High school cigarette smoking and post-secondary education enrollment: Longitudinal findings from the NEXT Generation Health Study.

The inverse association between smoking and educational attainment has been reported in cross-sectional studies. Temporality between smoking and education remains unclear. Our study examines the prospective association between high school cigarette and smoking post-secondary education enrollment. Data were collected from a nationally representative cohort of 10th graders who participated in the Next Generation Health Study (2010-2013). Ethnicity/race, urbanicity, parental education, depression symptoms, and family affluence were assessed at baseline. Self-reported 30-day smoking was assessed annually from 2010 to 2012. Post-secondary education enrollment was measured in 2013 and categorized as either not enrolled or enrolled in technical school, community college, or 4-year college/university. Multinomial logistic regression was used to evaluate the association between cigarette smoking duration and post-secondary education enrollment (N=1681). Participants who smoked 1, 2, or 3years during high school had lower odds of attending a 4-year college (relative to a no enrollment) than non-smokers (adjusted OR: smoking 1year=0.30, 2years=0.28, 3years=0.14). Similarly, participants who smoked for 2 or 3years were less likely than non-smokers to enroll in community college (adjusted OR: 2years=0.31, 3years=0.40). These associations were independent of demographic and socioeconomic factors. There was a prospective association between high school smoking and the unlikelihood of enrollment in post-secondary education. If this represents a causal association, strategies to prevent/delay smoking onset and promote early cessation in adolescents may provide further health benefits by promoting higher educational attainment.