• Allison N Kurti, Elias M Klemperer, Ivori Zvorsky, Ryan Redner, Jeff S Priest, and Stephen T Higgins.
• Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States. Electronic address: akurti@uvm.edu.
• Prev Med. 2016 Nov 1; 92: 141147141-147.

IntroductionIndividuals with a General Educational Development (GED) degree have the highest smoking prevalence of any education level, including high school dropouts without a GED. Yet little research has been reported providing a context for understanding the exception that the GED represents in the otherwise graded inverse relationship between educational attainment and smoking prevalence. We investigated whether the GED may be associated with a general riskier profile that includes but is not limited to increased smoking prevalence.MethodData were obtained from three years (2011-2013) of the National Survey on Drug Use and Health ([NSDUH], N=55,940]). Prevalence of risky repertoire indicators (e.g., ever arrested, seldom/never wears a seatbelt), indicators of social instability (e.g., frequent relocations), and risky demographic characteristics (e.g., male gender) were compared among high school dropouts, GED holders, and high school graduates using Rao-Scott chi square goodness-of-fit tests and multiple logistic regression.ResultsThose with GEDs differed significantly between both high school dropouts and high school graduates across 19 of 27 (70.4%) risk indicators. Controlling for risky profile characteristics accounted for a significant but limited (25-30%) proportion of the variance in smoking prevalence across these three education levels.ConclusionGED holders exhibit a broad high-risk profile of which smoking is just one component. Future research evaluating additional risk indicators and mechanisms that may underpin this generalized risky repertoire are likely needed for a more complete understanding of GED's place in the important relationship between educational attainment and smoking prevalence.Copyright © 2015. Published by Elsevier Inc.

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