Factors sway African-Americans to be less likely to quit smoking

Factors sway African-Americans to be less likely to quit smoking

University Park, Pa. -- Socio-economic factors are a major influence on why blacks are less likely than whites to quit smoking once they have started, although blacks are more likely to be lifetime nonsmokers than whites, according to researchers.

Differences between black and white cessation rates are reduced considerably when comparisons factor in gender, educational levels, age, marital status and geographic region, said Gary King, associate professor of biobehavioral health in the College of Health and Human Development.

"Disparities in quitting rates between the two groups are strongly influenced by socioeconomic status and do not appear as fixed attributes reflecting biological or genetic differences between African-Americans and whites," King added. "Adjusted differences in quitting between black and white women were not statistically significant for most years."

King is lead author of the paper, "Disparities in Smoking Cessation Between African Americans and Whites: 1990-2000," in the November issue of the American Journal of Public Health. His co-authors are: Anthony Polednak, Department of Community Medicine and Health Care, University of Connecticut Health Center; Robert B. Bendel, School of Nursing, Washington State University; My C. Vilsaint, University of Buffalo Medical School; and Sunny B. Nahata, a recent graduate student at Penn State.

The research team analyzed data from the National Health Interview Surveys of 30,660 African-Americans and 209,828 Whites, ages 18 to 64.

In the period 1990-2000, African-Americans reported a noticeably lower annual average of former smokers or tobacco "quitters" (14.6 percent) than did whites (25.8 percent), although this trend became less pronounced after 1994. During the same decade, an annual average percentage of blacks who said that they had never taken up smoking was 59.4, compared to 48.7 for whites.

"The higher percentage of lifelong nonsmokers among blacks can probably be attributed largely to parental prohibitions and various social norms that have curtailed tendencies toward smoking among African-American teenagers and women, as well as among nonnative black populations and blacks in certain U.S. geographic regions," King said. "The data suggest that cultural preventive influences have been more effective than cessation programs in reducing smoking rates among African-Americans."

Over the past decade and beyond, community-based initiatives have increasingly pinpointed high rates of smoking among black American adults and sought to reduce those rates through multidisciplinary and culturally appropriate programs aimed at both smoking prevention and cessation. King noted that such programs need to be continued if smoking rates among black and white Americans alike are to be reduced further.

"Increasing the affordability of and access to cessation aids such as over-the-counter nicotine replacement therapies and treatment for nicotine addition; greater mass media-based and targeted educational strategies (i.e. low income); public policy measures such as restrictions on smoking in public places and workplaces; industry restrictions on store advertisements and promotions; and increases in cigarette excise taxes would help to reduce disparities," King noted.

This study was partially funded by the Minority International Research Training Program of the Fogarty International Center at the National Institutes of Health.