data from the Monitoring the Future Project, an ongoing study of the behaviors, attitudes, and values of American students, show even higher rates in this age group, rising from about 28% in 1990 to about 33% in 2001. 2 In comparison, the overall adult smoking rate in 2004 was 20.9%. 1 Moreover, according to Hammond, smoking trends among young adults “may not be nearly as fixed or stable . . . as is generally assumed,” 3 (p181) with recent data showing that up to one fifth of smokers begin smoking after the age of 18 years. Despite the obvious need for knowledge that would help in addressing this problem, relatively few high-quality studies have compared smoking cessation attitudes and behaviors among young adults with those among adolescents and older adults, and most existing studies have focused on college students. 4 – 6 Moreover, although it has been shown that educational level is a strong predictor of smoking and quitting among the adult population as a whole, the few population-based studies of young adult smokers have not reported comparison data among individuals with different educational backgrounds. 7 – 12 Our primary goal was to determine whether there are differences in smoking cessation attitudes and behaviors among young adult smokers at various educational levels. In addition, we assessed the types of cessation assistance used by individuals in this age group and which of these forms of assistance predict quit attempts and successful smoking cessation. Such knowledge could help public health policymakers, health insurance companies, and medical care systems develop more effective targeted interventions for this high-risk age group.
