Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health



First Committee Member

Patrick Maloney

Second Committee Member

Nicole Kolm-Valdivia

Third Committee Member

Anthony Blake


Objective: To understand if children living in the home modify the relationship between health insurance and smoking.

Methods: This analysis used the 2021 Behavioral Risk Factor Surveillance System Survey. The outcome was being a current smoker with health insurance as the exposure. The analysis was stratified by children to determine if children changed how having health insurance impacted smoking. The odds ratios for each stratum were compared to determine if children was a modifying factor.

Results: Children had a modifying effect on health insurance. For someone with children, if they had insurance, their odds of smoking were 0.91 (95% CI: 0.80-1.03) times that of someone without insurance. For someone without kids, if they had insurance, their odds of smoking was 1.45 (95% CI: 1.31-1.60) times that of someone without insurance.

Conclusion: Children can have a modifying effect on the smoking status of the adults they live with. This shows that the effects of insurance differ based on if there are children in the home. In terms of altering someone’s smoking status, knowing their household makeup could be valuable information to understanding how insurance will impact them.

Included in

Public Health Commons