The role of risk tolerance as a mediator between household income and tobacco and alcohol use among mid-life adults in the United States

The objective of this study was to estimate the association between household income and tobacco and alcohol use and to measure the mediation effect risk tolerance – as measured across seven domains (driving, financial matters, occupational, health, faith in people, romantic relationships and major life change) – in describing tobacco and alcohol use. Findings from this study, based on data from the 2012 National Longitudinal Survey of Youth, provide insights into the relationship between health-related risk-taking behaviors and socioeconomic household-level outcomes. Regression and mediation tests showed that risk tolerance plays a significant role in describing smoking and drinking behaviors. A key finding from the study suggests that risk tolerance mediates (and sometimes suppresses) the income effect on smoking and drinking behaviors. Results from this study provide information that researchers, educators and policymakers can use to better understand the association between health behavior and socioeconomic status when attempting to combat chronic disease.