Race by Education Intersectional Differences in Exposure to Tobacco Advertisement in Baltimore City.

Objective: This study aimed to examine the intersectional effects of race and educational attainment on tobacco advertising exposure among adults in Baltimore, given the growing evidence on differential influence of education for Black and White populations. Methods: A survey was conducted in Baltimore, collecting data on educational attainment, demographics, and tobacco advertising exposure among adults (n = 3028, 22.7% 18 - 29, 17.9% 30 - 39, 23.4% 40 - 49, 20.9% 50-59, and 11.1% 60+ years old). The sample included both Black and White adult individuals. Logistic regression analyses were employed to assess the association between educational attainment and tobacco advertising exposure, without and with interaction with race, adjusting for relevant covariates such as age, gender, and employment. Sensitivity analysis also controlled for smoking status. Results: The study results indicated that while high educational attainment is associated with less exposure to tobacco ads, highly educated Black adults report significantly higher tobacco advertising exposure compared to highly educated White adults. Same results were observed after controlling for smoking status. Conclusion: Educational attainment may not exhibit a large protective effect against environmental risks such as tobacco ad exposure for Black populations, possibly because of segregation and racism that hinder highly educated Black people ability to move to low-risk neighborhoods.