Assessing the heterogeneity in the college attendance effects on smoking initiation and smoking frequency during young adulthood: resource substitution or multiplication?

Introduction College education has been shown to deter smoking, yet few studies examine heterogeneity in its effects across individuals. This study investigates how the smoking-deterring effects of college attendance vary by individuals’ likelihood of attending college.Theory Drawing on perspectives that highlight how resources may either compensate for (i.e. resource substitution theory) or reinforce each other (i.e. resource multiplication theory), we examined how college attendance influences smoking behaviors across social backgrounds.Methods We analyzed 15 waves of the National Longitudinal Survey of Youth 1997 to investigate how the effects of college attendance on smoking initiation (n = 1,383) operationalized as any self-reported cigarette use during follow-up and self-reported past 30-day smoking frequency (n = 1,589) vary by the likelihood of attending college by using the stratification-multilevel method.Results Our results indicated that, on average, college attendance reduces the likelihood of smoking initiation (β = −0.406, CI [−0.719, −0.093], p = 0.011) and smoking frequency (β = −0.871, CI [−1.582, −0.161], p = 0.016). Furthermore, the protective effect of college attendance on smoking initiation and frequency diminishes as the likelihood of attending college increases. Specifically, only among the lowest propensity individuals, college attendance reduced smoking initiation (β = −0.812, CI [−1.403, −0.222], p = 0.007) and smoking frequency (β = −1.492, CI [−2.927, −0.058], p = 0.041).Conclusion The findings support resource substitution theory, indicating that college attendance benefits individuals from more disadvantaged backgrounds by deterring smoking. Expanding college access for less advantaged populations may yield greater health benefits and help reduce health disparities.